Question: I’m reaching out to you in hopes that you can answer a question for us as it relates to ACA compliance. If an employee typically works less than 30 hours a week but does a 3 month period in which he works more than 30 hours a week, how does this affect our 6055 filing for 2016. Does the look-back period in 2015 average hours over a year, over a quarter, by pay period? Also, I believe I read that there is a ‘de minimus’ threshold for compliance which indicates that if less than 5 employees or 5% of workforce is not in compliance with the obligation to offer benefits for workers exceeding 30 hours in a work week, the penalty for non-compliance would not be imposed on these individuals.
If your plan is fully insured, the 6055 is filed by the insurer. If your plan is self-insured, the plan sponsor that establishes and maintains the plan must file the §6055 report. So if minimum essential coverage is provided under your self-funded plan, you must file a §6055 annual return with the IRS for every primary insured employee covered under the plan.
It depends on the stability/measurement period you are using. For purposes of the employer mandate penalties, the guidance permits you to use two methods to determine if an employee is a full time employee. The first is a “look-back measurement period/stability period” method where you may use a standard measurement/stability period for ongoing variable hour employees, while using a different initial measurement/stability period for new variable hour and seasonal employees. The second method is the “monthly” method where full-time employee status is determined on a month-to-month basis.
The group may not be penalized but every individual must have health insurance or will be penalized.