Setting Up Information for the Employer Shared Responsibility Reporting Under the Affordable Care Act (ACA)

The following steps outline the processes that you must complete to produce the employee 1095-C forms as well as the employer information electronic report that you will file with the US Internal Revenue Service (IRS).

For an overview, see: Employer Shared Responsibility Reporting Under the Affordable Care Act (ACA) Administration

arrow icon   To set up information for the Employer Shared Responsibility Reporting Under the Affordable Care Act (ACA):

  1. Create a GRE or legal entity.

    Create a GRE or Legal Entity if one does not already exist or update your business group and add the GRE / Legal Entity classification. See: Government Reporting Entities (GREs)

  2. Enable and populate the following flexfields.

    The following sections explain how to enable and populate these flexfields.

  3. Configure your plan setup.

    1. Identify all applicable healthcare benefit plans that are subject to the Affordable Care Act. For all such plans, date track to January 1, 2015, and configure the plan regulation "Patient Protection and Affordable Care Act" in the Regulations tab of the Plan window. Note that configuring this Regulation in the plan setup will also require creating a Reporting Group. See: Defining a Reporting Group.

      Note also that the "Patient Protection and Affordable Care Act" regulation is for Medical/Healthcare plans, so the correct Regulatory Plan Type to select is "Welfare". See: Defining Regulations for a Plan

    2. Define the following plan extra information types (EITs) for plans configured with the ACA regulation:

      • ACA Report Requirements

      • ACA Minimum Rate Requirement

      • ACA Multiple Option Min Plan

      Important: ACA Minimum Rate Requirement and ACA Multiple Option Min Plan are optional, only to be configured if needed. Configure the ACA Minimum Rate Requirement EIT if you are using Oracle Standard Benefits. Configure the ACA Multiple Option Min EIT if plans have multiple self-only options.

      To set up and define the EITs:

      1. Navigate to the Plans window.

      2. Search for a plan configured with the ACA regulation.

      3. Click Extra Information.

      4. Select the appropriate EIT.

      The following sections explain how to define the plan EITs.

      • ACA Report Requirements Extra Information Type (EIT)

        Complete the following steps to set up and use the ACA Report Requirements EIT.

        1. Register the ACA Report Requirements Plan EIT.

        2. Run the Register Extra Information Types (EITs) concurrent program using the Submit Request window with the following parameters:

          • Table Name: BEN_PL_INFO_TYPES

          • Information Type: ACA Reporting Requirements

          • Multiple Rows: Yes

          • Legislation Code: United States

          See: Setting Up Extra Information Types For a Responsibility

        3. Assign the ACA Report Requirements EIT to the applicable responsibilities that are authorized to maintain the benefits setup. Use the Information Type Security window to link the EIT to a responsibility. See: Setting Up Extra Information Types For a Responsibility. Select ACA Report Requirements as the Information Type and save.

        4. After the plan EIT is registered, specify the following fields:

          1. Reporting Year (mandatory): Select the reporting year.

          2. Provides Minimum Essential Coverage and Provides Minimum Values: For healthcare benefit plans that have been designated with the Patient Protection and Affordable Care Act plan regulation, set the fields to 'Yes' if the plans meet both the requirements.

          3. Spouse Offer Conditional: Select a value that is appropriate for Form 1095-C. If the offer to the spouse is conditional, then select Yes in the plan EIT for each applicable benefit plan. This field must be set to Yes for all ACA eligible plans. Otherwise the evaluation may not result in 1J or 1K codes being returned on Form 1095-C.

      • ACA Minimum Rate Requirement Extra Information Type (EIT)

        Use the ACA Minimum Rate Requirement Extra Information Type (EIT) at the plan level to store the minimum self-only rate for a plan configured with the ACA regulation effective for the applicable reporting year.

        Important:

        • Oracle Standard Benefits customers must provide the minimum self-only rate for all benefit plans that are configured with the ACA regulation. The Benefits ACA Archive Process will then evaluate which plan has the lowest self-only rate based on the person's eligibility.

        • The minimum self-only rate value entered in the plan-level ACA Minimum Rate Requirement EIT must be the monthly rate value.

        • This plan EIT is currently applicable to Oracle Standard Benefits customers only.

        Complete the following steps to set up and use the ACA Minimum Rate Requirement EIT.

        1. Register the ACA Minimum Rate Requirement EIT.

        2. Run the Register Extra Information Types (EITs) concurrent program using the Submit Request window with the following parameters:

          • Table Name: BEN_PL_INFO_TYPES

          • Information Type: ACA Minimum Rate Requirement

          • Multiple Rows: Yes

          • Legislation Code: United States

          See: Setting Up Extra Information Types For a Responsibility

        3. Assign the ACA Minimum Rate Requirement EIT to the applicable responsibilities that are authorized to maintain the benefits setup. Use the Information Type Security window to link the EIT to a responsibility. See: Setting Up Extra Information Types For a Responsibility. Select ACA Minimum Rate Requirement as the Information Type and save.

        4. After the plan EIT is registered, specify the following fields:

          1. Reporting Year: Enter the applicable reporting year.

          2. Minimum Self Only Rate: Enter the monthly minimum rate value for the self-only option for the ACA plan.

          3. Save your work.

          4. If there is more than one plan configured with the ACA regulation, then repeat steps for each plan.

      • ACA Multiple Option Min Plan Extra Information Type (EIT)

        Configure the ACA Multiple Option Min EIT if plans have multiple self-only options. This EIT helps you to record a single rate for the entire year, or rates on a monthly basis if the rate changes during the reporting year.

        Complete the following steps to set up and use the ACA Multiple Option Min Plan EIT.

        1. Register the ACA Multiple Option Min Plan EIT.

        2. Run the Register Extra Information Types (EITs) concurrent program using the Submit Request window with the following parameters:

          • Table Name: BEN_PL_INFO_TYPES

          • Information Type: ACA Multiple Option Min Plan

          • Multiple Rows: Yes

          • Legislation Code: United States

          See: Setting Up Extra Information Types For a Responsibility

        3. Assign the ACA Multiple Option Min Plan EIT to the applicable responsibilities that are authorized to maintain the benefits setup. Use the Information Type Security window to link the EIT to a responsibility. See: Setting Up Extra Information Types For a Responsibility. Select ACA Multiple Option Min Plan as the Information Type and save.

        4. After the plan EIT is registered, specify the following fields:

          1. Reporting Year: Enter the reporting year for which the rates are in effect.

          2. All Months: Enter the lowest monthly self-only rate for the plan if it is the same value for the entire reporting year.

          3. January... December: Enter the lowest monthly self-only rate for the plan offered to employees in the applicable month if the lowest rate changes during the reporting year.

    3. If your healthcare plan coverage is self insured, then set 'Primary Funding Method' to 'Self Insured" in the General plan setup for the applicable plans if it is not set already. Ensure that you are date tracked to January 1, 2015 when performing the update (if not previously set). See: Defining a Benefits Plan

    4. Review dependent designation requirements to ensure that the proper designation has been configured (i.e. designation may need to differentiate between spouse and children designation if such coverage is offered to your employees) for all applicable plans / options.

  4. Enable the ACA Reporting Special Information Type.

    Enable the ACA Reporting special information type (SIT) using the Special Information Types window. In the ACA Reporting row, select the Other check box and save your changes.

  5. Review or update employees or participants.

    Review your employee population:

    For each month during the reporting year, assess whether the person was subject to a safe harbor: Were they enrolled? If not, was it because the person:

  6. Define Employee Information for the Affordable Care Act (ACA).

    1. For all employees that are considered full time under the auspices of the ACA, designate them as Full Time ACA Eligible employees by checking the "ACA Full Time" flag on the Benefit tab in the People window, either on January 1, 2015 or the applicable effective date.

    2. Identify employees that were under an assessment period during the reporting year and capture the Assessment Period End date in the Special Information Type "ACA Reporting". Note that the Assessment Period End Date is used to determine if an employee is eligible as per the Affordable Care Act rules.

    3. Identify employees that are covered under a Section 4980H Safe Harbor or Relief and set field "Eligible for Section 4980H" to Yes in the Special Information Type "ACA Reporting".

    4. For any employees that are still eligible for safe harbor relief, optionally set an alternate code in the field "Safe Harbor Override" if different than the default code set at the GRE / Legal Entity level under "ACA Reporting Requirement". Note: Take special care when setting a value in the Person SIT as the IRS has special rules around how these codes can be applied to employees.

    See: Defining Information for the Employer Shared Responsibility Provision of the Affordable Care Act (ACA)

arrow icon   Setting Up Information for the Employee COBRA Offer Details Page:

The Employee COBRA Offer Details page helps benefits administrators to enter details about the US Affordable Care Act healthcare offers made to their active employees under COBRA when Oracle Advanced Benefits is not the source of COBRA Administration (i.e. it is administered instead by a third party) and there is a need to generate a Form 1095-C for these employees from the Oracle application.

Before a benefits administrator starts using this page, complete the following setup step:

Set the COBRA Outside EBS field to Yes in the ACA Reporting Requirement window. This step is required for the Benefits ACA Archive process to evaluate any data entered in the Employee COBRA Offer Details page. See: Entering the ACA Reporting Requirement Data for a GRE