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STEPS FOR PART III EMPLOYEE HEALTH COVERAGE AND DEPENDENT SUCCESS

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Full-Service and Premium Support ACA

  • Be sure that you are a self-insured company
  • Be sure that the ACA Plan self-insured checkbox is checked in the Configuration section. For FS clients, we will check this for you.

 

  • Be sure in the Company setup, you have checked Benefit Date Range if you are sending a coverage spreadsheet from your benefit provider. If FS clients, we will check this for you.

 

  • For Employee Health Coverage:

    • If using an Excel spreadsheet, fill according to the following template (it is a Transaction template)
    • If you are a Full-Service client and are sending a spreadsheet from your insurance company, be sure the spreadsheet is clear and has the fields as in the link above:
      • Showing the benefit period start date and benefit period end date for the year filing. For example, if the employee was a new hire and took insurance on March 1, the Benefit Start Date would show 3/1/2021 and if the employee had it the rest of the year, the Benefit End /Date would be 12/31/2021.  The file may have checks for each month they took the insurance.  That is acceptable.
      • Showing the Employees ID (this should be the same as your employee census file ID-it could be unique or SSN)

 

  • For Dependent Coverage:

    • If you are sending a spreadsheet from your insurance company, be sure the spreadsheet is clear and has the fields as in the Dependent Template shown here. Your FS Rep will sort out the correct columns.
        • Showing the benefit start date and benefit end date for the year filing. For example, if the employee was a new hire and the dependents elected insurance on March 1, the Benefit Start Date would show 3/1/2021 and if the dependent ends the benefit in October, the Benefit End /Date would be 10/31/2021
        • Showing the Employees SSN that each Dependent is with
        • Showing the Dependent SSN and/or Birthdate

 

Questions / Resources

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Last Review: 12/2/2021 – Revision: 0.0

Applies To:  ACA Compliance

Keywords:  Dependent

Categories: Dependents; ACA Plan; Year End – 1095-C and Filing

KB14-091

 

 

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