Employee Navigator will allow you to verify your data before transmitting to Nelco for filing and submission. Our Audit and Transmit link will walk you through the verification steps. Prior to starting these steps, you should verify that you have already completed the following:
- Setup Measurement Periods
- Assigned ACA classification to all employees
- Imported hours for variable hour employees
Verify ACA Plan Assignments and Employer Settings
Audit Employee Demographics & Enrollment Data
Preview Form Data
E-file
Verify ACA Plan Assignments and Employer Settings
Verifying ACA Plan Assignments
Now you will verify the values that have been assigned to your ACA Plans. Selecting (or failing to select) even one of the boxes incorrectly may impact the codes generated for Line 14 on the 1095 forms, as the system derives these codes based on the assigned values for each field.
- Review the values for each plan to verify that you have correctly indicated all attributes for each plan.
- Select Edit ACA Plan Assignments to make any edits to a value on a plan.
- Self-Funded: A plan where the employer assumes the responsibility for claim processing and payment. All enrollees must be reported on for ACA, including dependents, COBRA participants and retirees.
- Enforce ACA Eligibility: A check within the system that allows Employee Navigator to calculate the correct eligibility dates for different enrollments. If this is checked, the ACA classification of Variable Hour will not be eligible for benefits until passing their measurement period.
- Provides Minimum Value: A plan is minimum value if it covers at least 60% of the cost of benefits expected to be incurred under the plan.
- Provides Minimum Essential Coverage: MEC includes any major employer-sponsored medical plan, including retiree-only coverage, such as a retiree-only health reimbursement arrangement (HRA)
- Is Low Cost: Allows the system to simplify the calculations performed for affordability. There can be more than one low-cost plan.
- Spouse Coverage Excluded: When the plan does not offer the spouse coverage.
- Children Coverage Excluded: When the plan does not offer the child coverage.
- Conditional Offer to Spouse: A conditional offer is an offer of coverage that is subject to one or more reasonable, objective conditions (for example, an offer to cover an employee’s spouse only if the spouse is not eligible for coverage under a group health plan sponsored by another employer). Conditions attached to an offer may impact the spouse’s eligibility for a premium tax credit.
Part 1 Employer Information
The next step is to verify that the Employer information is complete and accurate. The data in this section is used to populate 1094 forms, as well as the employer information for the generated 1095s.
- Review the contact information including distinct EIN, employer name and address.
- If your company uses business units to file multiple ALE members, contact information must be completed and verified for each Employer Identification Number (EIN). Scroll down the page to view the information for each EIN.
- Review any selections about ALE, member of an ALE group, Multiple Employer Welfare Arrangement (MEWA), or Transition Relief.
- Note that information will only be visible if the boxes were selected on the Part 1 Employer Information page.
- Select Edit Part 1 Employer Information to make edits to any of the Employer Settings.
Audit Employee Demographics & Enrollment Data
Audit the employee's demographic and enrollment data to determine the eligibility of your employees, the enrollment information that needs to be reported and properly distribute the forms to your employees.
ACA Related Employee Data
Employees who are missing an ACA classification or hire date will be listed in the Employees Missing Required ACA report.
- Review any employees missing data by selecting the link.
- Missing data will be indicated in red.
- Edit individual employees by selecting edit or download all impacted employees using the Excel link.
- Make the necessary corrections and re-import the files with completed information.
Employees who have a hire date and ACA Classification will appear on the Employees with Entered ACA Data report. There may be employees who appear in two lists. For example, a Collectively Bargained employee who has the ACA Classification of Variable Hour will appear in both the Collectively Bargained and Variable Hour lists.
- Review a list of employees by selecting a Classification link.
- View an individual employee’s record by selecting edit.
- Modify the ACA classification from the ACA Demographics > Edit link.
Hours
Employees who have an ACA classification of Variable Hour and who are missing hours will be included in this report listed by the measurement or stability period with the missing hours. Hours must be entered based on the employee's measurement period, so 2017 and 2018 hours may be required.
- Review any employees missing hours by selecting the link.
- Missing hours will be indicated in red.
- Edit individual employees by selecting edit or download all impacted employees using the Excel link.
- Make the necessary corrections and re-import the files with completed information.
TIP: If an employee appears twice on this list then they have two separate stability periods that occur during the year. For example, a group has 12/1 plans. That means that if their VH ees have worked enough hours to be considered eligible for benefits would have a stability period from 12/01/2017-11/30/2018 and another stability period from 12/01/2018-11/30/2019. We would expect an ee who is missing hours to account for both of these stability periods to appear twice on this list.
Demographics
Employees who have missing or invalid demographic information (address, social security number, date of birth, etc.) will be listed in this report. All required demographic information must be completed.
- Review any employees missing or with invalid demographic information by selecting the link.
- Missing information will be indicated in red.
- Edit individual employees by selecting edit or download all impacted employees using the Excel link.
- Make the necessary corrections and re-import the files with completed information.
- Note that one item missing in an address will display all address fields in red.
Enrollment
There are multiple ways to upload your enrollment data to the system, particularly if you use are a benefits admin user. Reports in this section will allow you to review any discrepancies in data that have arisen or confirm that your eligible employees are listed as expected.
Audit Enrollments
- The self-funded enrollment conflicts will display any employee enrollment records where the employee is enrolled in both a self-funded plan AND a fully-insured plan for the same month. This discrepancy occurs when Employee Navigator has information for an employee from a benefits administration record AND from an imported historical record. This will not be a common occurrence.
- Only enrollments in self-insured plans will be reported in 1095-C Part III.
- Enrollment date conflicts will display any employee enrollment record where the employee has different enrollment dates listed for a plan within the same month. This discrepancy occurs when Employee Navigator has information for an employee from a benefits administration record AND from an imported historical record.
- 1095-C Part II, line 16 will only report enrolled coverage if employee was enrolled every day of the month.
- To troubleshoot any entries in these sections:
- Use the Key to determine if a listed employee was enrolled every day of the month or if a conflict exists.
- Select the employee's name for more information.
- Employees who are eligible for a medical benefit based on the plan rules but are not enrolled in a plan are displayed on this report. This includes:
- Employees who have declined coverage
- Employees without a medical enrollment at a company that offers self-funded plans
- Employees without a medical enrollment who are classified as ACA eligible when the company is an ALE and offers fully-insured plans
- Note that very few, if any, employees will have a month that indicates they were eligible and enrolled in the grid
- All other employees in the company who are not eligible or who are eligible and enrolled.
Enrolled & Ineligible
Employees who are not currently eligible for coverage but who are currently enrolled in a plan will display here. Employees on this report will not receive a 1095 form. The IRS requires forms to be provided ONLY to employees who were eligible for coverage.
Preview Form Data
Once data is entered, you can generate previews of what the form data will look like. You should compare the codes on the preview pages with the expected outcomes.
- Select Create Preview of Form Data
- Select View 1094C for each
E-file
E-filing with Nelco is now available for companies that have completed all steps of the audit and are confident that they are ready to print or e-file with the IRS.
We highly recommend viewing the E-filing with Nelco webinar before moving forward in this process.
After training, you can refer back to our Instructions for the E-file Portal article for assistance as you move through the process.
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