Benefit Plan and Option ACA Parameters

Use this procedure to set up benefit coverage plans and waive plans for accurate ACA Processing. You click the ACA button on Benefit Plan to specify parameters on health (HL) benefit types that are required for ACA regulatory processing.

  1. Access Benefit Plan (BN15).
  2. Inquire on the Company, Benefit Plan, and Plan.
  3. Click the ACA button to access Plan Details (BN15.3).
  4. Specify this information:
    Self Insured Plan

    Select Yes, if the benefit plan is a self-insured plan. If you select Yes, Covered Individuals are stored for ACA regulatory reporting.

    Priority

    Select the Priority of the ACA Health Plan for regulatory reporting. A benefit plan that offers more coverage will have a higher priority than one with less coverage value. Highest coverage is indicated by using a value of 1, whereas lowest coverage is 9999. Waived plans are required to be set up with the lowest coverage value to ensure proper ACA regulatory processing.

    Offer Code

    Select IRS Offer code for the benefit plan. The Offer Codes are used to describe the benefit offer that is extended to the employee. Definitions are explained in the IRS regulations. It is the end user's responsibility to assign an offer code that is representative of their benefit plan. Valid values are: 1A to 1U.

    Safe Harbor Code

    Select the IRS Safe Harbor code for the benefit plan when enrollment is waived or relief applies. The IRS Safe Harbor codes are explained in the IRS regulations. Valid values are: 2E to 2I and WV (waive plan).

    See What is the Safe Harbor Code?

  5. If Benefit Type is HL Health and Contribution Type is 1 Options Amount, then access Options Amount (BN18). This option can also be used for effective dating ACA parameters. Click the ACA button to access Plan Details (BN19.5) and complete the parameters for ACA regulatory processing:
Field ACA Benefit Plan ACA Waive Plan
ACA Self-Insured Plan Y or N Y or N
ACA Priority contains a value between 1 and 9999 contains a value between 1 and 9999
Offer Code 1A to 1U No Offer Code
Safe Harbor Code 2E to 2I WV
Override Employee Cost 0.00