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CONF I DENT I A L │ PAGE 65
Health and Welfare Benefit Brokerage Services Proposal
ACA Employer Shared Responsibility Reporting
Notes:
•
Collect the following information on each employee for each month beginning January 1, 2015:
1) employee status as full-time or part-time, 2) affordability standard of coverage offered, 3)
minimum value of plan coverage, and 4) any limited non-assessment period such as a waiting
period or initial measurement period. Dependent social security numbers required for self-insured
plans to complete Part III of 1095-C.
•
“
Non-employees
”
(Partners, Sole Proprietors, 2% Stakeholders of S-Corps, Retirees, and COBRA
Participants) are not reported on 1095-C Parts I & II. If covered under plan, however, would be
reported on B-Series form by carrier for fully-insured plans or Part III of 1095-C for self-funded plans
for proof of minimal essential coverage.
•
FTE is defined by the ACA as a full-time employee, averaging at least 30 hours per week or has worked a
total of at least 130 hours in the month.