Healthcare Reform Consulting for Your Business
Healthcare reform has made a huge difference in how businesses have to create their employee benefits. That means what used to be compliant is no longer acceptable. Are you finding it hard to get your healthcare benefits updated for your employees? EB Compliance Strategies provides you with the healthcare reform consulting you need to ensure everything is properly updated. Our compliance strategy team looks forward to providing you with the consulting assistance you require.
Determining Applicable Large Employer Status
One of the ways our team is ready to help your business is by determining your employer and controlled group status. This begins by us identifying your employees and determining the method for calculating your hours of service. This allows us to figure out how many full-time and how many part-time equivalent employees you have on your payroll in regards to healthcare reform regulations. We then document your ALE status and help you figure out the adequate healthcare coverage you need to provide to avoid “Pay or Play” penalties under the Affordable Care Act.
The consultants at our firm are also skilled at determining if the coverage you offer is the Minimum Essential Coverage (MEC), which provides the Minimum Value (MV) while remaining affordable at 9.5% for single-only coverage. We then test and use the best Safe Harbor provision for our calculation, including W-2 forms, rate of pay, and the federal poverty line. Some of the other healthcare reform consulting services we offer include:
- Determining Initial Measurement & Standard Measurement Periods
- Categorizing Employees as an Ongoing or New Employee
- Applying Look-Back Method to Ongoing & New Employees
- Evaluating “Pay or Play” Penalties, No Coverage Penalties, & Unaffordable/Inadequate Coverage Penalties
Documenting Required Plan Coverages under Market Reforms Including:
- Determination of Grandfather Plan Status
- Extension of Dependent Coverage to Age 26
- Elimination of Lifetime Dollar Limits
- Restrictions on Annual Dollar Limits
- Elimination of Pre-Existing Condition Limitations for Individuals under the Age of 19
- Uniform Summary of Benefits & Coverage (SBC) Requirements
- Choice of Healthcare Professional
- Preventative Services
- Out-of-Pocket Maximums for Single & Family
- Internal Claims, Appeals, & External Reviews
Employee Data Import/Review/Reconciliation
Using our flexible data mapping tool, we have the ability to consolidate your import data from different systems so you can have high-quality reconciliation reports with only accurate and complete information. Our tool accepts data files in virtually any format and maps and imports the information into a reporting system via SSL encryption or SFTP with PGP encryption. The program also provides you with an easy, on-screen review of your 1095-C form prior to printing. This enables you to review your form before distribution.
Print/Mail/Electronic Distribution
Working with our consulting firm helps to ensure you receive proper print, mail, and electronic distribution of your required healthcare forms. We help you with your consolidated 1095-C form, which enables you to provide one form per envelope per insurance contract. There is an option for TIN (SSN) masking as well with our assistance. Furthermore, we are able to help you generate an original Form 1095-C for print and distribution for a convenient turn-key approach. Distribution can be handles via desktop printing, desktop PDF emailing, standard printing and mailing, or an eStatement.
IRS Original/Correction Filings
Generate properly formatted files inclusive of separate records with the help of our team. We help you create filings for each covered insured and provide you with an e-file of the original filings. Additionally, we identify and track corrections and generate files for e-file submission to the IRS on your behalf.
Member/Customer Inquiries/Corrections
Make corrections easy by working with our consulting specialists. We provide a desktop form with detail view, edit, and print capabilities that make it easy for you to handle inquiries and corrections. Our program helps you automatically track any changes or corrections while ensuring there is a complete audit trail by user, date, and timestamp. Furthermore, your corrections history is easily viewed online at the individual member level as well as in a group via management reports.
TIN (SSN) Solicitations
Our consulting firm is ready to help you generate, log, and track TIN solicitations in order to help you comply with the IRS “reasonable cause” regulations therefore avoiding or abating penalties. We generate and distribute either a paper W-9 or a custom TIN (SSN) solicitation in bulk or one-off solicitation. These solicitation responses can be mailed to the client or to our firm and then can be attached to the 1094-1095 system as a “compliance event.” Collection, via eW-9 or e-SSN, is available so members can complete their information online via the system Web portal.
The system we offer tracks all compliance event activities, including outbound solicitation, date, and returned response date. This allows information to be viewed at the recipient level as well as the entire solicitation population level.
Management Reports
Run and view reports online in real time with the help of our consulting firm. We provide multiple standard reports for our client and give them the ability to customize their reports using a simple wizard. These reports can be exported to Excel or .txt files for your convenience. Additionally, you can schedule your reports to run automatically with our direct electronic delivery options.
Contact us to learn more about the different ways our healthcare reform consulting services can help your business. Our services are available to clients located in the Grand Rapids area, as well as throughout the entire state of Michigan.
