Midsized Employers Are Worried About Ongoing ACA Compliance Challenges

The Affordable Care Act and resulting ACA compliance challenges can be a tough labyrinth for employers to navigate. As an insurance agency focusing on group benefits management, Pontrelli, Timour & Associates understand the frustration of employers as they attempt to deal with the seemingly never-ending ACA compliance challenges. By focusing on compliance issues, business owners fail to do what they do best and really need to be doing – growing their bottom line. Luckily, PT Benefits can help your company overcome these difficulties, taking away unnecessary bureaucratic headaches.

Keeping Up With ACA Compliance Challenges

aca compliance challenges

Help with ACA Compliance Challenges

It’s hard to keep up with evolving regulations around the Affordable Care Act. As a result, employers are increasingly stressed about the volume of government regulation that often lead to fines and penalties for noncompliance. When it comes to senior level and C-suite executives at U.S. companies with 50-999 employees, two in five ranked the amount of government regulations as their top business concern in 2015. This is a significant spike when compared to previous years.

Business owners have less confidence in compliance with ACA regulations as compared to payroll tax laws and workforce regulations. When it comes to ACA compliance challenges, there are steps you can take to help your company avoid problems.

Three Basic ACA Compliance Steps That Can Help

  1. Seek expert help. Recognize that ACA compliance is not a one-time investment, but an ongoing journey. Trying to solve compliance challenges with only internal resources can sometimes end up costing more than working with an experienced Insurance Agency like PT Benefits.
  1. Take inventory of your current benefits plans and employee insurance offerings. Employing manual processes can increase the risk that critical information needed to deal with ACA compliance challenges is not being tracked. If you had trouble during your last ACA reporting cycle, you are likely to have trouble again. By working with PT Benefits, the manual processes are replaced by a well-oiled group benefits machine.
  1. Access quality ongoing service options. If getting a handle on the alphabet soup of regulations that go hand-in-hand with the Affordable Care Act, work with an experienced insurance agency that can provide ongoing service. There is no need to continue what seems to be an exercise in futility, By seeking the help of certified and trained ACA compliance experts, you not only can avoid penalties, you also can offer better employee benefits programs and improve employee morale.

PT Benefits Overcomes ACA Compliance Challenges

To learn more about how Pontrelli, Timour, & Associates can provide the help you need to overcome ACA compliance challenges, please pick up the phone and take the first step. By calling (626) 795-4138 and speaking with one of our group benefits managers, you can access the help you need today.

Six Things Applicable Large Employers (ALEs) Need To Know About Information Reporting and Health Coverage Offers

Applicable Large Employers (ALEs) are generally those employers with 50 or more full-time employees, including full-time equivalent employees in the preceding calendar year. If you are an applicable large employer, did you know the Affordable Care Act requires your company to file data returns that report information with the IRS and with your employees as well? Under the Affordable Care Act, not only are you responsible for jumping through all the hoops of providing coverage for your employees, you also need to be the main source of reporting such information to the Internal Revenue Service.

Applicable Large Employers (ALEs) Under ACA

applicable large employers

Applicable Large Employers (ALEs)

As a full-service employee benefits and insurance agency serving Southern California, Pontrelli, Timour & Associates understand that Obamacare has been driving you crazy as a business owner. Luckily, we are here to help guide ALEs through the obstacle course of providing the right benefits at the right cost, while advising you on resources to ensure your reporting requirements are executed on time. We are here to help ease the frustrations of the ACA, and help you contain costs, while keeping your valued employees happy with their benefit options.

Although many employers are not ALEs, thus not subject to this health care tax provision, the employers that do fall under the ALE definition must take action. If you are an applicable large employer you must use Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, and Form 1095-C, Employer-Provided Health Insurance Offer and Coverage. These IRS forms are used to report the information about offers of health coverage and enrollment in health coverage for their employees.

Here are six key points ALE’s need to know about the information returns they must file:

Six Key Points for Applicable Large Employers (ALEs)

  1. Form 1095-C is used to report information about each employee who was a full-time employee of the ALE member for any month of the calendar year.
  2. Form 1094-C must be used to report to the IRS summary information for each employer, and to transmit Forms 1095-C to the IRS.
  3. ALEs file a separate Form 1095-C for each of its full-time employees, and a transmittal on Form 1094-C for all of the returns filed for a given calendar year.
  4. Applicable Large Employers that offer employer-sponsored self-insured coverage use Form 1095-C to report information to the IRS and to employees about individuals who have minimum essential coverage under the employer plan.
  5. The information reported on Form 1094-C and Form 1095-C is used in determining whether an employer owes a payment under the employer shared responsibility provisions.
  6. Forms 1094-C and 1095-C, or a substitute form must be filed regardless of whether the ALE member offers coverage, or the employee enrolls in any coverage offered.

If you are an applicable large employer (ALE) and you have yet to file these forms, you are already sailing in treacherous seas. Luckily, Pontrelli, Timour & Associates can help applicable large employers right the ship of their companies and return to calm waters. The goal of PT Benefits is to make sure that our client companies that are ALE’s avoid unnecessary IRS fines while keeping in compliance. At the same time, we want to help you recruit and keep the best employees by offering you’re the best benefits program options available.

PT Benefits Can Help ALEs

To learn more about how PT Benefits can help applicable large employers, please contact us today by calling 626-795-4138 today.

California Small Group Definition Will Hurt Business Owners In 2016

When the small group definition of businesses by the Affordable Care Act is reduced to 50 employees or less in 2016, many California business owners are going to be unfairly hurt. In California, the small group definition is going to remain 100 employees or less. As a result, any business with 50 to 99 employees will be damaged by qualifying under the small group definition. Pontrelli, Timour & Associates, Inc. want to help our clients navigate these dangerous waters.

The Sacramento Business Journal reports that Covered California will move forward with an expansion of the definition of small employers under state law. This counteracts the new federal law that halts the change. On October 7, 2015, President Obama signed into law the Protecting Affordable Coverage for Employees (PACE) Act which repeals the Affordable Care Act provision that on January 1, 2016 would have mandated expansion of the definition of “small employer” subject to insurance market reforms from employers with 1 to 50 employees to those with up to 100 employees. Yet, in California, state law defines businesses with 100 or fewer employees as small.

California Small Group Definition Damages

california small group definition

California Small Group Definition Hurts Business Owners

When it comes to being a small group, benefits administration is more costly with less benefits offered to your employees. In addition, small group benefits have higher deductibles for employees and a higher out of pocket expenses. Overall, there was a 26% increase for small group companies in terms of overall healthcare costs in 2015.

Pontrelli, Timour & Associates, Inc. does not believe the California state government is being fair to local business owners. Why should local business owners be penalized because their companies are based in California? Is this a good way to convince businesses to either stay or come to the state? Why would the California definitions be different from the national definitions when the Affordable Care Act has set the bar for benefits administration across the country?

Employment Data & California Small Group Definition

Based on California labor market employment data, roughly 14 percent of all California employment — 2.3 million employees — fall in the 51-100 segment, while roughly 2.4 percent of all California businesses—33,000 employers—fall into the 51-100 market. In California small group definition, an employer has historically been defined as 50 or fewer eligible employees for group health insurance purposes. Unless an employer has a grandfathered large group plan, employers with 51-100 full time equivalent employees who renew or purchase coverage in 2016 will be required to follow all small group regulations.

For large groups, insurance providers commonly use health status or claims experience, industry risk factors, employer size, participation and contribution levels, age/gender factors and composite ratings to determine premiums. With the mandatory migration, those falling under the new small group definition will no longer be allowed those variations. For example, the gender factor will no longer be permitted and age rating will be limited, with a 2016 ratio maximum of 3 to 1.

Age, Family Size & Geography Insurance Factors

Family size, too, will be a determining factor in adjusting premiums under the 2016 provisions with the California small group definition. Up to three children under 21 years of age may be charged a premium within a family, but any additional children can receive coverage at no additional charge. Geographic regions within the state that are currently prescribed may also be changed significantly, as well as premiums for tobacco use, which may be increased up to but not exceeding 50 percent.

Group Benefits Leader Helping Small Group Business Owners

When the ACA small group definition becomes effective in the state of California in 2016, groups sized 51-100 will for the first time fall under the same requirements that currently apply to groups sized 1-50. The California small group definition simply is not fair. As insurance brokers and group benefits leaders, the goal of Pontrelli, Timour & Associates, Inc. is to make sure our present-day clients and our future clients are not hurt by these healthcare problems.

 

IRS Resources To Help Employers Stay In Compliance With ACA Health Care Law Tax Provisions

ACA health care law is important when it comes to staying in compliance with IRS tax provisions. As an employee benefits and insurance agency in Pasadena, Pontrelli, Timour & Associates focuses on providing our clients and potential clients with essential information about the latest health care law tax provisions. With the Internal Revenue Service in charge of enforcing the Affordable Care Act, such information helps business owners stay in compliance with ACA health care law and avoid unnecessary pitfalls. Although the IRS enforcesACA health care law compliance, they also provide excellent resources to understand health care law tax provisions.

ACA health care law

ACA Health Care Law Compliance

For example, the IRS provides easy access to recorded webinars from IRS about the Affordable Care Act’s employer provisions and related tax requirements. Such webinars are well-designed essential information for employers. If you are a business owner or a tax manager for a company, these videos can be reviewed anytime to better understand how the health care law may affect your organization. The goal is help a business stay in compliance with ACA health care law.

ACA Health Care Law Tax Provisions

Each of the following ACA videos on the IRS Video Portal provides about 40 minutes of detailed information on the specific tax provision mentioned in the title. For example, two of the most effective videos that are worth the effort and time to watch are as follows:

  1. Employer Shared Responsibility Provision

This video helps a company determine their applicable large employer status, payments, and transition relief for 2015. Applicable large employers (ALEs) face the biggest hurdles.

  1. Employer-Sponsored Health Coverage Information Reporting Requirements for Applicable Large Employers

This video provides access to employer-sponsored health coverage information reporting requirements for ALEs, including who is required to report, what information you are required to report, and how to complete the needed forms.

All of the Internal Revenue Service recorded webinars about ACA updates and healthcare provisions can be found in the IRS Video Portal using the following tabs: Businesses and Non-Profits. After clicking on one of these tabs, a business owner only needs to select “Affordable Care Act” from the list of topics on the left side of the screen. Once selected, a list of recordings about the above provisions and other ACA topics will appear.

Pontrelli, Timour & Associates understands if the webinars can seem long and overwhelming. Even when done well, the healthcare information provided remains complex for the non-professional. As an experienced insurance agency, we understand the importance of improving your group benefits offerings while saving money and staying in compliance. Our customer-centric solutions and client services are the cornerstone of your business.

From years of experience, PT Benefits has learned that a happy employee is a productive employee. To access the help your company needs to ensure ACA health care law compliance and future success, please call 626-795-4138 and talk to one of our trained professionals.