Answer Bank Category: Fine for not acting on COBRA trigger?

Question:

You clarified that we have to offer COBRA benefits to variable-hour employees who lose their eligibility. We did not do that. And we have a number of employees whose coverage was terminated.

What are the fines and how should we handle this now?

Answer:


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Question:

We have salaried employees who are scheduled three days a week. They generally work between 10 and 12 hours per day on those three days and then are off until the next week. We do not track their hours.

In reading the final regulations for the Affordable Care Act’s employer shared responsibility provisions, we saw we could use a days-worked equivalency whereby the employee is credited with 8 hours of service each day for which he or she works regardless of how many hours they actually work.

Under this method, we would only have to credit these employees with 24 hours of service (8 hours x 3 days) per week which would put them under the 30-hour threshold for offering coverage.

Is this correct?

Answer:


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Question:

Back in February 2016, we calculated our workforce numbers for 2015 and found we just hit the 50 full-time and equivalents mark.

We thought being an Applicable Large Employer meant we just had more year-end reports. Now we’re worried we might be on the line with the IRS for what those reports will show.

We haven’t done anything to check on when we should have been offering coverage.

What penalties are we facing?

Answer:


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Question:

We offer only Minimum Essential Coverage that does not provide Minimum Value.

Do we need to make sure it is affordable?

Answer:


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Question:

The new codes 1J and 1K *seem* to be replacements for 1D and 1E. But that appears incomplete. Shouldn't there be a 1L that matches with 1A?

We do make spouse offers conditional on the spouse not having other coverage available for less than $100 per month. But we don't think we should change a 1A to a 1K.

Answer:


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Question:

We are an Applicable Large Employer. We have a number of companies with their own Employer Identification Number that are commonly owned. Some employees move between companies during the year.

How do we handle them when we are looking at who we have to offer health coverage to?

Answer:


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Question:

What happens when an employee fails to make their contribution for coverage?

Answer

Question:

We have a full-time employee who will be going part-time. Can we discontinue coverage immediately when they go part-time?

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Question:

How long do waivers last?

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Question:

How does COBRA work when someone loses their eligibility for coverage?

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