According to the Affordable Care Act, all applicable large group employers are required to report health coverage information to the IRS. In order to be prepared to do this, you’ll need to:

  • Determine if your organization is an applicable large employer
  • Determine the kind of health insurance coverage you offered to full-time employees and their dependents, if any
  • Identify your full-time employees for each month and track health coverage information to help complete IRS Forms

Helpful Hints:

To determine the number of your business’s full-time employees, you will need to include the hours of full and part-time employees. For example, if you have two employees who work 15 hours per week each, that equals one full-time employee.

Small Employer:  Employer groups with up to 99 employees, (including full-time equivalent employees) on average

Large Employer: Employer group that has at least 100+ full-time employees (including full-time equivalent employees) on average

Full-Time Employee:  Employed on average at least 30 hours of service per week or 130 hours of service per month

Seasonal Employees:  as defined in 54.4980H-1(a)(38) – the term seasonal employee means an employee who is hired into a position for which the customary annual employment is six months or less.

Notice there is no reference to the number of hours of service for a seasonal employee.  The only requirements is the seasonal employee must customarily work six months or less and start at roughly the same time each year.  For example a ski instructor.  54.4980H-3(d)(3) states “For new variable hour employees, new seasonal employees, and new part-time employees, applicable large employer members are permitted to determine whether the new employee is a full-time employee using an initial measurement period…”  So seasonal employees are treated the exact same way as part-time and variable hour employees.

Even if a seasonal employee is working 80 hours a week for five months it won’t matter.  Because the snow will melt or the tomatoes will all be harvested and the employee will not come back until the next season.  For the next season the employer will be allowed to treat that same seasonal employee as a new employee because 13 weeks will have passed.

For more information on compliance requirements and determining your employer/employee status please go to:

Employer Compliance Checklist

Exchange Notices

Summary Plan Document

Notice of Modification

Plan Documents

Disclosure of Grandfathered Status

Calendar  Year  Plan (Check  on compliance early)

HIPPA Compliance

Form 5500

IRS Form 1095C & 1094-C

Evidence of measurement period

Employee Handbooks

Proof that employees have been offered and then accepted/declined coverage

Clear documentation of any disciplinary actions against employees 7-year document retention policy