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["TCBH"]
[]
["Company Name:","TCBH"]
["PART I -- ","MEASUREMENT & STABILITY RULES"]
["Measurement & Stability Rules"]
["Measurement and Stability Rules","Client setup feedback",{"$nulls":6},"Measurement and Stability Rules","Client setup feedback",{"$nulls":6},"Measurement and Stability Rules","Client setup feedback"]
[]
["Rule Name: ","STANDARD",{"$nulls":15},"STANDARD"]
[]
["Measurement Period","Client setup feedback",{"$nulls":6},"EBS Note:",{"$nulls":8},"Client setup feedback"]
["Start Date:",{"$nulls":7},"Measurement Period (MP) is the “look back period” during which an employer measures the hours of service for its employees in order to determine their status as full-time or part-time. Its value is between 3 and 12 consecutive calendar months, as chosen by the employer. \n• Start Date: enter the start date (inclusive) of the measurement period;  • End Date: enter the end date (inclusive) of the measurement period;  • Measurement Period Interval: enter measurement period interval (in months)."]
["End Date:"]
["Measurement period interval"]
[]
["Stability Period","Client setup feedback",{"$nulls":6},"EBS Note:"]
["Start Date:",{"$nulls":7},"Stability Period (SP) is the “hold period” during which employees are locked into full-time or part-time status based on the hours of service during the standard measurement period, regardless of how many hours the individuals work during the stability period. This period must be of at least 6 consecutive calendar months and no shorter in duration than the standard measurement period used by the employer. \n• Start Date: enter the start date (inclusive) of the stability period;  • End Date: enter the end date (inclusive) of the stability period;  • Stability Period Interval: enter stability period interval (in months)."]
["End Date:"]
["Stability Period Interval:"]
[]
["Current Administrative Period","Client setup feedback",{"$nulls":6},"EBS Note:"]
["Start Date:",{"$nulls":7},"Administrative Period (AP) = The period allowed to an employer to calculate the average hours worked over the Measurement Period. \n• Start Date: enter the start date (inclusive) of the Administrative period;  • End Date: enter the end date (inclusive) of the Administrative period."]
["End Date:"]
[]
["Full Time Employee Working Hours:"]
[]
["Select Safe Harbor Type (W-2/ Federal Poverty Line/ Rate of Pay)"]
[]
["Eligibility (pulling from your class setup; who is eligible for this rule?):"]
[]
[]
["Rule Name: ","NEW HIRE"]
[]
["Measurement Period","Client setup feedback",{"$nulls":6},"EBS Note:"]
["Start Date: (Date of Hire/ As per the New hire Effective Date)",{"$nulls":7},"Measurement Period is the “look back period” during which an employer measures the hours of service for its employees in order to determine their status as full-time or part-time. Its value is between 3 and 12 consecutive calendar months, as chosen by the employer -- • Date of Hire: system will consider hire date as the measurement period start date;  • As per the New Hire Effective Date: new hire effective date (Configured on Company Information Screen) is considered as the measurement period start date;  • Measurement Period Interval: In this field enter measurement period interval (in months)."]
["Measurement period interval"]
[]
["Stability Period","Client setup feedback",{"$nulls":6},"EBS Note:"]
["Start Date:\n * End of the Administrative Period (AP) + 1 Day\n * End of the Month Following 1 month from AP Start Date\n * End of the Month Following 2 month from AP Start Date\n * 1 Month from AP Start Date\n * 2 Month from AP Start Date\n * 3 Month from AP Start Date",{"$nulls":7},"Stability Period (SP) is the “hold period” during which employees are locked into full-time or part-time status based on the hours of service during the standard measurement period, regardless of how many hours the individuals work during the stability period. This period must be of at least 6 consecutive calendar months and no shorter in duration than the standard measurement period used by the employer.\n• End of the Administrative Period +1 Day: The next date after administrative period ends would be considered as the start date. \n• End of the Month following 1 month from MP Start Date: The end of month following 1 month from measurement period start date would be considered as start date.\n• End of the Month following 2 month from MP Start Date: The end of month following 2 month from measurement period start date would be considered as start date. \n• 1 Month from AP Start Date: The date after 1 month from the administrative period start date would be considered as the start date. \n• 2 Month from AP Start Date: The date after 2 month from the administrative period start date would be considered as the start date.\n• 3 Month from AP Start Date The date after 3 month from the administrative period start date would be considered as the start date.\n• Stability Period Interval: enter stability period interval (in months)."]
["Stability Period Interval:"]
[]
["Current Administrative Period","Client setup feedback",{"$nulls":6},"EBS Note:"]
["Start Date: (MP Start date + Mp interval + 1 Day/ 1 Month Before (MP Start date + MP interval)/ 2 Month Before (MP Start date + MP interval)/ 3 Month Before (MP Start date + MP interval))",{"$nulls":7},"Administrative Period (AP) = The period allowed to an employer to calculate the average hours worked over the Measurement Period.\nStart Date:\n• (MP Start Date + MP Interval ) + 1 Day: The next date after measurement period interval end date will be considered as start date.  \n• 1 Month before (MP Start date + MP interval): The date 1 month before the measurement period interval end date will be considered as start date. \n• 2 Month before (MP Start date + MP interval): The date 2 month before the measurement period interval end date will be considered as start date.\n• 3 Month before (MP Start date + MP interval): The date 3 month before the measurement period interval end date will be considered as start date.\nEnd Date:\n• End of the Month following 1 month from AP start date: The end of month following 1 month from administrative period start date would be considered as end date.\n• End of the Month following 2 month from AP start date: The end of month following 2 month from administrative period start date would be considered as end date.\n• 1 Month from AP start date: The date after 1 month from the administrative period start date would be considered as the end date.\n• 2 Month from AP start date: The date after 2 month from the administrative period start date would be considered as the end date.\n• 3 Month from AP start date: The date after 3 month from the administrative period start date would be considered as the end date."]
["End Date: (End of the Month following 1 Month from AP start date/ End of the Month following 2 Month from AP start date/ 1 Month from AP start Date/ 2 Month from AP start Date/ 3 Month from AP start Date/ MP End Date)"]
[]
["Full Time Employee Working Hours:"]
[]
["Select Safe Harbor Type (W-2/ Federal Poverty Line/ Rate of Pay)"]
[]
["Eligibility (pulling from your class setup; who is eligible for this rule?):"]
[]
["PART II -- ","ACA CUSTOMIZATION"]
["ACA Customization"]
[]
[]
["ACA Customization","Client setup feedback"]
["Plan Name(s) from Medical\n(Please enter the plan names as they appear in WorkTerra)",null,"Minimum Essential Coverage (For which plan this flag needs to be set?)",null,"ACA Plan (Which plans are ACA Plans? (which plans should the system look at for the purpose of the reporting))",null,null,"Safe Harbors (Which safe harbor need to set for each plans? (if not defined or different from line 47))",null,"Origin of Policy (some examples include: * Insured Employer-Provided Group Health Plan; * Government Sponsored Coverage; * Self-Funded Employer-Provided Group Health Plan; * SHOP (Small Business Health Options Program))",null,null,"Is plan minimum value? (Yes/No)","Employee lowest cost",null,"Plan start date (*if multi employer plan origin of policy)"]
{"$rows_empty":18}
["ACA Parameters","Client setup feedback"]
["Choose the salary for ACA Reporting [Gross annual salary / W2 wages / Benefit Salary]"]
["Additional Compensation Factors (Which options from below list should be added to the ACA Salary calculations)"]
[" Annual/One-Time Bonus"]
["Bonus per Interval"]
["Commission"]
["Reported Tips"]
[]
["EIN Class Mapping Details","Client setup feedback (*EIN Class contact information is needed for reporting to the IRS only and will not be visible to the individual employees)"]
["Name (Name of EIN Class)","Employer Identification Number","Contact (First Name, Last Name)","Contact Email Address","Contact Address Line 1","Contact Address Line 2","Contact City","Contact Postal Code","Contact Country","Contact State","Phone Number","Company class 1","Company class 2","Company class 3","Company class 4","Employee Status","Additional Eligibility Criteria"]
{"$rows_empty":12}
["PART III -- ","ACA REPORTING"]
["ACA Reporting"]
[]
[]
["ACA Reporting Options","Please select applicable forms and formats (*please refer to your SOW for the pricing for each report/service)",{"$nulls":6},"Reporting Responsibility Quick Reference Guide"]
[]
["Form 1095-B, Health Coverage.  Health insurance providers (for example, health insurance companies) send this form to individuals they cover, with information about who was covered and when. ","WorkTerra to Generate Forms?",null,"Distribution Method",null,"Client Feedback and Comments",null,null,"Applicable Large Employer With Fully Insured Coverage"]
[{"$nulls":8},"Who Files","Which Form","Which Parts"]
[null,null,null,"Employer will distribute internally",{"$nulls":4},"Insurer","1094-B","All"]
[{"$nulls":8},"Insurer","1095-B","Part I: Responsible Individual; Part II: Employer Sponsored Coverage; Part III: Issuer or Other Coverage Provider;  Part IV: Covered Individuals"]
[{"$nulls":8},"Employer","1094-C","Part I: Applicable Large Employer Member; Part II: ALE Member Information; Part III: ALE Member Information-Monthly; Part IV: Other ALE Members of Aggregated ALE Group"]
[{"$nulls":8},"Employer","1095-C","Part I: Employee and Applicable Large Employer Member; Part II: Employee Offer and Coverage"]
[]
["Form 1095-C, Employer-Provided Health Insurance Offer and Coverage.  These forms are used by applicable large employers to report Code § 6056 information (and, for self-insured plans, Code § 6055 information) to employees.","WorkTerra to Generate Forms?",null,"Distribution Method",null,"Client Feedback and Comments",null,null,"Applicable Large Employer With Self-Insured Coverage"]
[{"$nulls":8},"Who Files","Which Form","Which Parts"]
[null,null,null,"Employer will distribute internally",{"$nulls":4},"Employer","1094-C","Part I: Applicable Large Employer Member; Part II: ALE Member Information; Part III: ALE Member Information-Monthly; Part IV: Other ALE Members of Aggregated ALE Group"]
[{"$nulls":8},"Employer","1095-C","Part I: Employee and Applicable Large Employer Member; Part II: Employee Offer and Coverage; Part III: Covered Individuals"]
[]
["Form 1094-B: used to transmit individual statements (Forms 1095-B) containing Code § 6055 information to the IRS. ","WorkTerra to Generate Report(s)?",null,"Filing with IRS",null,"Client Feedback and Comments",null,null,"Non-Applicable Large Employer With Fully Insured Coverage"]
[{"$nulls":8},"Who Files","Which Form","Which Parts"]
[null,null,null,"EBS will deliver the IRS required electronic file to allow the employer to file their 1094 and 1095 with the IRS",{"$nulls":4},"Insurer","1094-B","All"]
[{"$nulls":8},"Insurer","1095-B","Part I: Responsible Individual; Part II: Employer Sponsored Coverage; Part III: Issuer or Other Coverage Provider;  Part IV: Covered Individuals"]
[{"$nulls":8},"Employer","N/A","filing obligation falls entirely on the insurer"]
[]
["Form 1094-C:   used by applicable large employers to transmit employee statements (Forms 1095-C) containing Code § 6056 information (and, for self-insured plans, Code § 6055 information) to the IRS.","WorkTerra to Generate Report(s)?",null,"Filing with IRS",null,"Client Feedback and Comments",null,null,"Non-Applicable Large Employer With Self-Insured Coverage"]
[{"$nulls":8},"Who Files","Which Form","Which Parts"]
[null,null,null,"EBS will deliver the IRS required electronic file to allow the employer to file their 1094 and 1095 with the IRS",{"$nulls":4},"Employer","1094-B","All"]
[{"$nulls":8},"Employer","1095-B","Part I: Responsible Individual; Part III: Issuer or Other Coverage Provider; Part IV: Covered Individuals"]
[{"$nulls":8},"Insurer","N/A","filing obligation falls entirely on the employer"]