Sometimes your groups may have employees or plans with special circumstances. We have created this list of Frequently Asked Questions regarding some of the unique situations you may have with a group.
What if a group had both self-funded and fully insured plans in the same calendar year?
- The system has the ability to create the appropriate 1095 form for employees if all plans are created with the appropriate dates, Self-funded plans are marked as such in Assign ACA Plans and employee and dependent enrollments are uploaded. Because a self-funded plan was used for at least a partial year, the employee will receive a 1095-C form that indicates the enrollment information in Part III for any months enrolled in the self-funded plan. The remaining months will indicate the appropriate code based on the fully-insured plan.
What if a group has international employees?
- The system does not have the capability to process international addresses for physical mailing of forms. However, we recommend using the company address for any international employees (reflecting the information you would use for that group in Part I - Employer Information). Physical forms would then be mailed directly to the company and can be distributed to international addresses by the company directly. Alternatively, you have the ability to provide email addresses and select Online Retrieval in Nelco which would enable any international employees to log in directly to Nelco, our e-filing and mail/print partner, to retrieve and review their individual 1095 forms.
Can I print the 1094 and 1095 forms from the Nelco site and mail them directly into the IRS?
- No, the IRS has specific rules about the format required in order to accept the 1095 forms. When printing from Nelco, the forms are available in a portrait format and the IRS expects the forms in a landscape format.
Can I base contribution amounts on a percent (9.56%) of the employee's salary?
- Yes. We are now able to specify contributions based on % of monthly earnings. For more info, see Plan Setup: Medical Contributions
- If you are not able to configure your plan contributions using "employee cost % of monthly earnings", we recommend using the Import Low Cost Plan Cost to provide an individual employee's exact cost for the 1095 form.
What if a group is not using Business Units to report that they are a member of an ALE group?
- Nelco gives you the ability to manually edit the 1094 form in their portal. If you have set-up members of an ALE group as separate companies in Employee Navigator, here is what you need to do:
- Set-Up in Employee Navigator
- Part 1 Employer Information
- Do NOT check off Question 1: Are a member of an ALE Group? You will manually check this off in Nelco's portal.
- DO check off Question 2: Are you an ALE? If you are a member of an ALE group you are an ALE. This is will allow to produce the 1095-Cs for your employees.
- Go through the Audit and E-File steps as instructed. Transmit the forms to Nelco.
- Set-Up in Nelco
- Once the forms are transmitted, you will enter the E-File site to see the data. Confirm that the expected forms are listed and Select "Next." Then select "Edit 1094-C."
- Editing the 1094-C- NOTE: Other information on this form will be filled out based on the information that was sent from Employee Navigator.
- ALE Member Information
- 21. Is ALE Member a member of an Aggregated ALE Group? Select: Yes.
- ALE Member Information Monthly
- Aggregated Group Indicator- Select the appliable month's where the group was a member of an ALE group. If they were a member of an ALE group for the entire year, Select "All 12 Months."
- Other ALE Member of the Aggregated ALE Group
- Add the legal business name and EIN of the the other ALE members. Select "Add ALE Member" to add the member information.
- Select "Next" when all the other ALE members have been added to the form.
- Continue to process and pay for the forms as you walk through the rest of Nelco's portal.