ACA Reporting

Noncompliance with the Affordable Care Act (ACA) reporting and compliance requirements for the Employer mandate could cost you millions of dollars.

ACA Reporting offers an integrated, end-to-end solution saving you time —and money

Managing the requirements of the Affordable Care Act’s (ACA) Employer Shared Responsibility mandate can be complex and time-consuming. Noncompliance with the regulations could cost you millions of dollars. In fact, the Congressional Budget Office (CBO) estimates that the IRS will collect as much as $1 billion in employer mandate penalties each year through 2032.¹

Optavise offers a complete and integrated ACA Reporting solution that takes on the administrative burdens to ensure ACA compliance —lightening your load and letting you get back to what matters most: your strategy and your people.

Achieving compliance can be challenging!

Employers rely on their benefits administration partner to help assure compliance, contain costs, and provide for the well-being of their employees. But now, you can expect more —much more. Our compliance solutions help you manage risk, employee notifications, employer reporting, and regulatory requirements.

Since 2015, Optavise has successfully generated and filed more than two million IRS Forms 1095-C and 1094-C through a comprehensive process that includes:

Secure data gathering
Single source system
Calculate and generate forms
Print-ready files for IRS form 1095-C
Federal and State filing
Live call center support for employees

Data gathering and integration

Gathering the necessary data for ACA reporting can be a challenge, as it is often housed in multiple systems (e.g., payroll, benefits administration, plan data) and in non-compatible formats.

When ACA Reporting services are paired with Benefits Administration, a majority of the data required is already on hand, streamlining the data gathering process and making your job a lot easier. Optavise will then securely gather and integrate all additional information needed into a single source system.

Data calculations and form generation

Generating the IRS Forms 1095-C requires a series of calculations to accurately determine eligibility as well as the appropriate form field codes for Minimum Essential Coverage, Minimum Value, and coverage level.

Optavise will work with your data to perform the necessary calculations and generate the required IRS Forms 1095-C. Data testing and validation is also performed to ensure quality and accuracy.

Where eligibility is based on hours worked, Optavise offers variable hours tracking where we’ll track, measure, monitor, manage and communicate changes in eligibility status based on your specified measurement period. This service is available for an additional fee.

Fulfillment and distribution of forms

The mandate requires that all IRS Forms 1095-C be distributed to plan participants before March 2nd of each year covering the previous year.

Optavise will provide you with a print-ready file of the generated IRS Forms 1095-C with all calculated data and codes pre-populated and ready for distribution. Digital copies of Forms 1095-C may also be made available to participants, accessible through a secure benefits portal.

Print and mail services are available, if desired, for an additional charge. Failure to distribute Forms 1095-C to plan participants could result in a fine of $290 for each required form, up to $3,532,500 annually.¹

Federal and state filing

In addition to generating and distributing IRS Forms 1095-C to plan participants, you must also submit copies of all Forms 1095-C to the IRS along with a summary form, the Form 1094-C. This filing must be completed by February 28th each year if filed on paper, and by March 31st of each year if filed electronically.

Inaccurate data or late filings could result in a $290 fine for each required form, up to $3,532,500 annually.¹

With our ACA Reporting services, we’ll take care of this for you, preparing and transmitting an electronic filing of the IRS Form 1094-C and Forms 1095-C before the filing deadline. In California, New Jersey, Rhode Island, and Washington D.C., where organizations must file copies of Forms 1095-C as part of their state’s ACA reporting requirements, state filing services are available for an additional fee.

Call center support

Your employees may have questions about when, where, and how to access their Form 1095-C and why they need it. Optavise provides live call center support to help your employees get the answers they need while allowing you to focus on more strategic initiatives.