While we have included the most common job status and coverage type change events within this document, there are many additional employment scenarios that you may encounter that need to be documented for ACA reporting purposes.  To assist with these, we have assembled the accompanying Scenario Spreadsheet, which contains additional scenarios.

The Scenario Spreadsheet was designed to make documenting unique situations as easy as possible, provided you understand a few simple tips:

Key Cells

Key values for each situation are represented with a bold outline, allowing you to quickly identify those values that must be addressed in your reporting:


Important Tips

At the top of each Spreadsheet page you will find some important information about reporting and the scenarios include on that tab:

 

  • All Employees: Anyone employed during the current calendar year must be reported, even if they are not eligible for coverage.
  • Waived Coverage: If an employee waives coverage, enter the lowest cost plan offered to the employee in the Plan ID field.
  • Coverage Begin Date: If the employee’s coverage began prior to the start of the year, you do not need to document the exact date. You can simply enter 1/1/20xx (current reporting year), indicating the employee had coverage at the start of the year. (Using the exact date is also acceptable; use whichever date is easiest for you to provide).

 

Waiting Periods

Every company sets its own waiting period for new and transitioning employees. Since many situations need to be coded differently depending on whether or not your company uses a waiting period and how long that period is, we have designed the Scenario Spreadsheet to adapt to your company’s waiting period guidelines:

  • Waiting Period: Enter the appropriate waiting period, in days, for your company. If your company does not require a waiting period, enter “0”.
  • Effective Date: If the coverage effective date is the first of the month following the waiting period, enter “1”. If it begins immediately following the end of the waiting period, enter “0”.

Once you have updated these values, the Coverage Begin Date will update dynamically, based upon the Status Begin Date entered in the corresponding line.
  • In the example above, Alan Parker was hired on 3/15/2018, so his Status Begin Date was that same date. This company has a 60-day waiting period, so he became eligible for coverage in mid-May; however, the effective date does not begin until the first of the month, so Alan’s Coverage Begin Date was 6/1/2018.

 

Note: This Coverage Begin Date field can also be updated manually.


Coverage End Date

The spreadsheet provides similar functionality for employees that lose coverage after a Termination.

Coverage Continues Through End of Month

If you enter a “1” in the circled yellow field, the Coverage End Date will automatically calculate to the end of the month following the Term Date:



Coverage Ends Same Day as Termination

If you enter a “0” in the yellow field, the Coverage End Date will automatically calculate to equal the same day as the Term Date:

 

Note: The Coverage End Date field can also be updated manually.


Additional Resources:


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