Solution

Affordable Care Act Management

Put ACA compliance on autopilot

Simplify ACA management

Equifax draws upon years of experience in providing employers with compliance, tax, and employment-related services to help manage the Affordable Care Act. Our award-winning technology will securely collect and aggregate the data necessary to manage ACA so we can handle the processes and communication between employees, the exchanges, and the IRS.

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Eligibility tracking

Our award-winning ACA Management Platform aggregates the necessary data from any source to track hours, determine eligibility, predict future enrollment volume, and provide alerts for potential compliance risks and penalties. Equifax’s ACA Management Platform is backed by N-version programming which is also used in banking and flight control systems. This means the technology spot-checks calculations in two systems that were independently developed to confirm the calculations are identical. Additionally, you’ll have peace of mind knowing you have an audit trail and your data is protected by Equifax’s security standards and proven track record of handling sensitive data.

  • Ongoing data management and validation
  • Eligibility projections and determinations
  • Affordability calculations and “what if” modeling
  • Fine risk assessments and notifications  

IRS form preparation and distribution

Equifax will collect payroll, benefits, leave, and other required data from any system or location and translate the data into the appropriate indicator codes to populate 1095-Cs as well as collect the information necessary to populate 1094s. We offer print and electronic delivery of the forms and can consolidate 1095-Cs with W-2s to streamline the employee experience and deliver significant savings in time and postage costs. In addition, our integration with tax preparers facilitates simplified tax returns for employees which can lead to fewer manual errors. In the event that an employer is fined, Equifax can also manage the appeal process with the IRS.

  • Print and electronic delivery of 1095-Cs to employees
  • Self-service reprints and corrections
  • Call center support for employee questions
  • Integration with tax preparers
  • Optional W-2 integration for consolidated tax form delivery 
  • Automated eFiling to the IRS

Exchange verifications

When an employee applies for a subsidy, or premium tax credit, the exchange to which the employee applied will request employment and income information to determine whether the individual qualifies. Most often, employees will contact their employer to get this information, leading to a magnitude of requests for Payroll, Benefits, and HR. Equifax streamlines the transfer of information between employers and government agencies which translates into fewer verification requests and an accelerated determination of whether the employee will receive a tax credit. In fact, CMS is leveraging Equifax as the primary data source to verify employment and income on subsidy applications and has contracted with us to provide verification of benefits in the future.

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Subsidy notices and appeals

When an employee is awarded a subsidy, the employer will receive a notification from CMS or the state exchange. The notification may not always be sent to the desired location making it difficult to collect and respond within the required timeframe. Equifax will process and store the notification, and if the subsidy is protestable, we will flag the record as a potential appeal. Once authorized, we can complete and distribute the appeal form to the applicable state or federal exchange. 

Equifax currently works with CMS, HHS, and state exchanges to streamline the processes for subsidy-related verifications, notifications, and appeals. For employers using our service, this potentially means fewer subsidy appeals and fine disputes down the road because CMS will have obtained the subsidy application information upfront.

  • Receive notifications on behalf of employers
  • Upload and store subsidy notifications
  • Send notification when appeals are authorized
  • Populate and distribute appeal form

Marketplace notifications

The ACA requires that employers send notifications to their employees regarding their healthcare options within 14 days of hire. By collecting and distributing ACA-related information the day an employee is hired, employers can protect themselves from additional paperwork and penalties down the road. During the onboarding process, Equifax can electronically deliver marketplace notifications and can capture electronic consent for delivery of the 1095 as well as W-2 to the employee. The employee will benefit by receiving information quickly and having online access to the forms while the employer will benefit from the elimination of administrative work and postage costs associated with sending 1095s and W-2s.

  • Delivery of marketplace notifications within 14 days of hire
  • Capture consent for electronic delivery of 1095s and W-2s at time of hire
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Compliance reporting and analytics

Without insight into cost and risk exposure, employers are unable to forecast and plan accurately. Ensuring this information is relayed accurately and in a timely manner is imperative because fines are assessed monthly. When employers understand their risks ahead of time, they are able to take action to proactively avoid penalties. Equifax offers compliance awareness reports and alerts to prevent year-end surprises. Our compliance scorecard allows employers to see an estimate of their potential 4980H(a) and 4980H(b) penalties by month and our employee profile view provides insight into each employee’s eligibility track record. We offer a library of report templates that are updated often and provide employers with the most relevant information needed to manage ACA compliance. Reports can be scheduled for auto distribution to ensure all stakeholders are aware of compliance trends and risks.

Employee communication

Employees will undoubtedly have questions around their eligibility status and the information that is provided to them on their 1095s. Most employers lack the resources to properly respond to these inquiries and often they do not have the necessary information to provide answers. With over 10 years of call center support for tax-related questions, Equifax is positioned to answer questions and keep employees well-informed.

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