Archive for the ‘ACA’ Category

Perfect Attendance! How to Handle Leaves of Absence under the ACA | Panama City Employee Benefits

October 12th, 2015 by Clemons

By Danielle Capilla, Chief Compliance Officer at United Benefit Advisors

The Patient Protection and Affordable Care Act (ACA) requires applicable large employers (ALEs) to offer full-time employees health coverage, or pay one of two employer shared responsibility penalties. An ALE is an employer with 50 or more full-time or full-time equivalent employees (for 2015, this threshold is 100). A full-time employee is an Counting employeesemployee who works 30 hours or more a week.

Leaves of absence can make it difficult for an employer to determine if or how an employee counts toward the ALE threshold of 100, as well as determining if an employee is considered full time and must be offered coverage.

Under the ACA, any hour for which an employee is paid or entitled to payment must be counted as an hour of service. This includes:

  • An hour worked
  • Vacation
  • Holiday
  • Sick time
  • Incapacity (including disability)
  • Layoff
  • Military duty
  • Paid leave

Exceptions to the rule exist for:

  • Hours worked by a student as part of the Federal Work-Study Program (or a similar state or local program)
  • Hours which are considered income from sources outside the United States
  • Hours performed as a “bona fide volunteer”

For hourly employees, an employer must count actual hours worked or paid.

For employees who are not paid hourly, an employer must use any of these three methods:

  • Counting actual hours worked or for which vacation, holiday, etc. are paid
  • Crediting an employee with eight hours’ work for each day for which the person was paid for at least one hour of work, vacation, holiday, etc.
  • Crediting an employee with 40 hours’ work for each week for which the person was paid for at least one hour of work, vacation, holiday, etc.
  • An employer using a crediting system must be careful not to underestimate an employee’s hours. For instance, an employer may not use the eight hour method for an employee who works 10 hours a day, three days a week.

As a general rule, if an employee terminates employment or is terminated from employment (not a layoff) and is rehired within 13 weeks (26 weeks for individuals working for an educational institution), or has unpaid non-FMLA (Family and Medical Leave Act) leave and returns to work within 13 weeks, the employee’s status as either full-time or non-full time must be reinstated, and he or she cannot be treated as a new hire, subject to a waiting period. Coverage must resume by the first of the month on or following the date the employee returns to work.


Request UBA’s ACA Advisor, “Perfect Attendance! How to Handle Leaves of Absence under the ACA” for comprehensive help with:

  • Methods for counting hours to determine full-time status (including educational institutions)
  • FMLA, USERRA, and jury duty
  • Unpaid leave
  • Layoffs
  • Disability
  • Conveying policies
  • Determining ALE status
  • Crediting hours to employees


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Affordable Care Act Information Returns | Panama City Employee Benefits

September 17th, 2015 by Clemons

By Danielle Capilla, Chief Compliance Officer at United Benefit Advisors

Under the Patient Protection and Affordable Care Act (ACA), individuals are required to have health insurance while applicable large employers (ALEs) are required to offer health benefits to their full-time employees. In order for the Internal Revenue Service (IRS) to verify that (1) individuals have the required minimum essential coverage, (2) individuals who request premium tax credits are entitled to them, and (3) ALEs are meeting their shared responsibility (play or pay) obligations, employers with 50 or more full-time or full-time equivalent employees and insurers will be required to report on the health coverage they offer. (If ALEs are not offering coverage, they will have to report on that, too).

Reporting will first be due early in 2016, based on coverage in 2015. All reporting will be for the calendar year, even for non-calendar year plans. Mid-size employers (those with 50 to 99 employees) will report in 2016, despite being in a period of transition relief in regard to having to offer coverage. The reporting requirements are in Sections 6055 and 6056 of the ACA. Sections 6055 and 6056 reporting is done on IRS Forms 1094-C, 1095-C, 1094-B, and 1095-B.

For calendar year 2015, the required forms must be filed by February 29, 2016, or March 31, 2016, if filing electronically. Employers with 250 or more 1095 Forms must file electronically with the “Affordable Care Act Information Returns” or AIR. The IRS is encouraging all entities to file electronically. Employers utilizing a vendor service should confirm that the service they are using can handle the act of reporting, electronic or otherwise. Employers using a vendor should confirm that their chosen vendor is set up to file the returns for them, and have or will have successfully completed the testing phase. Employers who wish to use a vendor instead of filing themselves should be aware that many of the reporting vendors have a capped amount of clients they can assist.

Employers who are doing their own electronic filing should ensure they are ready to use the AIR system. Being ready to use the system is a time-consuming process; ample time should be given to ensure an employer is up and running.

For detailed information on the steps employers should follow to use AIR, download UBA’s ACA Advisor, “Affordable Care Act Information Returns”


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