Completing Obamacare 1095-C Reporting With Online Benefits Enrollment Software

Published by John Dalmata on November 9, 2015

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Completing Obamacare 1095-C reporting can be broken down into four steps:

Data Collection
Testing
Analysis
Reporting

The data collection is the longest process, but translating the information into the reporting forms is the hardest.

Anyone who has gone down the path of hiring a TPA to complete their ACA Reporting is familiar with the immense data-dump that comes with the service partnership. And a one-time dump isn’t enough. There is on-going monthly eligibility tracking, enrollment management, and hours-accruals that can make for some redundant spreadsheets and administrative processes.

How does an online benefits enrollment system streamline and simplify the ongoing Obamacare data-gathering and annual reporting process?

1. Auto-capture coverage offer dates

On the 1095-C, Lines 14 and 16 are driven by:

types of coverage offered
offer dates
and employee premium contributions.

Online benefits enrollment software captures this information when it identifies the date that the employer initiates the coverage offer, flags the offer as extended to employee, spouse, dependents, or family, and calculates the employee plan contribution.

As long as the system has a means of capturing employee wage information (ideally through payroll integration), it will be able to further perform affordability determination testing.

2. Maintain dependent eligibility information

Self-insured employers have the extra task of completing code 6055 reporting for employee dependents on top of their play or pay requirements. It’s a greater administrative tracking burden, and tracking employee and dependent DOB and SSNs requires secure filing systems.

Online benefits enrollment systems allows employees to enter information securely from self-service portals, and allows self-insured employers to house all of their dependent 1095-C reporting data in one system.

This means running quick census reports without carrier coordination or managing PII on multiple spreadsheets.

3. Gain an expert set of eyes

With Obamacare, employers need their benefits advisers to help them make important compliance decisions and strategic cost-saving measures. This means having all the data needed to make those decisions in an accessible location for both employer and adviser.

Melissa Winn (follow at @EBA_Winn) of Employee Benefits Adviser Magazine reported that increasing numbers of brokers are providing complimentary technology resources to clients: “Technology is one of the biggest factors in the benefits industry. The brokers have really embraced it.” The shift to tech-resourcing for benefits administration has been a tremendous value-add to the health insurance broker-client relationship.

An online benefits enrollment system allows both the employer and broker-partner to have on-demand cloud-access to member data. That means the employer doesn’t have to become the Obamacare expert, and broker partners can make informed recommendations without hours of researching and coordination with insurance carriers.