ACA-Updating the Affordable Plan Offered Rule within ACA Profiles

ACA Profiles: Updating the Affordable Plan Offered Rule

Overview

Each ACA Profile is configured with the Affordable Plan Offered rule which will determine if an employee was offered an affordable health plan based on any of the available safe harbor calculation methods, during the given month on the ACA timeline.

If At Least One Is True Settings: The rule looks at any benefit plans designated with base type Health and compares the cost of the plan to one of the Safe Harbor settings in this rule. If a plan costs more than the settings listed here it will not be considered affordable. Not all the settings listed here are required when using this rule. You can define one or all of the settings, depending on how your company uses the module.

The Affordable Plan Offered rule will look at each statement in the order they are listed and determine if it is true.

Example: Using the figures shown above in the example, if the Plan Monthly Cost is less than or equal to the percentage entered of the Federal Poverty Line divided by 12, the ACA Timeline will list Y in Affordable Plan Offered field. If this statement is false, the rule then checks to see if the Plan Monthly Cost is less than or equal to the percentage entered of the Hourly Rate multiplied by 130. If one statement is true, Y will populate if the Plan Monthly Cost is less than or equal to the percentage entered of the one of the Plan Monthly Cost settings shown.

Note: The calculation of poverty level will look up the poverty level for residents of Alaska and Hawaii. The poverty level calculation uses the Alaska poverty level entry for residents of Alaska or the Hawaii poverty level entry for residents of Hawaii. For all other employees, the federal poverty level is used. Poverty levels are updated within the system once the levels are published.

The IRS releases the adjusted affordability percentage each year. Therefore, a new Affordable Plan Offered rule will need to be added to each ACA Profile each year with the adjusted percentage. The affordability percentage for each year can be found here.

How to Update the Affordable Plan Offered Rule

1. Navigate to Admin tab (gear icon) > Profiles/Policies > ACA (Affordable Care Act)

2. Click the pencil icon to View/Edit Profile

3. Click ADD RULE (upper right corner)

4. Select the Affordable Plan Offered rule

5. Scroll down to where the rule is added and click the blue arrow to move up. The new Affordable Plan Offered rule should be placed directly above the Minimum Value Offered rule:

6. Click the pencil icon to View/Edit Rule

7. Enter the Effective From and To dates, Enter the new affordable percentage in each of the 3 boxes, Save.

IMPORTANT: The Affordable Plan Offered Effective From and To dates must reflect the health plan year. For example: If the plan year start is 1/1 then enter 01/01/YYYY to 12/31/YYYY. If the plan year start is 7/1 then enter 7/01/YYYY to 06/30/YYYY. The rules cannot have overlapping dates.

8. Click Save (upper right corner)  and click the blue back arrow (upper left corner)  to take you back to the ACA Profiles screen.

 

9. Repeat steps 2 through 7 for each ACA Profile. Do not update the Non-Employee/No ACA profile.

 

10. Update the tracker with date completed.

How to Update the Affordable Plan Offered Rule.docx