As ACA regulations become more complicated, CAPS is dedicated to helping our clients stay informed and in compliance with all employer responsibilities and obligations.
We understand that every client’s employee demographics and employer responsibilities are different. The ACA administrators at CAPS can help you manage those responsibilities by providing customized reports based on your specific data and requirements for staying compliant with current regulations.
CAPS offers a robust marketplace of coverage options for individual employees. Employees can select personalized benefit plans from a variety of choices covering medical, dental, and vision, as well as home, auto, accident, and long-term care. A useful subsidy calculator allows employees to compute costs in real time.
EMPLOYER SHARED RESPONSIBILITY (EMPLOYER MANDATE) PROVISION
Please use this table to understand whether you will need to make an offer of health care coverage and whether you are required to file the informational returns with the IRS in 2016.
|Employer Size||Employer Mandate Responsibility||Filing Responsibility|
|Small Employer (0-49)||Exempt||Exempt unless you offered coverage through a self-funded health plan|
|Medium Employer (50-99)||Required to offer health care coverage to 95% of your full-time employes beginning in 2016||Forms 1094 & 1095|
|Large Employer (100+)||Required to offer health care coverage to at least 70% of your full-time employes in 2015 95% in 2016||Forms 1094 & 1095|
For example, if an employer has 48 full-time employees and determined that they have 4 FTE’s, they are considered an ALE and must offer health care coverage to their eligible employees.
Information returns (forms 1094-B & C and 1095-B & C)
Small = 0-49 FTE's
Large = 50+ FTE's
|Employer Health Plan||Employer Files
Forms 1094-B /
Forms 1094-C / 1095-C
|Small Employer||Fully Insured||No (Insurer Files)||No|
|Small Employer||Self-Insured||Yes (Parts I, III, and IV on Form 1095-B)||No|
|Small Employer||Multiemployer Plan||Yes (Parts I, III, and IV on Form 1095-B)||No|
|Large Employer||Fully Insured||No (Insurer Files)||Yes (Parts I, II on Form 1095-C)|
|Large Employer||Self Insured||No||Yes|
|Large Employer||Multiemployer Plan||No (Insurer Files)||Yes (Parts I, II on Form 1095-C)|
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