You must create at least one employer record with a tax year and control number before you create employee 1095s.
Menu Path
From the Human Resources menu, select Periodic Routines. In the Affordable Care Act section, select 1095 Maintenance. From the action bar, select Setup Employer.
Manage Employer Records
Add a Record
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On the Setup Employer page, select New.
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On the Employer tab, select the Tax Year from the drop-down list. This defaults to the current system year.
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Enter a unique Control Number for the employer record. The tax year and control number combine to identify a work file when you create employee 1095s.
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Enter the fields on the Employer tab as required. For details, refer to the Fields section.
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If your organization is eligible for 1095-B status and you want to file Form 1095-B, select the 1095-B checkbox.
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If your organization is a Designated Government Entity (DGE), select the Designated Government Entity tab and fill in the information. None of these fields are required.
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On the Monthly Information tab, you can fill in the data for your Minimal Essential Coverage (MEC) Offer Indicator, Full-Time and Total Employee Count, Aggregated Group, and Section 4980H Transition Relief. You can indicate whether this information applies to the full year or changes by month. Refer to the Fields section for more information on the fields and checkboxes in this tab. For 1095-B organizations, this section is not required.
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If your organization is part of an Aggregated Applicable Large Employer Group (ALE), select the Aggregated ALE Group tab. As per the IRS, if your organization was a member of an Aggregated ALE Group for any month of the calendar year, you must report the names and EINs of up to 30 of the other Aggregated ALE Group members in order of size, descending from largest. For 1095-B organizations, this section is not required.
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On the Pay Information tab, enter the Pay Groups to be considered for the Full Time Employee Count Calculation. Enter * (asterisk) to include all pay groups. Select the Calculation Date: C-Check Date, S-Pay Start Date, or E-Pay End Date. Enter the Pay Runs for Total Employee Count Calculation. Pay runs must include the 12th of the month for which they are entered. Pay runs must be separated by a pipe (|) symbol. Do not use a comma (,). For example 123|A98.
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Select Accept to save.
Edit a Record
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Choose the 1095 Employee File Update page and select Setup Employer to display the ACA 1095 Maintenance Setup page.
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On the ACA 1095 Maintenance Setup page, enter search criteria to search for the employer record you wish to edit.
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In the List section, select the record you wish to edit, then select OK.
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You can edit any field on the tabs of the employer record.
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Select OK to save or Back to abandon changes.
Delete a Record
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Choose the 1095 Employee File Update page and select Setup Employer to display the ACA 1095 Maintenance Setup page.
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On the ACA 1095 Maintenance Setup page, enter search criteria to search for the employer record you wish to delete.
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Select the record, then select Delete.
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If a 1095 work file containing records has already been created for the given year and control number, an error page displays and you cannot delete the record. You must first use the Purge option to delete the 1095 records before deleting the employer record.
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If no 1095 work file has been created for the selected tax year and control group, a confirmation will display. Select Yes to delete or No to cancel the delete.
Select Calculation Method
From this page, you can also determine the method to create the 1095 records. The Use Deduction Benefits Date and Use Benefits Module checkboxes on the Employer record determine if your organization uses the Deduction Benefit Effective Date method or the Benefits Module Record. You can choose one or the other of these checkboxes. If you choose neither, the 1095 records are generated with the Check History method.
The information regarding the employer name, certificates of eligibility, and tabs other than the Employer tab is included in the 1094 transmittal.
You can also set your organization with 1095-B status. New for 2020, organizations with fewer than 50 full-time employees are eligible. This reduces submission requirements for organizations and has the software produce the 1095-B form.
If your organization is eligible for 1095-B status, it is optional. You may continue to file the 1095 form if you wish.
How the system determines monthly coverage
When you run the Create Employee 1095 process, the system evaluates each calendar month of the tax year and determines the appropriate benefit group and coverage offer for each employee. The calculation method you select on this page controls the data source the system uses to make that determination.
The system stores one benefit group code per calendar month in the employee 1095-C record (January through December). These monthly benefit group values correspond to the benefit group codes defined in Benefit Group Maintenance and drive the offer codes and employee share amounts reported on Form 1095-C, Line 14 and Line 15.
Determination logic by calculation method
Check History method (neither checkbox selected)
The system uses the ACA Hours Tracking table and active payroll deduction records to determine monthly coverage.
For each month:
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The system identifies the employee's active payroll deductions that have a matching record in the Benefit Status Table.
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The system assigns the plan status based on the highest-priority deduction active in that month. Priority order is Q (Qualified) first, then D (Declined Qualified Plan), then N (Non-Qualified).
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Using the plan status and the Benefit Group Maintenance records, the system assigns the benefit group for that month.
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If no matching deduction is found, the month receives no coverage (offer code 1H — No offer of coverage).
Use Deduction Benefits Date method (Use Deduction Benefits Date checkbox selected)
The system uses the Benefit Effective Date and Deduction Stop Date fields in employee payroll deduction records to determine which months the employee had active coverage.
For each month:
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The system checks whether the Benefit Effective Date falls on or before the last day of the month and the Deduction Stop Date (if present) falls on or after the first day of the month.
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If the deduction is active for any portion of the month using the benefit effective date range, the system assigns the coverage for that month.
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If the benefit effective date is blank or the deduction stop date falls before the start of the month, that month receives no coverage.
Use this method when your organization tracks the benefit effective date separately from the payroll deduction start date, and when that date more accurately reflects the employee's coverage start.
Use Benefits Module method (Use Benefits Module checkbox selected)
The system uses the Employee Benefits System to determine monthly coverage. This method requires the Employee Benefits System module and the Benefits checkbox selected on the Human Resources Profile.
For each month:
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The system retrieves the employee's active benefit enrollments from the Benefits module for each month.
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Covered individuals (dependents) are also retrieved from the Benefits module for self-insured employers.
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The benefit group for each month is determined based on the active benefit plan enrollment in the Benefits module.
Use this method when your organization maintains benefit enrollments in the Employee Benefits System and wants those enrollments to automatically drive 1095-C coverage reporting.
What happens when no benefit group is determined for a month
If the system cannot determine a benefit group for a given month, the month is left blank on the 1095-C record. A blank month does not suppress the row on Form 1095-C — the system reports offer code 1H (No offer of coverage) for that month. Review the 1095-C records for any employees with unexpected blank months, and update the records manually as needed before filing.
Employees terminated mid-year
The system uses the employee's termination date to determine the months the employee was not working. Months after the termination date will not receive a benefit group from the automated create process. For reporting purposes, offer code 1H is used for months in which employment was not active. Verify that termination dates are recorded accurately before running the Create Employee 1095 process.
Your organization may use a combination of calculation methods by creating separate employer control number records, each with a different method. Be careful not to create duplicate 1095-C forms for a single individual when using multiple control numbers.
Steps to Take on This Page
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Set up an employer record using a specific tax year and control number.
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Determine, on the employer record, what method your organization plans to use to create the 1095 (check history, deduction, or benefits module).
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Store other information for the 1094 transmittal. If desired, you may set up multiple control numbers to allow 1095 creation in different ways for dependent groups.
Action Bar Items
The following items display on the Action Bar under specific conditions:
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Item |
Description |
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Calculate Full-Time Employee Count |
Select to calculate the full-time employee (FTE) count. This calculation requires accurate ACA Hours Tracking table records. It also requires the Pay Groups section of the Pay Information tab, and Tax Year and Calculation Date fields in the Employer tab to determine which records to process and calendar month fields update. This Action Bar item is available based on the following conditions:
The calculation performs as follows: The program checks hours worked by each employee per month. If an employee worked more than 130 hours in a month, one is added to the FTE Count. Hours worked less than 130 in a month are added to the total hours worked. Each month's sum of hours worked is divided by 120. That result is added as FTE count. This is added to the already-counted FTEs to be collected as that month's Full-Time Employee Count in the Monthly Information tab. Manual edits to the Total Full-Time Employee Count fields will be overwritten by this program calculation. |
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Calculate Total Employee Count |
Select to calculate the total employee count. This updates the Total Employee Count column on the Monthly Information tab with the number of checks processed for that month. This calculation requires accurate pay run numbers containing checks that include the 12th of each month in the month’s pay run fields on the Employer Record's Pay Information tab. Check history records must also be accurate and not voided. This Action Bar item is available based on the following conditions:
The calculation performs as follows: The program reviews records and counts accurate matches. These totals will fill the Total Employee Count month fields in the Monthly Information tab. Manual edits to the Total Employee Count fields will be overwritten by this program calculation. |
Calculate Full-Time Employee Count
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Choose the 1095 Employee File Update page and select Setup Employer to display the ACA 1095 Maintenance Setup page.
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On the ACA 1095 Maintenance Setup page, enter search criteria to search for the employer record you wish to edit.
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In the List section, select the record you wish to edit and then select OK.
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On the Action Bar, select Calculate Full-Time Employee Count. Refer to the Action Bar Items section for a description of the calculation.
Calculate Total Employee Count
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Choose the 1095 Employee File Update page and select Setup Employer to display the ACA 1095 Maintenance Setup page.
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On the ACA 1095 Maintenance Setup page, enter search criteria to search for the employer record you wish to edit.
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In the List section, select the record you wish to edit and then select OK.
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On the Action Bar, select Calculate Total Employee Count.
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In the Print window, specify how to generate the report, then select OK. The report's default file name is employerpayrun.rpt.
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Review the report for accuracy and make changes if needed.
Fields
Employer Tab
|
Field |
Description |
Valid Values |
|---|---|---|
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Tax Year |
The tax year for which ACA 1095 forms are being prepared. The tax year and control number combine to identify a work file. |
Not applicable |
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1095-B |
Indicates whether to create and print 1095-B forms instead of 1095-C forms. When this option is not selected, the system defaults to 1095-C reporting. |
Not applicable |
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Control Number |
A unique control number to identify this employer setup record within a given tax year. |
Not applicable |
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Federal ID Number |
The employer's Federal Employer Identification Number (EIN) assigned by the IRS. |
Not applicable |
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Employer Name |
The full legal name of the Applicable Large Employer (ALE) member. |
Not applicable |
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Street Address |
The employer's primary street address for IRS correspondence. |
Not applicable |
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Street Address 2 |
An additional line for the employer's street address, if needed. This can include apartment, suite, or building numbers. |
Not applicable |
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City |
The employer's city. |
Not applicable |
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State |
The employer's state. |
Not applicable |
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Zip Code |
The employer's zip code. |
Not applicable |
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Country |
The employer's country. |
Not applicable |
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Calculation Method |
The method used to determine employee ACA coverage during the 1095 load process. Recommended method: For most districts, the Check History method is recommended because it relies on verified payroll data and does not require additional benefit date maintenance. Use the Deduction Benefits Date method only if your organization maintains Benefit Effective Dates and Deduction Stop Dates consistently in employee deduction records. Use the Benefits Module method only if your organization has the Employee Benefits System module licensed and configured.
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Valid values:
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Check History Date |
When the Calculation Method is set to Use Check History, select the date from the check history to determine the coverage months. |
Valid values:
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Self Insured |
Indicates whether the employer is self-insured, meaning the employer (rather than an insurance company) sponsors and funds the health coverage plan. If your organization's healthcare provider is providing the information for the 1095-B for covered individuals and your organization is just reporting on offers to employees, clear this box. If this box is blank, printed 1095 records will not display covered individuals. |
Not applicable |
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SSN Masking Method |
Controls how Social Security Numbers are displayed on ACA maintenance pages for users without SSN security privileges.
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Valid values:
Defaults to M if not set. The field value is retrieved from the SSN Masking Method field on the Local System Options tab of the Human Resources Profile page. |
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Transmitter Control Code |
The employer's Transmitter Control Code (TCC) assigned by the IRS for electronic filing through the AIR (ACA Information Returns) system. Required for electronic submission of 1094-C/1095-C forms to the IRS. |
Not applicable |
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Contact Name |
The name of the person to contact regarding the ACA filing. |
Not applicable |
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Phone |
The phone number of the contact person in the format XXX-XXX-XXXX. |
Not applicable |
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Member of Aggregated ALE Group |
Indicates whether the ALE is a member of an Aggregated ALE Group (a group of related entities that are treated as a single employer under the ACA employer shared responsibility provisions). If your organization and other organizations are offering coverage together, or you are part of a consortium, select this option. When this option is selected, the Aggregated ALE Group tab is enabled for entering the names and EINs of other ALE members, including yourself. |
Not applicable |
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Authoritative Transmittal |
Indicates whether this record represents the authoritative transmittal for this ALE member. The authoritative transmittal is the final, definitive filing submitted to the IRS for the tax year. |
Not applicable |
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Multiple Profiles for District |
Indicates whether the district has multiple reporting profiles. When this option is selected, an additional field for entering 1095 counts from other profiles is displayed. |
Not applicable |
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Certifications of Eligibility |
The Certifications of Eligibility section corresponds to Part III of IRS Form 1094-C (Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns). It allows the Applicable Large Employer (ALE) member to certify which eligibility methods or transition relief provisions apply for the tax year. These definitions are according to IRS documentation as of September 15, 2015, and your organization should check the most recent IRS documentation at www.irs.gov.
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Not applicable |
Designated Government Entity Tab
If your organization is part of a designated government entity, you will enter the DGE information on this tab. If this does not apply to your organization, leave this tab blank. Refer to IRS documentation (www.irs.gov) for more information on whether this designation applies to your organization.
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Field |
Description |
|---|---|
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DGE Name |
Name of the Designated Government Entity (DGE) to which your organization belongs. |
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Federal ID Number |
Employer Identification Number (EIN) assigned by the IRS for the DGE. Use a dash to separate the first two digits from the remaining digits: for example, 99-9999999. |
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Street Address |
Street address for the DGE to which your organization belongs. |
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City |
City for the address of the DGE. |
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State |
State for the address of the DGE. |
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Country |
Country for the address of the DGE. |
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Zip Code |
Zip code for the address of the DGE. |
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Contact Name |
Name of the primary contact for the DGE. |
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Phone |
Phone number for the primary contact person for the DGE. |
Monthly Information Tab
Your organization can add and store data on this tab, as well as calculate the Full-Time Employee Count and Total Employee Count.
This section is not required for 1095-B organizations.
|
Field |
Description |
|---|---|
|
MEC Offer Indicator |
Indicates that the employer offered minimum essential coverage to at least 95% of its full-time employees and their dependents for the months indicated, or the calendar year if the All 12 Months checkbox is selected. |
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Full-Time Employee Count |
The number of full-time employees for your organization. This checkbox is not required if the 98% Offer Method checkbox on the Employer tab is selected. |
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Total Employee Count |
The total number of employees, including full-time employees and non-full-time employees and employees in a Limited Non-Assessment Period, for each calendar month. |
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Aggregated Group |
Select this checkbox to indicate your organization is a member of an Aggregated Applicable Large Employer Group. If this checkbox is selected for any month of the calendar year, you must fill in the Aggregated ALE Group tab. Refer to the description of the Aggregated ALE Group tab for more information. |
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Section 4980H Transition Relief |
Drop-down list indicating the employer is eligible for Section 4980H Transition Relief for the selected months. Select:
These codes are determined by the IRS. For detailed descriptions of the relief, including which employers are eligible for relief status, refer to the IRS documentation in the Instructions for Forms 1094 and 1095 (www.irs.gov). These drop-down lists are inactive. |
Aggregated ALE Group
If your organization is a member of an Aggregated Applicable Large Employer Group, such as a consortium, you will need to fill in this tab. As per the IRS, if your organization was a member of an Aggregated ALE Group for any month of the calendar year, you must report the names and EIN of up to 30 of the other Aggregated ALE Group members. If there are more than 30 members of the Aggregated ALE Group, enter the 30 with the highest monthly average number of full-time employees, for the year or for the number of months during which the ALE Member was a member of the Aggregated ALE group. Regardless of the number of members in the Aggregated ALE Group, list the 30 members in descending order by the highest average monthly number of full-time employees.
This section is not required for 1095-B organizations.
|
Field |
Description |
|---|---|
|
Name of Other ALE Member |
Name of the member organization for your Applicable Large Employer Group. |
|
EIN |
Employer identification number for the group member. |