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Life Health > Health Insurance

ACA compliance guru hopes for ‘controlled group’ relief

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The incoming Trump administration could simply make the Affordable Care Act employer health coverage reporting requirements go away in a few weeks.

Arthur Tacchino, chief innovation officer at Baton Rouge, Louisiana-based SyncStream Solutions, thinks the 1095-C notice requirements will stick around for the coming tax season, and that the requirements could cause especially severe problems for any of your clients who happen to have multiple locations and multiple employer identification numbers.

When multi-location entities are trying to decide whether they’re “controlled groups” for ACA reporting purposes, and which entities should handle the 1095-C’s for workers who happen to work in more than one location, “it causes mass chaos,” Tacchino said today in an interview.

Related: Mastering the ACA compliance maze

Tacchino, a lawyer who has been helping insurance professionals understand the Affordable Care Act since it rumbled to life, now works at a company that helped employers send about 1 million 1095-C forms for 10,000 employers for 2015, and “a little more” for 2016.

The employees, former employees and others with some kind of relationship with an entity who get the notices are supposed to use the notices to document whether they qualify for ACA public health insurance exchange tax credits or other government health programs.

Individuals will also use the 1095-C forms to show the Internal Revenue Service whether they have enough of what the government classifies as “minimum essential coverage” to avoid paying the ACA individual “shared responsibility” penalties, or amounts owed by many people who fail to have enough major medical coverage for the year.

The Trump administration could decide not to enforce the 1095-C rules. But given that regulators will use the forms to determine whether some taxpayers lied to the ACA public exchange system when they applied for premium tax credit subsidies, the rules could persist, Tacchino said.

Given the politics surrounding ACA premium tax credit fraud, “I would make sure I was enforcing this law at least for this reporting period,” Tacchino said.

Most employers Tacchino runs into who know about the rules are doing their best to comply, and he has not seen any Internal Revenue Service to throw the book at employers who have gotten flawed forms out more or less on time.

But Tacchino said some entities that have relationships with other entities do not realize that they have enough full-time equivalents to have to send out 1095-C’s. If a multi-location entity does send out 1095-C’s, several different entities in the family could end up sending out different 1095-C’s for the same worker, he said.

ACA rules call for one entity to provide one 1095-C for a worker who works at multiple entity locations, he said.

IRS has tried to flesh out 1095-C program guidance, but gaps remain, and figuring out who to contact to get answers has been difficult, Tacchino said.

Tacchino said one way for the IRS to help would be to put out firm guidance saying that it will not take action against an entity that does its best to comply when the rules are unclear.

Related:

Republicans forge ahead with ACA change efforts

IRS postpones ACA reporting deadline

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