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1095 Export Data Validation PROCESS FOR REVIEWING THE ACA 1095 EXPORT REPORT

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Page 1: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

1095 Export Data Validation

PROCESS FOR REVIEWING THE ACA 1095 EXPORT REPORT

Page 2: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

ACA 1095 Data Validation Process Page 2 of 20 Updated by D W MOORE Last Updated: 04/13/2018

1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export report. Here are the steps for running this report:

1. Log into Benefitsolver. 2. Click on Reports in the navigation toolbar and select Standard Reports.

3. Select ACA 1095 Export from the Report Type dropdown menu. 4. Assign All structure groups (for your division). Located under the available groups

window in blue. 5. Run Dates should be 01/01/209 - Last Day of Last Month. If you are validating your data

on 9/6/2019 you would use 8/31/2019 and so on. 6. Click Generate Report.

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Page 3: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

ACA 1095 Data Validation Process Page 3 of 20 Updated by D W MOORE Last Updated: 04/13/2018

SPECIAL NOTE ON DATA BATCHING!

The ACA 1095 Export reports data available as of the latest monthly data batch. Benefitsolver batches 1095 ACA data on a monthly basis on the 5th of the month. This means if you run the ACA 1095 Export report on November 15th, you will only see data as of the last batch that ran on November 5th.

Benefitsolver batches one month behind. This means the batch ran on November 5th is actually batching the data from October and adding it to the data set. If you run the report on December 6th, however, the report would then include November’s data.

The ACA 1095 Export report will be in a Queued status on the Reports Dashboard. When it has successfully run, you will receive an e-mail notification. You may simply refresh the page by clicking the Dashboard tab or navigate back to the Reports Dashboard to access the finished report. Simply click the report name to open.

Page 4: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

ACA 1095 Data Validation Process Page 4 of 20 Updated by D W MOORE Last Updated: 04/13/2018

Using the ACA 1095 Export, review the data to ensure it meet your needs. Here are a few steps that you can perform to validate your data.

7. Organize the data on the report to only look at members that need to file for the reporting year.

8. Confirm the data set includes records for all employees that should be reported. 9. Confirm the data set includes records for all dependents that should be reported. 10. Look for blank fields of data within the data set on the report.

Note! You may have blanks reported in the Safe Harbor column (column Q) if all other available codes do not apply. If a value of UN (“Undetermined”) indicates the data in Benefitsolver has an output for multiple codes. The employer must select the appropriate code in the scenario.

Note! You may have blanks reported in the Minimum Premium Amount Offered to Employee at Employee Only Rate column if no other data applies.

11. Confirm the codes represent what you wish to report for Offer of Coverage Code (column O; defaulted at 1A), Minimum Premium Amount Offered to Employee at Employee Only Rate (column P; defaulted at 0), and Safe Harbor Code (column Q; defaulted at 2C).

12. Confirm the appropriate FEIN value (N) is present for each employee and dependent. 13. Confirm that you see the correct number of reporting months per employee and

dependents. The reporting month is the column labeled “Month”. The numbers indicate the month of the year. For example: 1 is Jan, 2 is Feb, 3 is March and so on.

14. Confirm that self-insured indicator (column S) is “s” since this is a self-funded plan.

Note: If the employee was not covered for a month then the self-funded indicator needs to be blank or it may generate a 1095 form when it should not.

15. Confirm that the Coverage indicator (column AD) is populated with an N or Y for covered No or covered Yes. This, in conjunction with the Self-Insured Indicator will determine coverage indicators on the printed 1095.

Page 5: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

ACA 1095 Data Validation Process Page 5 of 20 Updated by D W MOORE Last Updated: 04/13/2018

Figure 1: A sample output of the ACA 1095 Export report. Please note, the above image contains fictitious data and is not real employee information. There is also additional information further to the right of the above

screenshot that is vital to the 1095 Data Validation.

As you review, if you find items that need correction or you wish to present different codes for Offer of Coverage or Safe Harbor, make the appropriate corrections directly on the ACA 1095 Export report. Complete your review and updates/corrections then save the document as a Comma Delimited Value file, (.csv). Do not send corrections via e-mail. Please reach out to your Client Centric Team for the preferred method of submitting the updates.

Page 6: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

ACA 1095 Data Validation Process Page 6 of 20 Updated by D W MOORE Last Updated: 04/13/2018

Appendix: 1095 Code Rules and Derivation Logic WHAT THE OFFER OF COVERAGE CODES MEAN:

SPECIAL NOTE FOR LINE 14

If we aren’t able to determine if coverage was offered to a member, the Benefitsolver system will use code 1H as it assumes there was no offer. This will effect clients who are currently not using Benefitsolver for benefit administration services (Stand Alone ACA).

Page 7: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

ACA 1095 Data Validation Process Page 7 of 20 Updated by D W MOORE Last Updated: 04/13/2018

WHAT THE SAFE HARBOR CODES MEAN

CODES THAT BUSINESSOLVER CAN SUPPPORT

Page 8: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

ACA 1095 Data Validation Process Page 8 of 20 Updated by D W MOORE Last Updated: 04/13/2018

HOW BUSINESSOLVER DETERMINES OFFER CODES

DATA REQUIREMENTS THAT WE NEED TO DETERMINE OFFER CODES (FOR 1095 STAND ALONE EMPLOYEE GROUPS):

Page 9: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

ACA 1095 Data Validation Process Page 9 of 20 Updated by D W MOORE Last Updated: 04/13/2018

HOW BUSINESSOLVER DETERMINES SAFE HARBOR CODES

DATA REQUIREMENTS THAT WE NEED TO SAFE HARBOR CODES (FOR 1095 STAND ALONE EMPLOYEE GROUPS):

Page 10: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

ACA 1095 Data Validation Process Page 10 of 20 Updated by D W MOORE Last Updated: 04/13/2018

EXPLANATION OF BUSINESSOLVER CODE DERIVATION:

Page 11: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

ACA 1095 Data Validation Process Page 11 of 20 Updated by D W MOORE Last Updated: 04/13/2018

Step 2 How to Review ACA 1095

IRS Dashboard

ACA 1095 IRS Dashboard Review This process outlines out to review the ACA IRS Dashboard and verify setup of profiles for each FEIN. Teams and clients are encouraged to review each profile setup thoroughly prior to employee statements being generated and employer data being transmitted to the IRS during the 1st Quarter.

NOTE: An IRS Dashboard Profile must be created for each necessary filing based on a company’s corporate structure. The client will need to notify Businessolver how they must file for 1094/1095 reporting purposes. We suggest that all clients consult with their legal counsel and tax attorney to ensure proper filing.

Process Overview Step Owner Description

1 Client Admin 16. Access the ACA IRS Dashboard 17. Navigate to the ACA Dashboard

2(a) Client Admin 18. Review Profile Setup for “B” Form Filing (small employers with self-insured medical plans)

19. Click on appropriate profile to review errors 20. Review each category within the profile

2(b) Client Admin 21. Review Profile Setup for “C” Form Filing (large employers) 22. Review error(s) 23. Determine how to correct error(s) 24. Correct error(s)

3 Client Admin 25. Preview Sample 1095 Forms to QA 26. Go to Member Record 27. Preview 1095 Form

Page 12: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

ACA 1095 Data Validation Process Page 12 of 20 Updated by D W MOORE Last Updated: 04/13/2018

Process How-To Step 1: Access the Dashboard

1. Under Administration, select ACA Administration 2. Select ACA IRS Dashboard from the dropdown

3. Choose the appropriate Reporting Year and Profile from the respective dropdowns

Page 13: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

ACA 1095 Data Validation Process Page 13 of 20 Updated by D W MOORE Last Updated: 04/13/2018

Step 2(a): Review Profile Setup for “B” Form Filing (small employers with a Self-Insured medical plan)

Basic Information

This tab includes information about the profile as a whole, along with what services Businessolver is providing for that particular profile.

B Form Information

This tab includes information about the company being reported within this filing.

28. 1) Plan Month – This relates to the

employer’s Plan Year 2) Profile Name 3) Plan Sponsor 4) FEINs – the appropriate FEIN(s)

should be listed that are filing together. These are pulled directly from Company Information, Billing Setup, or unique FEINs available on individual member records.

5) Will BSC be sending data to the IRS?

6) Will BSC be creating 1095 statements for employees?

7) Will BSC be printing and mailing 1095 statements for employees?

8) IRS Forms – B or C forms are selected, depending on size of company

9) Template for Employee Statements – appropriate standard template is selected

10) Template for Employer Statement – appropriate standard template is selected

11) Safe Harbor – if applicable, appropriate default Safe Harbor option selected

Page 14: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

ACA 1095 Data Validation Process Page 14 of 20 Updated by D W MOORE Last Updated: 04/13/2018

Page 15: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

ACA 1095 Data Validation Process Page 15 of 20 Updated by D W MOORE Last Updated: 04/13/2018

Page 16: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

ACA 1095 Data Validation Process Page 16 of 20 Updated by D W MOORE Last Updated: 04/13/2018

Step 2(b): Review Profile Setup for “C” Form Filing (large employers)

Basic Information

This tab includes information about the profile as a whole, along with what services Businessolver is providing for that particular profile.

30.

29. 1) Plan Month – This relates to the

employer’s Plan Year 2) Profile Name 3) Plan Sponsor 4) FEINs – the appropriate FEIN(s)

should be listed that are filing together. These are pulled directly from Company Information, Billing Setup, or unique FEINs available on individual member records.

5) Will BSC be sending data to the IRS?

6) Will BSC be creating 1095 statements for employees?

7) Will BSC be printing and mailing 1095 statements for employees?

8) IRS Forms – B or C forms are selected, depending on size of company

9) Template for Employee Statements – appropriate standard template is selected

10) Template for Employer Statement – appropriate standard template is selected

11) Safe Harbor – if applicable, appropriate default Safe Harbor option selected

Page 17: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

ACA 1095 Data Validation Process Page 17 of 20 Updated by D W MOORE Last Updated: 04/13/2018

C Form Data Parts I and II

This tab includes information about the company being reported in this filing.

Page 18: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

ACA 1095 Data Validation Process Page 18 of 20 Updated by D W MOORE Last Updated: 04/13/2018

Page 19: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

ACA 1095 Data Validation Process Page 19 of 20 Updated by D W MOORE Last Updated: 04/13/2018

C Form Data Part III

This tab includes information about the company’s offer of coverage; FT Employee Counts; Total Employee Counts; if they were part of an aggregated group during a specific month; and 4980H Transition Relief Indicator.

Note! Prior to Validating or Transmitting you will need to load employee counts. The Load Employee Counts button is at the bottom left. It should be utilized each year to update counts.

Transition Relief Indicator: If the employer certifies by selecting Section 4980H Transition Relief that it is eligible for Section 4980H Transition Relief and is eligible for the 50 to 99 Relief, code A should be selected. If the employer certifies by selecting Section 4980H Transition Relief that it is eligible for Section 4980H Transition Relief and is eligible for the 100 or More Relief, code B should be selected. An employer will not be eligible for both types of relief.

C Form Data Part IV: Only completed if employer is part of an Aggregated ALE Group

This tab includes information about other members of the employer’s Aggregated ALE Group. Employers should enter the members of the ALE group with the highest monthly average number of full-time employees. Employer must also complete Part III and indicate which months it was a part of an Aggregated ALE Group.

Page 20: 1095 Export Data Validation - ACEC Life Health Trust · 2018. 4. 13. · 1095 Data Review Process To audit your 1095 data within Benefitsolver, you will need to run the ACA 1095 Export

ACA 1095 Data Validation Process Page 20 of 20 Updated by D W MOORE Last Updated: 04/13/2018

Step 3: Preview Sample 1095 Forms to QA

1. Navigate to Member record 2. Select 1095 Reporting Info from member dropdown menu 3. Select appropriate Reporting Year 4. Click Preview to view sample 1095 form that would be generated based on Profile setup.