Now that tax season has arrived, it is time to file your income tax return and notify the IRS of your health insurance status. Requirements for proof of insurance vary according to the size of the company for whom you work.
The proof of coverage will be provided to you in one of two ways:
Form 1095-A if you obtained coverage using Covered California.
Form 1095-B if you did not use the marketplace but obtained health insurance directly from an insurance carrier. Medicare recipients will also receive Form 1095-B.
Watch your mail for these forms and make sure to file them with your 2021 taxes.
Now that you know which forms to file, pay attention to deadlines. Here’s a brief reminder of those dates…
January 31. You should receive either a 1095-A or 1095-B from your insurance company prior to this date. If you do not, we suggest that you contact the carrier.
April 18. This year, the deadline for filing your individual income tax return or to request an extension from the IRS falls on Monday, April 18. You can file a paper return by mail, or file it online. Make sure to accurately answer all questions regarding your health insurance status.
Make sure to keep your proof of health insurance coverage in a secure place, just in case the IRS requests this information in the future. As we’ve already stated, file it along with your tax return.
ACA Compliance can be a tricky issue, and deadlines are critical. Please reach out to us if you need more assistance with the filing requirements.
As you might already know, California law now requires all employers with more than 5 employees to either offer their workers a qualified retirement program (such as a 401k) or enroll in the state-sponsored CalSavers program. Passed in 2016, the law is designed to address the needs of 7 million Californians who lack a retirement plan. For the past five years, the law has been gradually phased in, and now smaller employers must comply.
If you employ between 5 and 49 workers, the deadline to comply with the CalSavers mandate will be June 30, 2022. Compliance will consist of either establishing a retirement plan or enrolling in a plan with CalSavers.
Up to this point, the state has simply encouraged employers to comply. But now, penalties for lack of compliance will begin to take effect. Steps taken will include:
- First, the Franchise Tax Board will send a letter to companies not in compliance
- Then, companies that remain non-compliant for 90 days will be penalized in the amount of $250 per eligible employee
- Then, if non-compliance extends beyond 180 days, the state will impose an additional penalty of $500 per employee
Enrolling your company in a retirement plan through CalSavers might appear, on the surface, to be the easiest way to comply with the law. However, that doesn’t mean that CalSavers is necessarily the best fit for you or your employees. The program imposes a number of regulations that some employers find to be too much of a hassle.
The other option is to explore retirement plan options with a qualified benefits planning professional, who can explain the pros and cons of different plans. The following plans are acceptable alternatives under the law:
- 401(a) – Qualified Plan (including profit-sharing plans and defined benefit plans)
- 401(k) plans (including multiple employer plans or pooled employer plans)
- 403(a) – Qualified Annuity Plan or 403(b) Tax-Sheltered Annuity Plan
- 408(k) – Simplified Employee Pension (SEP) plans
- 408(p) – Savings Incentive Match Plan for Employees of Small Employers (SIMPLE) IRA Plan
- Payroll Deduction IRAs with Automatic Enrollment
We can help with this. Schedule a consultation with us, and we will help you understand your options across a variety of different plans.
As an individual, you are subject to the rules of the Affordable Care Act with regard to minimum essential healthcare coverage. For those of you covered under an employee-sponsored healthcare plan, it is important to understand notice deadlines so that you can begin gathering your documents for tax season.
How large is your employer?
If you work for an Applicable Large Employer (ALE) which employs 50 or more full-time employees on average, you should receive a Form 1095-C from that organization. Government entities and tax-exempt organizations must also comply with this requirement.
If you work for a non-ALE, or small business that provides a self-funded healthcare plan, they must distribute to you a copy of Form 1095-B. This notice will provide you with proof of your minimum essential coverage.
Those who are not covered by an employer- sponsored plan will receive a 1095 form directly from their insurance carrier.
What are the deadlines?
Whether you’re subject to Form 1095-B or 1095-C, your employer is required to send the form to you by January 31, 2022. They can mail you the form, offer it to you in person, or transmit it electronically (via email) if consent has been requested and obtained.
You will need this information in order to file your individual income tax return and provide proof of healthcare coverage. While the federal individual mandate penalty is currently set at 0 dollars, the state of California does impose its own mandate and penalty regarding healthcare coverage. You will be required to provide this information on both your federal and state income tax returns.
Remember, the tax filing deadline is April 15, 2022. If you do not receive your form, or have questions about these requirements, give us a call and we’ll be happy to help.
As we approach the end of the year, employers should begin to prepare for tax season. Per the Affordable Care Act, you are required to file a number of forms with the IRS as well as send notices to your employees.
Who must report?
Applicable Large Employers (ALEs), defined as a business which employs, on average, 50 or more full-time workers. Any employer can qualify as an ALE, including tax-exempt organizations and government entities. Use Forms 1094-C and 1095-C to report to the IRS and distribute applicable copies of the 1095-C to each employee.
Non-ALEs (smaller businesses with less than 50 employees) which sponsor a self-funded healthcare plan must comply with IRC 6055 requirements and report to both the IRS and individuals covered by minimum essential coverage. Use Forms 1094-B and 1095-B for these purposes. These forms will be sent to you by your insurance carrier.
What are the deadlines?
Employees must be notified of healthcare coverage, via a 1095-B or 1095-C as the situation warrants, by January 31, 2022. You may distribute these forms by mail, in person, or via electronic means (email) with consent.
Paper filing with the IRS must be completed by February 28, 2022.
Electronic filing with the IRS is mandatory for those employers filing 250 or more Forms 1095-C. You must file via the ACA Information Returns (AIR) system and do so by the deadline of March 31, 2022.
For more information on your filing requirements, with regard to the IRS and employee notices, call our office for more personalized assistance.
As you probably already know, offering your employees health insurance can be one of the best ways to both attract and retain the best workers. Providing a group healthcare plan also keeps workers healthier and happier, reduces the number of sick days and schedule interruptions, and inspires loyalty to your company. But of course, obtaining a group healthcare plan can be challenging for smaller businesses, for numerous reasons.
If you’re concerned about your ability to meet standard employer contribution and/or employee contribution ratios, this notice is for you: For a limited time, between November 15 and December 15, health insurance providers offer a one-month Special Open Enrollment Window (SOEW) for smaller businesses.
During this time, you can enroll yourself and employees into a healthcare plan without having to worry about the above participation requirements.
This enrollment period is required by the Affordable Care Act, so you won’t be turned away. But because the enrollment period is so limited, with only one month to take action, we definitely suggest that you get started on this task now.
You can start by talking to your employees about healthcare plans, and ask them about their opinions. Both employees and employers benefit when communication is a two-way street, and everyone is happier when their views are taken into consideration. After gathering some basic information on your company’s needs, it’s time to consult with an expert who can guide you through these decisions.
We understand you already have a group health plan, but maybe you know of another business associate who needs this information.Tell them to please give us a call, and we will discuss their situation. Then, we can help them explore their group health insurance options.
As you probably already know, California’s Individual Mandate for health insurance took effect at the beginning of 2020. At that point, all California citizens were required to maintain minimum essential health coverage for all twelve months of the year.
The requirements allowed for employer-sponsored plans, plans purchased through Covered California, plans purchased directly from providers, Medicare plans, and Medi-Cal (the Medicaid program in California). Any of these options fulfilled the requirement for minimum essential coverage, but those who failed to enroll in one of the above plans faced a penalty on their state income tax return in most cases.
For 2021, the penalty for failing to maintain health insurance coverage has increased to the following amounts:
- A flat amount based on the number of people in the household; $800 per adult and $400 per dependent child up to an annual maximum of $2400
- A percentage of household income; 2.5 percent of all gross household income over the tax filing threshold
The state assesses the penalty as whichever calculation (of the above formulas) yields the larger amount.
Some exemptions to the law do apply, but it is not recommended that you rely upon those. Even if you qualify for an exemption, the cost of going without healthcare coverage could greatly exceed the penalties outlined above. Give us a call to discuss your health insurance enrollment options, so that we can get you covered for 2022.
Those with a health insurance plan, either private or employer-sponsored, often report that their plan still does not provide for all of their healthcare needs. Indeed, health insurance policies are subject to restrictions on their coverage, and you should expect to self-pay for part or all of some services, medications, and so on. But the lack of dental coverage can sometimes result in large, unexpected bills… And an aching tooth is hard to ignore.
That’s why many people choose to add a dental insurance policy to their overall coverage. A dental policy can help you to manage expenses and reduce the amount you end up paying out-of-pocket.
But as with other types of health insurance, it’s important to understand the different types of dental insurance policies before selecting one.
A Dental Health Maintenance Organization (DHMO) offers prepaid dental care to members who subscribe to services. You pay a monthly fee, and then receive all of your dental care from the DHMO facility or from independent dentists contracted by the DHMO. However, no benefits are provided if you seek care outside of this network. In most cases, a DHMO tends to be the least expensive option.
A Preferred Provider Organization (PPO) works similarly to an indemnity plan. You pay a premium and can then seek care from a list of preferred providers. These providers have agreed to group pricing and to follow certain rules and procedures set forth by the plan. If you stay within the network of providers, you can obtain services in exchange for lower fees. You can also seek care outside of the PPO network but will generally pay a higher co-pay when doing so.
Fee-For-Service dental care applies to those with dental insurance, and those without. If you go this route, you can seek dental care from any dentist, regardless of networks, assuming that they are accepting new patients. You are responsible for paying the fees for services rendered. But if you have dental insurance that covers fee-for-service dental care, you can submit your bill to your provider, and they will reimburse you according to the rules of your policy.
If you’re interested in adding a dental insurance policy to your main healthcare plan, call us to discuss your options. We can help you identify the type of policy that fits your family’s needs and helps you to maintain a manageable healthcare budget.
As a business owner, you know that a comprehensive healthcare package keeps your workers healthier, happier, and more satisfied with their employment. Of course, it also benefits you, as healthier employees miss fewer workdays and operations remain more stable.
But while healthcare does provide immense benefit, it cannot protect employees against all of life’s ups and downs. In the event of a short-term or long-term disability, due to injury or illness, how would employees handle the loss of income on top of their health concerns?
Disability insurance provides an answer to this concern.
Group disability insurance can round out a lucrative employee benefits package. Typically, a disability insurance policy can provide the covered individual with up to 60 percent of their former income when out of work due to disability (up to certain limits).
A variety of disability insurance policies are available, depending upon your employees’ needs and preferences. Some of the benefits might include:
Portable policies – with some policies, employees can continue them even after separation from the employer.
Flexible premium payments – premiums can be paid by the employer or employee or shared by both.
Potential tax benefits – premiums can be paid on a pre-tax or post-tax basis, depending upon your preferences, and those made with pre-tax dollars can be used as a business tax deduction.
Lower premiums – employees can access disability insurance at lower rates when they have access to a group plan.
In addition, a disability benefits package can serve as a valuable tool in recruiting and retaining talented, dedicated employees.
Group disability benefits packages can be designed around a variety of employer and employee needs and can apply to short-term or long-term disability (or both). Give us a call to learn more about this valuable benefit, and we can walk you through your options.
We do Employee Benefits. For over 30 years we have assisted small businesses with a knowledgeable and caring approach. We free you to do your job. We clarify any confusion with insurance forms, policies and procedures. Give our phone number to your employees. Diamond Certified and Better Business Bureau A+ Ratings
We know your name & your company. We know you and care about your insurance needs. We value your employees. We do not pass the buck or just provide you with the carrier’s 800#. We take the time to listen, find the answer, and then get back to you with a simple and thorough explanation – no snappy answers – we want you to understand.
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We work with all insurance carriers including Covered California to find the lowest cost and best benefits for you and your employees.
We set you up, run employee meetings, process enrollments, and we are available for employee questions. We are here 12 months a year, not just on the day you enroll.
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provides easy accessible information and tools to help you manage your day to day HR functions and challenges.
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we set up your Premium Only Plan to assist you and your employees with important tax savings.
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Although we do not administer your COBRA duties for you, we enlist the services of a proven professional, Sterling Administrators.
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The Employee Retirement Income Security Act, or ERISA, is a federal law that regulates certain group-sponsored benefit plans. The law requires employers to disclose plan information to all eligible employees, subject to strict guidelines. As an employer, here’s what you need to know.
Who is subject to ERISA? Churches and government employers are exempt from ERISA regulation. Most other private-sector corporations, partnerships, and proprietorships must comply with this set of laws. When in doubt, employers should consult a business planning attorney.
Which group benefit plans fall under ERISA regulation? Most employer-sponsored plans, such as medical, dental, and vision plans are subject to ERISA, along with health savings accounts, healthcare FSA, and HRA accounts. Even vacation and scholarship plans fall under the law.
However, ERISA typically does not apply to:
- Cafeteria Plans
- Premium-Only Plans
- Section 125 Plans
- Premium Conversion Plans
- Pre-tax Premium Plans
- Health Savings Accounts when employers have limited involvement
- Dependent Care FSAs
- Dependent Care Assistance Plans
- Transit and parking plans
- Adoption Assistance
- Educational Assistance and Tuition Reimbursement
- Paid time off
- On-site medical clinics for the purpose of providing first aid
*Even minimal endorsement, such as using the company name on brochures, could make the plan non-exempt from ERISA.
What is the Summary Plan Description and how must employers provide it? The SPD communicates rights and obligations to plan participants and beneficiaries and summarizes the main provisions of the plan. Employers must provide a SPD to beneficiaries within 90 days of coverage, via email, regular mail, or hand delivery. Failure to comply with this requirement can trigger fines from the Department of Labor.
What is an ERISA “wrap”? A wrap document can help small employers in particular meet their ERISA obligations. The Wrap SPD requirement applies to all employer sponsored group health insurance offerings, including a one-person plan. A wrap document “wraps around” all ERISA health and welfare benefits and includes required disclosures that are not typically found in other documents. These include details like the allocation of duties and responsibilities between the employer and the insurer, or the rights participants are entitled to under ERISA
What else do employers need to know about ERISA? ERISA regulations can become complicated. This document outlines 18 things employers need to know about ERISA compliance, in order to avoid violations and potential fines.
We can also help you to understand your employer-sponsored benefits plans. Call us with any questions you might have about plan administration, and we will be happy to help.