As the year winds down, HR teams are once again preparing for ACA reporting season. While the official IRS deadlines may still be months away, early fall is the most important time to review and reconcile employee data to ensure accurate Form 1095-C reporting. Delays or inaccuracies in updating hours, eligibility, or plan elections can easily snowball into compliance issues, resulting in costly penalties or time-consuming corrections in the new year.
The Affordable Care Act’s employer mandate requires applicable large employers (ALEs) to offer affordable, minimum essential coverage to eligible full-time employees and to accurately report this information to the IRS. Meeting these requirements depends on maintaining precise and up-to-date data throughout the year. Even small delays, such as a missed eligibility change or a late update to a new hire’s hours, can cause discrepancies between HR, payroll, and benefits records. These inconsistencies often become evident only when the 1095-C forms are being prepared, leaving little time to make corrections.
Now is the ideal time for HR departments to conduct a data audit to verify that everything in the system reflects the current workforce. This review should include:
- Employee Classification and Hours
Confirm that all employees are correctly categorized as full-time, part-time, or variable-hour based on actual hours worked. Review measurement and stability periods for variable-hour employees to ensure accurate full-time status determinations. A delay in reclassifying an employee can lead to an incorrect 1095-C offer-of-coverage code or a missed offer of coverage.
- Hire and Termination Dates
Cross-check hire and termination dates across HR, payroll, and benefits systems. Even small mismatches, like a termination date entered one pay period late, can create discrepancies in months of reported coverage and cause inaccurate reporting for Line 14 or 16 of the 1095-C form.
- Offer-of-Coverage Records
Verify that all eligible employees received an offer of health coverage and that the offer dates are accurately documented. Ensure any changes in plan eligibility, such as moving from a waiting period to active coverage, are reflected in the system.
- Plan Elections and Coverage Changes
Review plan enrollment data for accuracy. Employees who changed coverage levels, added or removed dependents, or waived coverage during the year should be correctly reflected in both HR and carrier files. Late updates here can result in incorrect or missing months of coverage on the 1095-C form.
- Dependent and Social Security Number Accuracy
Ensure dependent information, including SSNs and birthdates, is complete and correct. Missing or invalid data can cause IRS rejections or additional data validation requests later in the process.
- Payroll and Premium Contributions
Confirm that the payroll system aligns with the benefits data for premium deductions and affordability calculations. Misalignment can cause inaccurate affordability coding on Form 1095-C.
Addressing these data points early gives HR teams time to correct issues before the reporting process begins. Waiting until January to resolve inconsistencies often means working under pressure while juggling open enrollment wrap-up and year-end payroll tasks.
Taking a proactive approach now also helps avoid potential IRS penalties. Late or inaccurate 1095-C filings can result in fines per employee, and missing offers of coverage to eligible full-time employees can trigger Employer Shared Responsibility Payments. Ensuring that employee data is current and consistent across all systems is the best way to demonstrate compliance and reduce risk.
By reviewing ACA-related data this fall, HR teams can enter the new year confident that reporting will be accurate, timely, and far less stressful. Early preparation not only supports compliance but also strengthens internal data integrity and efficiency across HR and benefits operations.
Benefit Allocation Systems (BAS) provides best-in-class, online solutions for: Employee Benefits Enrollment; COBRA; Flexible Spending Accounts (FSAs); Health Reimbursement Accounts (HRAs); Leave of Absence Premium Billing (LOA); Affordable Care Act Record Keeping, Compliance & IRS Reporting (ACA); Group Insurance Premium Billing; Property & Casualty Premium Billing; and Payroll Integration.
MyEnroll360 can Integrate with any insurance carrier for enrollment eligibility management (e.g., Blue Cross, Blue Shield, Aetna, United Health Care, Kaiser, CIGNA and many others), and integrate with any payroll system for enrollment deduction management (e.g., Workday, ADP, Paylocity, PayCor, UKG, and many others).
This article is for informational purposes only and is not intended as legal, tax, or benefits advice. Readers should not rely on this information for taking (or not taking) any action relating to employment, compliance, or benefits. Always consult with a qualified professional before making decisions based on this content.
