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ACA Compliance Resources

ACA Compliance Resources

Part 4: Health Insurance for Employees and Dependents

In this section, you will state whether your organization provides insurance to its employees, if it is
minimal essential coverage, and whether it provides minimum value.

  • Answer “Yes” for “Insurance Provided” if you offer health insurance to your qualifying
  • Minimum Essential Coverage Yes/No: The vast majority of employer provided health
    insurance plans offer minimal essential coverage. A health plan that meets the minimum
    value standard will be designed to pay at least 60% of the total cost of medical services
    and include benefits for substantial coverage of physician and inpatient hospital services.
  • Minimum Value Yes/No: If you are unsure if your plan offers minimal essential coverage
    and/or minimum value, contact the administrator of your health insurance plan or your
    insurance broker.
If you do not provide health insurance to your employees, you skip to section 14, “For
which calendar year will you first be reporting to the IRS using this solution?”

Employee Contributions

Some employers provide health insurance at no cost for the employee, but have them contribute to the
cost of coverage for their dependents.

If you do not require the employee to pay for any of the cost for your least cost option for employee
self-only coverage, select No, else select Yes.

The “least cost” plan is the plan for which an employee would pay the least amount for health
insurance coverage.

If “No” is chosen the user will be moved to section 10, “Do you provide health insurance
to the spouse or the domestic partner of your employee?”

If “Yes” is chosen on the Employee Contribution page, you need to enter the cost to the employee for
self-only coverage.

  • Enter the dollar amount equal to the amount that an employee would pay on average per
    month for the least expensive option for employee only coverage.

Spouse and Dependent Health Insurance

Answer “Yes” if you extend the opportunity for your employees to enroll their spouse, domestic
partner, or dependent children into an employer provided health care plan.

Coverage Beginning Dates

Some health care plans allow for coverage to begin on the 1st day of the month following a defined
number days of employment. Others will allow coverage to begin mid-month following a defined
number of days of employment.

  • If your health coverage always begins on the 1st of the month, select “Yes”, otherwise, select
If “Yes” is selected, you will be brought to the next page asking for length of time in months
If “No” is selected, you will be brought to the next page asking for length of time in days.
  • “Yes” selection from previous page
  •  “No,” selection from previous page
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