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Importing Health Deductions for Employees Without Payroll Deductions for Certain Months such as Retirees or Teachers

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KB14-032

The ACA solution does require monthly deductions/benefits for Health coverage. If there are no payroll benefit/deductions for any reason in a month, the system will show that the employee is not covered for those months. When a benefit/deduction transaction does not exist for a particular month the way to tell the system that the employees are covered is to upload a Benefit Transaction with zero UNITSTOPAY, RATEAMOUNT and AMOUNT for each month the employee does not have a benefit/deduction transaction.

For example, employee ACKE0001 is a teacher paid on a 9-month schedule with only benefits/deductions transactions for the 9 months the employee received a check yet had coverage for 12 months. Because we need to import monthly transactions for the entire year, we will import 3 lines of zero amount benefit transactions for the 3 months a paycheck was not received.

zero 2

Note: you can edit the file in Excel then save as a Tab Delimited Text file before importing.

This scenario is often found with Educational Institutions that cover the employees for the year but deduct from the paychecks spread over 9 months.

Other situations that you will need to upload Health coverage transactions are:

  • Employer pays 100% of the coverage for the employee
  • Employee is on FMLA during the month and coverage remained in force
  • Employee is on military duty during the month and coverage remained in force
  • Employee is on jury duty or illness during the month and coverage remained in force

Self-Insured plans will need to upload Benefits for Part III proof of coverage as below:

  • Retirees with zero hours but have Health coverage
  • Partners or owners who have zero hours but have Health coverage

See the latest updates to this window: https://www.integrity-data.com/faq-items/kb-show-health-benefits-zero-dollar-payroll-health-deductions-employee-covered/

Questions / Resources

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Last Review: 8/21/2020 – Revision: 1.1

Applies To:
ACA Compliance and Law for Cloud Users

Categories:  Import of Data

Keywords:  Monthly, Deductions

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