ACA full-time employees:
ACA full-time employees are employees who work on
average of at least 30 hours a week.
130 hours of service in a calendar month is treated as the monthly equivalent of 30 hours of service per week.
Employer provided health benefits:
Generally, employer provided health benefits are not
taxable when provided to the employee, spouse, or
dependents, unless for domestic partners or purchase
of taxable benefits.
Employer Shared Responsibility:
Employer Shared Responsibility is the ACA’s provision
for certain employers to offer either minimum essential
health coverage to full-time employees that is
affordable and provides minimum value, or potentially
make an employer shared responsibility payment to
the IRS.
Form 1095-C Line14 reports:
Form 1095-C Line 14 reports the offer of health
coverage to an employee for each month to which
coverage applies. The All 12 Months box is used if the
indicator code is the same for every month of the year.
Where are HSA contributions reported on the W-2?
Health Savings Account contributions are reported on
Form W-2 in Box 12 with Code W. Contributions
reported include employer contributions and employee
contributions in a §125 cafeteria plan.
Health Savings Accounts eligibility:
Health Savings Accounts may be established by
individuals covered by a high deductible health plan
defined as having an annual deductible above the
established limits.
Form W-2 Box12 Code DD reports:
The total cost of employer-provided health coverage
provided during the calendar year.
Health coverage nondiscrimination:
Third-party insurance company provided plans have no
nondiscrimination requirements.
Self-insured plans reimbursing employees’ medical expenses may not
discriminate in favor of highly compensated employees.
How areHRAs taxed?
Health Reimbursement Arrangements (HRA) are health plans whose contributions and reimbursements are excluded from income.
How is Box12 Code DD calculated?
The amount reported in Form W-2 Box 12 Code DD is calculated by using the premium charged, COBRA applicable premium, or modified COBRA premium methods.
Reimbursed COBRA premiums:
Reimbursed COBRA premiums are excluded from
income to maintain coverage for current or former
employees. Premiums can be paid to an insurance
company or directly to the employee with
substantiation.
Reimbursed medical expenses:
Reimbursed medical expenses are excluded from an
employee’s income to the extent they do not exceed
actual expenses and the medical care is provided (with
no future or anticipated expenses).
Traditional Health Maintenance Organization (HMOs)
Under the traditional scheme, an HMO has its own
health care facility or facilities, and patients (for
example, employees and their families) receive medical
services at the HMO’s facilities.
What are Health Savings Accounts?
Health Savings Accounts (HSA) are tax-exempt trusts or custodial accounts created exclusively to pay the account holder’s qualified medical expenses.
What are medical expenses?
Medical expenses include qualified medical expenses, prescribed and over-the-counter medications, drugs, or insulin. Nonqualified expenses: reimbursement of premiums for health plans.
What is COBRA continuation?
COBRA continuation is the continuation of health
coverage after the loss of coverage by an employee or
dependent in a qualifying event for a certain period of
time.
What is an ALE?
An applicable large employer has 50 full-time
employees in the prior calendar year and can be
subject to the employer shared responsibility penalty
under the ACA.
What is an HRA?
A Health Reimbursement Arrangement (HRA) is a plan
solely funded by an employer, reimbursing employee
medical expenses up to a maximum dollar amount.
What is Form 1094-C?
Form 1094-C, Transmittal of Employer-Provided
Health Insurance Offer and Coverage Information
Return, is filed with the IRS with Forms 1095-C
documenting health coverage information.
What is Form 1095-C?
Form 1095-C, Employer-Provided Health Insurance
Offer and Coverage, is filed with the IRS and furnished
to full-time employees documenting the employer’s
offer of health coverage.
When is Form 1095-C due?
Form 1095-C is furnished to employees by January 31.
It is filed with the IRS on paper by February 28 or electronically by March 31.
HMO Point-of-Service (POS) plan
Allows covered employees and their dependents to use non-HMO health care providers (in network), with the inclusion of deductibles and insurance copayments.
Preferred Provider Organization (PPO)
health care delivery system giving participants a choice of a higher level of benefits and lower out-of-pocket costs if they use doctors who are part of the PPO’s network.
What are the deductibles for a High Deductible Health Plan (HDHP)?,
annual deductible of at least:
$1,650 for self-only coverage or
$3,300 for family coverage
and has an out-of-pocket expense limit of no more than:
$8,300 for self-only coverage
$16,600 for family coverage
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Module 192
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Module 3130
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Module 291
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W-2 Box 12 Codes31
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Taxable or Nontaxable Wages34
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Tips, Rates, Formulas81
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Module 4102
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Module 549
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Module 697
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Module 748
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Module 834
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Module 913
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Module 1015
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Forms143
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Calculating Pay13
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Calculating Federal Income Tax18
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Calculating Social Security and Medicare Taxes3
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IRS Publication 15-T7
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W-2 Copies & Boxes34
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941 Reporting29
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Payroll Source Book Questions595
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Combined Notes392
