Frequently Asked Questions
ACA Management Tool®
Q: What is the Patient Protection and Affordable Care Act?
A: The Patient Protection and Affordable Care Act (PPACA, or ACA) is a United States federal statute signed into law on March 23, 2010. It represents the most significant regulatory overhaul of the United States health care system since Medicare and Medicaid were passed in 1965. The ACA was enacted to increase the quality and affordability of health insurance, lower the uninsured rate by expanding private and public insurance coverage, and reduce costs of health care for individuals and the government. It consists of a combination of measures to accomplish these goals including Individual Mandates and Employer Mandates.
Q: What is the Employer Mandate?
A: Generally, the employer mandate specifies that employers must offer health insurance that is affordable and provides minimum value to 95% of their full-time employees and their children up to age 26, or be subject to penalties. It applies to employers with 50 or more full-time employees, and/or full-time equivalents (FTEs).
Q: How will my employee information be loaded into the ACA Management Tool®?
A: The ACA Management Tool integrates easily with any type of scheduling, payroll, or Human Resource Information System software. In just a few simple steps, your employee information will be securely uploaded to the ACA Management Tool. Your dedicated Customer Service Representative will assist you with implementation and maintenance & can answer questions regarding the ACA Management Tool or the Affordable Care Act.
Q: Will the ACA Management Tool® calculate my total FTE (full-time equivalent) count?
A: Yes. The ACA Management Tool is able to calculate your full-time employee and full-time equivalent employee counts.
Q: Will the ACA Management Tool® help me determine if I am an Applicable Large Employer?
A: Yes. After integrating your employee information in the ACA Management Tool, you can quickly and easily determine if Applicable Large Employer status applies. Additionally, you can immediately determine which employees qualify for coverage, track the employees that are approaching the threshold, and generate the necessary IRS forms for reporting.
Q: Why should I choose the ACA Management Tool®?
A: ACA Management Tool provides you with Tracking, Reporting, and Analysis tools in one easy to use package and gives you the Control and Knowledge needed to stay on TRACK® with healthcare reform & maintain compliance with the Affordable Care Act and IRS reporting regulations.
Q: What are the 1095-A, 1095-B and 1095-C forms and what is the difference?
A: These are the Affordable Care Act coverage reporting forms. The 1095-A will be sent to anyone that purchased health insurance through healthcare.gov. The 1095-B is available to anyone who purchased health insurance directly from an insurer, or if they received coverage through their small business employer (not subject to the employer mandate). The 1095-C will be sent to anyone that was offered or received health coverage from an Applicable Large Employer (subject to the Employer Shared Responsibility Provision).
Q: When are the 1094/1095 Affordable Care Act Forms due for Tax Year 2024?
A: The IRS deadlines for Tax Year 2024 are:
1095s postmarked to employees/responsible individuals: March 3, 2025
E-filing 1094/1095s to the IRS: March 31, 2025
Q: Will you mail the Form 1095s to my employees?
A: Subscribers to the ACA Management Tool® have the option to purchase our Print, Pack & Mail package for $2.25 per Form 1095 mailed on their behalf. We print the forms, tri-fold them, package them in a dual window envelope & mail them using First Class USPS postage. If any forms are not deliverable or marked return to sender, they are returned to the employer for further processing.
Q: Do I need to obtain my own TCC number?
A: No. You do not need to obtain your own TCC (Transmitter Control Code) number if you purchase a subscription to the ACA Management Tool®. All subscribers transmit the data required under IRS §6055 and §6056 directly from within their subscription via ACA GPS, LLC’s TCC. We are registered with the Internal Revenue Service’s (IRS) Affordable Care Act Information Returns (AIR) Program as both a transmitter and a developer.
Q: How are the ACA forms similar?
A: The ACA forms provide information about your health coverage during the previous year. Although you may receive more than one form, and they may come from different sources, they should all be kept with your tax records.
Q: Can your solution handle both measurement methods outlined in the Affordable Care Act regulation?
A: Yes. ACA Management Tool® allows an employer to track employees using either the Lookback Measurement Method or the Monthly Measurement Method. The system creates an audit trail by documenting all status changes at the employee level. The employer dashboard provides insight into employees that are near the threshold, at the threshold, or over the threshold of eligibility. The dashboard also alerts the employer to any upcoming events that are on the 30-day horizon (i.e. Measurement Period Ending, Administrative Period Beginning, IRS filing deadlines, etc.).
Q: Does your solution allow an employer to compare scenarios, assess the risk of penalties, and drill into details of specific employees that present penalty risks?
A: Yes. ACA Management Tool® provides employers with an overview and detailed analysis of their compliance status in regards to the Affordable Care Act regulation, including both Section 4980H(a) and Section 4980H(b) penalties. The user has the ability to compare scenarios for different categories of workers using both the Lookback and Monthly Measurement Methods. Employers can analyze data at the Company level, or any subdivision (department, location, region, etc) within the company. Additionally, an employer can drill down to the individual employee level for a detailed current and historical status report from multiple areas within the application.
Q: Can you transmit to the IRS?
A: Yes. ACA GPS has obtained a TCC (Transmitter Control Code) from the Internal Revenue Service’s (IRS) Affordable Care Act Information Returns (AIR) Program as both a transmitter and a developer. Subscribers to the ACA Management Tool® electronically file their 1094/1095 C (or B) forms to the IRS via ACA GPS’s TCC number. Employers do NOT need to apply for their own TCC number with the IRS. Subscribers do not need to conduct IRS testing or attempt to create an XML file.
Q: What is Minimum Essential Coverage (MEC)?
A: The IRS provides detailed guidelines regarding Minimum Essential Coverage requirements. Click here to view the chart provided by the IRS.
Q: Where can I find instructions on mailing the forms to the IRS?
A: Instructions for shipping & mailing the forms to the IRS are available through these links: 2021 Instructions for Forms 1094-C and 1095-C or 2021 Instructions for Forms 1094-B and 1095-B
Q: Where can I find instructions on electronically filing the forms to the IRS?
A: Instructions for electronically filing the forms to the IRS are available through these links: 2021 Instructions for Forms 1094-C and 1095-C or 2021 Instructions for Forms 1094-B and 1095-B.
However, if you subscribe to the ACA Management Tool®, you do NOT need to apply for a TCC number with the IRS. There is no need for you to conduct IRS testing or attempt to create an XML file. ACA GPS is authorized to transmit all 1094/1095 B and C submissions to the IRS for private businesses, government entities, and insurance companies.
For all 5 previous Tax Years, 100% of ACA Management Tool® subscribers met the deadlines for distribution of the 1095 forms and electronic filing of the 1094/1095 forms with the IRS. Additionally, those subscribers that received “TIN/SSN Validation Error” messages were able to correct and resubmit to the IRS in a timely manner, at no additional cost to the employer.
- No TCC needed
- No IRS testing needed
- No XML file needed
- Guaranteed submission to the IRS
- One Tool® does it all – the ACA Management Tool®
Q: Where can I get more information on the IRS and the ACA?
A: The IRS website contains information regarding the Affordable Care Act, including guidelines and FAQs for individuals and employers, on their website. For more information on the Affordable Care Act, you can visit the US Department of Health & Human Services website.
Resources:
- Health Insurance Marketplace
- Internal Revenue Service: “Employer Shared Responsibility”
- Internal Revenue Service: “Q & A on Employer Shared Responsibility”
- Internal Revenue Service: “Affordable Care Act Tax Provisions”
- U.S. Department of Health & Human Services: General Info
- The Henry J. Kaiser Family Foundation: “Summary of the Affordable Care Act”
- The Bill: “Patient Protection and Affordable Care Act”
- Federal Register: “Shared Responsibility for Employers Regarding Health Coverage”