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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
Safe Harbor Statement
The following is intended to outline our general product direction. It is intended for information purposes only, and may not be incorporated into any contract. It is not a commitment to deliver any material, code, or functionality, and should not be relied upon
Copyright © 2016, Oracle and/or its affiliates. All rights reserved. |
commitment to deliver any material, code, or functionality, and should not be relied upon in making purchasing decisions. The development, release, and timing of any features or functionality described for Oracle’s products remains at the sole discretion of Oracle.
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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
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including the waived plan
Identify Self-Insured Plans
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Identify Reportable DBAs
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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
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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
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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
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= 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
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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
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•
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
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• 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
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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
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•
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
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– 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
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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
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• 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
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• 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
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If not 1, no Line 16 codes
If not 1, no Line 16 codes
If not 1, no Line 16 codes
reportreportreport
Based on IRS instructions
Based on IRS instructions
Based on IRS instructions
Optional to help with review
Optional to help with review
Optional to help with review
Example 1: Employed All Year
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Offer/Enrolled
Example 2: Hired in July
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Not employed Not full month Offer/EnrolledEnrolled at least one day each month
Example 3: Terminated in August
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Not employedOffer/Enrolled Not full month
Enrolled at least one day each month
Example 4: Waived Coverage
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Offer/Waived
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ESUs, Fixes
ACA Baseline ESUs
9.0 9.1
JL23457 JM18743
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JL23457 JM18743
JL23485 JM18843
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My Oracle Support References
• Reported Issues (2086250.1)
– Check here for updates going forward
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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
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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)
9.0 9.1 Description 9.0 ESU 9.1 ESU
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
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(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)
9.0 9.1 Description 9.0 ESU 9.1 ESU
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
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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)
9.0 9.1 Description 9.0 ESU 9.1 ESU
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
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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
9.0 9.1 Description 9.0 ESU 9.1 ESU
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)
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Reported Issues – Form 1095-C Inquiries (P08119)
9.0 9.1 Description 9.0 ESU 9.1 ESU
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
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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
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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
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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.
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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
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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.
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tables
• Working with 1095-C information
• Printing 1095-C for recipients
tables
• Electronic filing
• Corrections processing
Available November 10, 2015 Planned March, 2016