Configure PPACA Reporting Settings for Benefits Administration

Configure reporting settings for your organization for the Patient Protection and Affordable Care Act (PPACA) on the PPACA Reporting Settings page.

1. From the PPACA Reporting Settings page, select Edit.
2. In the Defining Applicable Large Employers (ALEs) section, select either the Component Companies or Tax Groups at the Define Applicable Large Employer (ALE) By field. This field is required.
   Note

   If you have added entries to the ALE Members business rule with the PPACA Reporting Settings configured for Component Companies and need to change to Tax Groups (or vice versa), you must first delete all entries in the ALE Members business rule. In addition, ALE Members cannot be deleted or modified once data has been either imported or manually entered on the Offer of Coverage page for one or more employees.

3. In the Printing 1095-C Forms section, select from the following options:

   • Check the Furnish Paper Copy of Form 1095-C to Terminated Employees box to include terminated employees who may have opted in for electronic-only copies of their Form 1095-C, but now need to receive a paper copy. This generally applies to employees who may no longer have access to Employee Self-Service in UKG Pro.

   • Check the Mask SSN for Individuals on Printed Forms 1095-Cs box to hide social security numbers only on the printed form, except for the last four digits. The masking of the SSN is applied to Part I - Employee Information and to Part III - employee or dependents listed with an SSN. When an employee views his/her electronic Form 1095-C on the portal, the SSN is still visible on the electronic PDF version of the form.

4. Select the month and year for the Benefits Administration Start Date to indicate the first day of the month your organization started to use Benefits Administration. This field is required.
   • The start date should reflect the later of:
     • The month and year you first began to use the Benefits Administration solution; or
     • The start of your first plan year in Benefits Administration
       Note For example, if you first began to use Benefits Administration in Fall 2023 for open enrollment for a benefits plan year that begins on 1/1/2024, enter a January 2024 start date (not a Fall 2023 start date).
   • For new customers launched with UKG Pro and Benefits Administration mid-year, enter a January start date in the year Benefits Administration was implemented.
5. Check the Include Coverage Stop Date in the Calculation of the Coverage Period box to include the stop date in the calculation for the covered individuals and their coverage months. To determine this, you must decide whether the coverage stop date in the medical plan represents the last day of coverage or the first day the employee no longer receives coverage. This applies to the calculation of Part II Line 16 safe harbors and self-insured employers reported on Form 1095-C, Part III. This field is required.
6. In the Auto-populating 1095-C Forms section, select from the following:
   • I store payroll and deduction information in UKG Pro and want UKG Pro to auto-populate Part II - Offer and Coverage when I generate 1095-Cs.

     For Benefits Administration PPACA Auto-population, it is required that you enable the Part II Offer and Coverage setting to generate Forms 1095-C based on approved, eligible medical offers. You must store payroll information in UKG Pro and configure the associated ALE business rules to auto-populate Form 1095-C. Part II reports offers of coverage information for all full-time employees receiving a Form 1095-C regardless of whether employees chose to enroll or not.

   • I store deduction and coverage information for my employees and their dependents in UKG Pro and wantUKG Pro to auto-populate Part III Covered Individuals when I generate the 1095-Cs (optional field).

     Part III is for ALE members with a self-insured medical plan or HRA plan configured in Benefits Administration, specifically for employees and dependents enrolled in coverage. After this check box is selected and the data is generated via the Generate and Finalize Forms page, the action cannot be reversed.

     • Include Terminated Employees (optional field)

   • I use UKG Pro to track enrollment information for employees who were NOT a full-time employee for any month of the calendar year and want UKG Pro to includes these employees when I generate the 1095-Cs to report Self-Insured Coverage (COBRA participants, retirees, etc.). Select this option to include terminated employees who have never had an active record in the reporting year but need to be included in Part III due to receiving COBRA coverage in a self-insured plan. After this option is selected and the data is generated via the Generate and Finalize Forms page, the action cannot be reversed.

   • Select Include Coverage Stop Date in the calculation of the coverage period (optional).

   • Select a code to set the Default Affordability Safe Harbor method to prioritize and prevent the remaining affordability codes from auto-populating (optional). You can make a selection and still manually update the remaining codes, if needed.

     • If you choose a default affordability safe harbor method, auto-population will only leverage that safe harbor method to determine affordability. When a full-time employee waives coverage, and their offer of coverage was not affordable by the default you selected, 1095-C, Line16 will be blank.
     • If you do not choose a default affordability safe harbor method, auto-population will prioritize federal poverty line (2G), W-2 wages (2F), and rate of pay (2H) in that order when calculating 1095-C Line 16 safe harbor for full-time employees who waive coverage.

       Table 1. Default Affordability Safe Harbor Methods

       Method	Code
       Federal Poverty Line	2G
       Form W-2 Box 1 Wages	2F
       Rate of Pay	2H

       Important In cases where you have a mid-year (or post January 1) go-live with the Benefits Administration solution, it is recommended that you enable the setting temporarily for the remainder of the year and only choose from the Federal Poverty Line or Rate of Pay safe harbors for that year. (1) Enable the Default Affordability Safe Harbor setting; (2) Use the safe harbor codes 2G or 2H, avoid using 2F as it is not supported for mid-year go-lives); (3) Avoid leaving the code field blank; and (4) If desired, reconfigure the Default Affordability Safe Habor setting at the beginning of your next plan year where you may then choose from any of the three safe harbors or choose to leave it blank.
7. In the Calculating Hours and Eligibility section, select the applicable options:

   • Check the Exclude Payroll Opening Balances from ACA Hours Calculations to exclude all the payroll opening balances and earnings codes to calculate ACA hours. When left unchecked, the nightly ACA jobs will run and include all the payroll opening balances and earnings codes to calculate ACA hours.

   • For employees in a Healthcare Measurement Group (HCMG), check one of the options listed for treating a terminated employee as a new hire after 13 or 26 weeks. If an employee is rehired sooner than 13- or 26-weeks following termination, then the employee will remain in their HCMG and continue their measurement and stability periods. If the employee is not rehired within the period you select, then they will restart an initial measurement period if they're rehired later.

   1. 13 weeks from their termination date (for non-educational organizations)
   2. 26 weeks from their termination date (for educational organizations)
   3. I will manually remove and add employees to health care measurement groups
8. Select Save. The PPACA Reporting Settings page appears with the selected configurations.