Affordable Care Act




Affordable Care Act

The provisions of the Affordable Care Act affect business in a big way and reach much further than the health care industry. New regulations on reporting and monitoring require businesses to put more emphasis on payroll administration, so having a reliable payroll provider is now more important than ever. Our team understands this and we have designed solutions for health care reform that will ensure your business complies with ACA provisions.

TelePayroll has been in the payroll business for over 50 years so you can feel confident that we have the knowledge and experience to keep your business compliant and running smoothly.

Detailed Information:




Reporting

The ACA reporting requirements may seem daunting at first, but with TelePayroll’s reporting options, it will be as simple as running a normal payroll.

Standard Payroll Reporting


The following reports are included at no cost with our standard payroll processing:
  • ACA Eligibility Report – Reports hours worked within a specified date range to calculate average hours per week or per month.
  • ACA FTE Report – Calculates the total number of full-time employees and full--time equivalents (FTE) you have per month. The report summarizes the data for ease of reporting aggregate totals and can also include the individual employees’ total paid hours and average hours per month. This report will designate whether an employer is large or small for ACA reporting purposes.
  • ACA FTE Projection Report – Calculates the total projected number of full-time employees and FTEs based on your schedule for a month.

Time and Attendance Reporting


With our Time and Attendance service, it's easy to identify which employees are close to the threshold of needing health coverage under ESR. *Please note that you must use our time and attendance service to be eligible for this report.
  • Approaching Threshold Report – Lists employees who are approaching an employer-defined threshold, such as being a full-time employee after passing 32 hours. Can also forecast when an employee will reach a defined threshold.







Monitoring

Monitoring your employees' hours is an important part of the Employer Shared Responsibility provision. TelePayroll provides two monitoring packages to help you stay compliant.

Standard Monitoring


With our Standard Monitoring package, our staff will track if your company is approaching the applicable large employer threshold and which employees may subject you to penalties under the Employer Shared Responsibility mandate.
  • Applicable Large Employer Analysis and Monitoring - Track and calculate of the number of full-time employees and FTEs to help determine if you are an applicable large employer and subject to ESR provisions or approaching this status at any given point in time.
  • Full-Time Employee Analysis and Monitoring – Assists in determining which of your employees may subject you to ESR penalties if you do not offer adequate and affordable coverage. The analysis shows you measurement periods, allows for designation of stability periods, tracks ongoing employees vs. new hires and allows a sliding scale of measurement ranges to ensure adequate monitoring of newly hired employees.

Insurance Monitoring


When your business is partnered with TelePay Insurance for health coverage, you can be sure that adequate coverage is offered to all eligible employees.
  • Coverage Adequacy Analysis and Monitoring – Helps you determine the adequacy of your health coverage by evaluating whether it provides minimum essential coverage, minimum actuarial value, and affordable coverage according to ESR provisions.


ACA Timeline



Dependent Coverage - Extends dependent coverage for adult children up to age 26 for all individual and group policies.

Medical Loss Ratio Rebate – Requires health plans to report the proportion of premium dollars spent on clinical services and other related costs. Insurers are required to provide rebates for coverage to employers, who can use the rebate to reimburse employees, reduce future premiums, or improve plan benefits.

Restrictions on Cafeteria Plans - Increases tax on distributions from HSA that are not used for qualified medical expenses from 10% to 20%.

Summary of Benefits and Coverage – Requires private individual and group health plans to provide a uniform summary of benefits and coverage (SBC) to all applicants and enrollees. The goal is to help consumers compare health insurance coverage options before they enroll and understand their coverage once they sign up.

Elimination of Employer Medicare Tax Deduction – Eliminates the tax-deduction for employers who receive federal subsidies for Medicare Part D retiree drug payments.

Employee Notice of Coverage Options – Requires employers to provide all employees with a notice describing the health coverage available through insurance exchanges. (Open enrollment begins 10/1/13)

Limit to FSA Contributions – Limits the contribution amount for a flexible spending account to $2,500, with an annual increase by the cost of living adjustment.

Medicare Tax Increase – Increases the Medicare Part A (hospital insurance) tax rate on wages by 0.9% (from 1.45% to 2.35%) on earnings over $200,000 for individual taxpayers and $250,000 for married couples filing jointly. Also imposes a 3.8% assessment on unearned income for higher-income taxpayers.

W-2 Reporting – Requires employers issuing 250 or more Forms W-2 in the preceding calendar year to report the cost of coverage under an employer-sponsored group health plan.

Automatic Enrollment – Employers with 200 or more employees are required to enroll employees into the employer’s group health insurance plan automatically.

Health Insurance Exchanges – Creates state-based health insurance exchanges that individuals and small businesses with up to 100 employees can use to apply for qualified coverage.

Individual Insurance Requirement – U.S. citizens and legal residents are required to have and maintain health insurance, or pay a fine starting at $95/person or 1% of income in 2014, increasing to $695 in 2016.

Limit on Waiting Period – 90 day maximum waiting period for health coverage.

Nondiscrimination Rule – Prevents employer group health plans from discriminating in favor of highly compensated employees.

Pre-Existing Conditions / Annual Limits – Prohibits pre-existing condition exclusions and annual limits on the dollar value of coverage.

Wellness Incentives Program – Permits employers to offer employees rewards of up to 30% (potentially increasing to 50% for programs established to reduce or prevent tobacco use) of the cost of coverage for participating in a wellness program and meeting certain health-related standards.



2015

Employer Shared Responsibility – Assess a penalty of $2,000 per full time employee on employers with 100+ employees that do not offer coverage and have at least one full-time employee who receives a premium tax credit. Employers with 100+ employees that provide coverage but have at least one full-time employee who receives a premium tax credit will pay the lesser of $3,000 for each employee receiving a premium credit or $2,000 for each full time employee. In both cases, the first 30 employees are exempt.

2016+

Employer Shared Responsibility (50-99 employees) – Delays the ESR penalty for employers with 50 to 99 employees until January 1, 2016.

2018 – Tax on High-Cost Insurance - Imposes a 40% excise tax on employer-sponsored health plans if group health coverage exceeds the following estimated limits: $10,200 for individual coverage and $27,500 for family coverage.



ACA Calculator

Number of Full-Time Employees

Total Employee Count

Total Monthly Hours For All Part-Time Employees



(Part-time employees must average less than 30 hours per week during the month)

The calculator determines the number of full-time equivalent employees on staff. Part-time employees are capped at 120 hours per month, so the calculator takes all part-time employee hours and divides the total by 120. The total full-time equivalent employee number is then added to the total full-time employee count to determine if you are an applicable large employer. In 2015, applicable large employers are defined as having 100 or more full-time or full-time equivalent employees on staff.

100 Or More Employees

Your company has employees, which may cause penalties under the Employer Shared Responsibility provision if minimum coverage is not offered. Learn more about ESR penalties.

Number of Full-Time Employee Equivalents1


1 No fee is paid on part-time employees or full-time employee equivalents.