Entering health care coverage for an employee

You use the ACA tab in the 5-2-1 Employees window to enter health coverage information for each employee, for each month of the year. This information is used to determine whether your company needs to file the federal 1095-C form for an employee.

Note: For definitions of "minimum essential health coverage" and "self-insured plan," detailed information about the codes defined by the Affordable Care Act (ACA), and which codes to use in your company, see the Internal Revenue Service website. You could also contact your tax advisor for assistance with the ACA requirements.

Whenever you change any of the codes or coverage for the employee or a covered individual, the same change is applied automatically to all subsequent months.

Tip: If you need to change health coverage codes for many employees—for example, when updating codes in January—use the Update All Employees' ACA Settings window, available from the Options menu. For more information, see Updating ACA Settings for All Employees.

To enter health coverage information for an employee:

  1. Open 5-2-1 Employees, and then click the ACA tab.
  2. Select the year for which you need to add health coverage information for ACA reporting purposes, and then:.

    1. For the employee, enter the following information in the top part of the tab for each month of the year:

      • Work Status (Full Time, Part Time, Seasonal, Exempt)
      • Offer of Coverage Code (as defined under the Act)
      • Safe Harbor Code (as defined under the Act)
      • Share of Min Plan Premium (the employee's share of the lowest premium)
      • Zip Code.

        • If you entered 1L, 1M, or 1N as the Offer of Coverage Code, enter the zip code for the employee's residence.

        • If you entered 1O, 1P, or 1Q as the Offer of Coverage Code, enter the zip code for the employee's primary work location.

    2. If your company provides self-insured health coverage to employees, enter information as follows for the employee's spouse and each dependent:

      1. In the lower portion of the tab, click Add Individual.
      2. In the blank row that appears, enter the name of the covered individual, their relationship to the employee, and their Social Security Number (SSN) or date of birth.
      3. Select the checkbox for each month of coverage for the individual.

      Note: To delete a covered individual from the tab, you click the X at the end of the row that includes their name.

  3. If you want to end coverage for an employee (say, after termination), clear the Work Status selection for the month after coverage ends, and then change the Offer of Coverage Code, Safe Harbor Code, Share of Min Plan Premium, and Zip Code, as needed.

  4. Click [Save].