affordable care act health coverage information returns · reported issues –form 1095-c inquiries...

Affordable Care ActHealth Coverage Information Returns

Alicia Gambrell

Copyright © 2016, Oracle and/or its affiliates. All rights reserved. |

Alicia GambrellPrincipal Product ManagerOracle JD EdwardsJanuary 19, 2016

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Preparing to Produce Forms

Identify Reportable Plans (P08320)• Reporting based on• Reporting based on

– Plan Type UDC value with Special Handling Code = M

– Set up on all plans, including the waived plan

Copyright © 2016, Oracle and/or its affiliates. All rights reserved. | 5

including the waived plan

Identify Self-Insured Plans


Identify Reportable DBAs


Review Employee Enrollment (P08330)• Reporting for

reportable plans based

dates that fall within the

• Reporting for reportable plans based on

– enrollment with Active Begin Status and

– dates that fall within the


dates that fall within the reporting year– dates that fall within the

reporting year

Review Dependent Information (P08336)• Reporting based on• Reporting based on

– An employee’s dependent records with effective dates that fall within the reporting year


on plan, but should. Bug – (currently not matching

on plan, but should. Bug 22322351)

Set up Part II Offer and Coverage (P08117) • Need a record for each

reportable plan/option

•

• Need a record for each reportable plan/option (or DBA if not using benefits)

• Line 15 only if Line 14 = 1B, C, D, or E


= 1B, C, D, or E

Set up Part II Offer and Coverage (P08117)

• Waive Plan• Waive Plan

– Similar setup as other valid plans

– Line 16 could be blank or a safe harbor code of your choice


your choice

ACA Employee Eligibility (P081161)

• Each reportable

• need to create new

• Each reportable employee must have Eligibility record(s) for the reporting year

• No need to create new records in the future unless the status changes


•

changes

• If you know status at time of hire, add the record

Periods of Employment (R08118/P08118)• R08118 based on HR • R08118 based on HR

History (F08042)

• Tracks occurrences of Date Started and Date Terminated


• If no history for an employee, Offer and Coverage build (R08119) uses current Employee Master dates

Hours Worked by Month (R08124/P08124)• R08124 based on • R08124 based on

Timecard history (F0618)

• Each reportable employee must have a record


record

• Pay Type table set up via P08393 (optional)




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Building Report Data

AIR Workbench (P08210) • All ALE Members can

•

• All ALE Members can be processed in one AIR ID

• If you need to process by ALE Member, you can data select on Tax Identification Number


•

Identification Number (F08124.TAXX) in R08119

• An employee processed for a Tax ID in an AIR ID can’t be processed in another

AIR Processing Parameters / AIR Status (P08210)

• Not yet functional….

– AIR ID to be Corrected

– Build 1094-C

– Form 1094-C Build Date


– Form 1094-C Build Date

• First three statuses are • First three statuses are indicators set manually

Offer and Coverage Workfile Build (R08119) POs - Benefits

• When using benefits• When using benefits

• Date that represents start of enrollment


start of enrollment

• Self insured plan indicators

• Drives X in Part III SI checkbox

• Reporting of covered individuals

POs – DBA • When using DBAs (not • When using DBAs (not benefits)

• Only complete if you are reporting based on DBA history

• If you use benefits for


• If you use benefits for some enrollment and DBAs only for other, system looks first for benefits enrollment in a month, and if not found, looks for reportable DBAs

POs – Employee


• When using DBAs (not • When using DBAs (not benefits)

• Only complete if you are reporting based on DBAs only

Change to setup instructions:Change to setup instructions:

• An employee who waives coverage must also have a record in Offer and Coverage Setup (P08117) with the Line 14, 15, and 16 values.

POs - ProcessingDBA Only Processing DBA Only Processing DBA Only Processing

If Self-Insured Plans

If Self-Insured Plans

If Self-Insured PlansUseful

reportUseful reportUseful report


If not 1, no Line 16 codes



reportreportreport

Based on IRS instructions



Optional to help with review



Example 1: Employed All Year


Offer/Enrolled

Example 2: Hired in July


Not employed Not full month Offer/EnrolledEnrolled at least one day each month

Example 3: Terminated in August


Not employedOffer/Enrolled Not full month

Enrolled at least one day each month

Example 4: Waived Coverage


Offer/Waived



Section Header without PictureSubtitle

26

ESUs, Fixes

ACA Baseline ESUs

9.0 9.1

JL23457 JM18743


JL23457 JM18743

JL23485 JM18843

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My Oracle Support References

• Reported Issues (2086250.1)

– Check here for updates going forward


Reported Issues – Offer and Coverage Build (R08119)

9.0 9.1 Description 9.0 ESU 9.1 ESU

22300311 22300277 Offer and Coverage Setup (P08117) records for employees

cause incorrect Line 14 and 16 codes

22300311 22166821

22366608 22365513 Active employee with no Eligibility record for months between

hire and enrollment Line 14 and 16 are blank. Modified logic to

assume not eligible if no F081161 record for a month.

Employee with no hours in a month in Hours Worked by Month

Prerelease

build on

1/19. GA

1/26

Prerelease

build on

1/19. GA

1/26


Employee with no hours in a month in Hours Worked by Month

(P08124) reports as 2A not 2B. Modified logic to remove check

on hours to determine employment

1/26 1/26

22533521 22529405 Enrollment End Date not checked to determine whether the

offer of coverage was for the full month.

2D logic not correct in all cases when R08119 PO set.

Additional changes for reporting 2A based on Periods of

Employment and not hours worked or DBA history.

In QE In QE

Reported Issues – Part III Covered Individuals (R08120)


22544266 22315980 Dependents have no months Xd. F08120 record has an End

Date earlier than the Start Date

In QE 22315980

22325565

Employee with more enrollment in more than one plan, with

more than one date effective records for the year, have

incorrect months Xd

(Fixed under 22544266/22315980)

n/a n/a


(Fixed under 22544266/22315980)

22322351 Dependents should be reported based on a match to the

employee’s plan, but they are not.

On Hold On Hold

22345178 Enhancement to add a processing option so that customers can

choose whether to report dependents based on plan match or

not.

On Hold On Hold

22544292 22321852 Dependent with prior year enrollment only is reporting in Part

III

In QE 22321852

22544308 22324314 When an employee has no dependents, the employee is not

reporting in Part III

In QE 22324314

Reported Issues – Part III Covered Individuals (R08120)


TBD 22310226 When an employee works for different companies throughout

the year, Part III Months of Coverage reports complete

information for year, rather than splitting the information

between ALE Member forms as it does for Part II.

22564700 22353857 For an employee with more than one consecutive enrollment

record for the year, Part III Months of Coverage have no Xs.

n/a n/a


record for the year, Part III Months of Coverage have no Xs.

(Fixed under 22544266/22315980)

22544789 22449843 An employee enrolled in a waive plan under an offer of

coverage that is self-insured should not report in Part III.

In QE Prerelease

build

1/19. GA

1/26

22564700 22566756 Months of Coverage not correctly Xd in start month and end

month based on employee enrollment or dependent data

In QE In QE

Reported Issues – Print Form 1095-C (R08119B)


22301769 22328435 When a dependent does not have an SSN, but has a birth date,

today’s date is printing instead of birth date

22301769 22328435

22558562 22332948 Print Form 1095-C does not update the Workbench (P08210)

Print Status with a 1.

In QE 22332948


22327944 22328487 R08119B is not page breaking correctly. Also, if not covered

individuals, Part III lines are not printing

22327944 22328487

22547587

When Line 15 cost reports in the All 12 Months column, but

Line 14 reports in Jan through Dec (due to different code

values), the Line 15 cost is not printed

Reported Issues – Preliminary Reports and Setup


22558124 22393860 Hours Worked by Month (R08124) produces a blank report and

no data is created. With certain User Profile Date Formats

(such as MDY), the report incorrectly determines data selection

year.

(Workaround: temporarily change Date Format to MDE)


Reported Issues – Form 1095-C Inquiries (P08119)


22561126 22477984 When Line 15 cost reports in the All 12 Months column, but

Line 14 reports in Jan through Dec 9 (due to different code

values), the Line 15 cost is not displayed

In Dev In Dev

22513862 22513862 Adding to Offer and Coverage Detail or importing to Import

Offer and Coverage, the Reporting Company number populates

the description column.

In QE In QE


the description column.

(Workaround: on Corporate Tax Id for Federal A, populate

Parent Company)

22544070 22543496 Import Offer and Coverage does not include the Self-Insured

Flag. Covered Individuals cannot be imported later if no SI Flag

In QE In QE




35

Troubleshooting

Determining Line 14*

Code Description Setup/Derived1A Qualifying Offer Set up in P08117

1B Minimum Essential Coverage (MEC) Offered

to Employee

Set up in P08117

1C MEC Offered to Employee and Dependents Set up in P08117

1D MEC Offered to Employee and Spouse Set up in P08117

1E MEC Offered to Employee and Dependents

and Spouse

Set up in P08117


and Spouse

1F MEC not Providing Minimum Value Set up in P08117

1G Offer of Coverage to employee who was not

full-time for any month and who enrolled in

self-insured coverage for at least one month

Employee ACA Eligibility (P081161) is ineligible for every month of the year and

employee is enrolled in a self-insured plan.

1H No Offer of Coverage No enrollment, or enrollment not for full month.

No DBA history, and employee has not waived.

Or, plan itself is set up as 1H (not MEC)

1I Qualifying Offer Transition Relief 2015 Set up in P08117

May be derived based on 1094-C settings and IRS instructions logic

*This chart represents high-level information

about code setup or derivation and is not intended to portray all logic details

Determining Line 16*

Code Description Setup/Derived2A Employee Not Employed During Month Base on Periods of Employment. Employee not employed on any day of the month

2B Employee Not a Full Time Employee Condition 1: The employee is employed, ACA eligibility status is Not Eligible, and they are not enrolled in

coverage.

Condition 2: The employee is employed, enrollment end before end of the month, employee is terminated

in the month.

Condition 3: For January 2015, coverage was offered no later than the first day of the first pay period. PO is

set to populate 2B.

2C Employee Enrolled in Coverage Offered Employee is enrolled in a plan for an entire month.

If enrolled plan is a waived plan, not a 2C.

2D Employee in Limited Non-Assessment Period Employee LNAP set up in P081161.

Or, PO is set to populate Start month with 2D.


2E Multi-employer Interim Rule Relief For reporting offers of coverage for 2015, an employer relying on the multiemployer arrangement interim

guidance should enter code 1H on line 14 for any month for which the employer enters code 2E on line 16

2F Section 4980H Affordability Form W-2 Safe

Harbor

Set up in F08117

2G Section 4980H Affordability Federal Poverty

Line Safe Harbor

Set up in F08117

2H Section 4980H Affordability Rate of Pay Safe

Harbor

Set up in F08117

2I Non-Calendar Year Transition Relief Set up in F08117

*This chart represents high-level information

about code setup or derivation and is not intended to portray all logic details

My Oracle Support

• Troubleshooting Supplement (2089317.1)

• Check here for updates going forward





39

Future Roadmap

Release Plans

• Phase 1

• Setup for Form 1095-C

• Generating 1095-C reporting work tables

• Phase 2

• 1094-C setup

• Generating 1094-C reporting work tables

Planned

The IRS Extends Filing Deadlines for 2016

Employers now have until March 31, two months past the original Feb. 1 deadline, to provide Form 1095-C to individuals. Electronic filing with the IRS has been extended an additional three months to June 30, 2016.

The IRS Extends Filing Deadlines for 2016

Employers now have until March 31, two months past the original Feb. 1 deadline, to provide Form 1095-C to individuals. Electronic filing with the IRS has been extended an additional three months to June 30, 2016.

Copyright © 2016, Oracle and/or its affiliates. All rights reserved. | Oracle Confidential – Internal/Restricted/Highly Restricted 40

tables

• Working with 1095-C information

• Printing 1095-C for recipients

tables

• Electronic filing

• Corrections processing

Available November 10, 2015 Planned March, 2016

affordable care act health coverage information returns · reported issues –form 1095-c inquiries...

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