Additional ACA Compliance Services
We offer additional services beyond the features that are standard - or even expected.
Analytics & Reporting
The Benefitsolver platform has a number of standard reports and graphical analytics tools that will provide you the necessary information you need to complete the ACA-required forms, including:
- PCORI section of the IRS Form 720 – Businessolver houses the data required to complete the PCORI section of IRS form 720 for self-insured health plans via an integrated analytics tool. The analytics display a point-in-time count of all enrolled members (employees and dependents) as of a specified point in time.
- Transitional Reinsurance reporting (2014-2016) – The ACA requires health insurance issuers and self-funded group health plans to fund a Transitional Reinsurance Program in place from 2014 to 2016. Businessolver reports average member counts for you to submit to the Department of Health and Human Services to comply with the ACA.
The Benefitsolver platform supports auto enrollments at the plan level. Employees can be automatically enrolled in a set of default plans regardless of whether an employee logs in during annual enrollment, or previous elections can be rolled over to the next year during annual enrollment.
The Benefitsolver platform tracks when an employee waives coverage. If an employee waives coverage, a waive reason can be required for each benefit waived. Waive reasons are available in Benefitsolver, providing you proof of offered coverage – including a time and date stamp of any waived coverage.
ACA appeals and inquiries processing will address:
- Exchange Premium Tax Credit (PTC) Appeals (as defined under ACA provisions) based on employee eligibility for coverage by the employer-sponsored plan;
- Employee Eligibility Appeals according to hours worked (provided by the client) to determine eligibility as defined by ACA; or
- Coverage Claims Appeals (as defined under ACA provisions) which will be referred to the medical plan carrier to determine claims payment.
Businessolver provides clients with a cumulative monthly report that aggregates employer and employee contributions. Standard reporting includes year-to-date accumulations for the following plan subgroups: Medical, Dental, Vision, Prescription Drug, and EAP plans built within Benefitsolver. Report details include: SSN, Employee ID, Plan Type, Structure Group, Term Date, Department, Pay Frequency, Plan Effective Date, and Cost Year to Date.
Summary of Benefits and Coverage
Employers are required to provide participants an Health & Human Services (HHS)- approved Summary of Benefits and Coverage (SBC) explanation. Businessolver offers a few options for delivering SBC information to employees including posting the document within the system and incorporating it as an information tool during enrollment. We have also included the required glossary of terms into the documents themselves, rather than as a separate attachment, making it easier for users to understand complex terminology.
Businessolver configures and updates ACA StatusTrackerSM services at the client’s direction. The client is responsible for all compliance requirements. Businessolver provides ACA status tracking tools and information, which may be used by the client to assist with reporting and compliance needs. However, Businessolver is not responsible for ensuring the accuracy, completeness, or final compliance of client with respect to Employer Shared Responsibility Final Regulations (79 FR 8543), or other applicable laws and regulations.