California law requires the state to screen all individuals disenrolled from Medi-Cal for possible enrollment in the lowest-cost silver-tier plan available to that person on Covered California. If their income is less than 400 percent of the FPL, they will qualify for PTC subsidies to help pay for some, or all, of the silver plan’s premium. If a PTC is linked to an employee of your company, the IRS is supposed to compare the Tax Identification Number with W-2 and ACA 1095-C reporting data to determine whether an employer is subject to the ACA Large Employer rules and if the employer offered this person ACA compliant coverage. If those records are not sufficient to clarify the employer’s compliant offer of coverage, the IRS is directed to send a 226-J penalty letter indicating that the employer might be subject to an “Employer Shared Responsibility Payment” amounting to thousands, perhaps millions, of dollars. California began its re-evaluation of Medi-Cal beneficiaries’ eligibility (in
April 2023) for people who were enrolled effective June 1 st (of any prior year). Those who no longer qualify for coverage will be disenrolled from Medi-Cal, effective July 1, 2023. These recertifications continue each month until May 2024. What do HR professionals need to do to keep their employers safe? Applicable Large Employers (ALEs) must annually report to the IRS (and in California, also to the Franchise Tax Board), via the IRS 1095-C reporting form. There are penalties for not issuing a valid 1095-C to employees and a separate penalty for not filing a 1095-C with the IRS. If intentional disregard is alleged by the IRS, these penalties alone could be $1,180 per worker per year. Over and above the reporting and disclosure rules, if an ALE is found to have failed to offer Minimum Essential Coverage (MEC) to at least 95% of full-time employees, they could be subject to the 4980H(a) penalty, which is $240 per month ($2,880 annually) per employee in 2023.
If the employer did offer MEC but failed to offer coverage that qualified as “Affordable” and meaningful enough to be considered “Minimum Value” to any full- time employee that received a PTC in a given month, the 4908H(b) penalty could apply, which in 2023 is $360 per month ($4,320 annually). It is also important for HR professionals to know that ACA’s “Family Glitch” was fixed in 2023. Instead of basing the affordability determination for a family’s employer-sponsored health insurance on just the cost to cover the employee, the determination will now be made based on the cost to cover the employee plus family members, if applicable. This definition of affordability only applies in terms of the family’s eligibility for the PTC. It does not impact the IRS safe harbor rules for affordable offers of coverage. Should you have questions about any ACA compliance issues, Western Growers Insurance Services is here to assist.
THE BEST WAY TO MANAGE PATHOGENS BEFORE THEY BECOME AN ISSUE.
When targeting soil borne disease and nematodes, TriClor and TELONE TM can be applied in a single pass. This reduces application costs, promotes early root development, and improves soil health. For more information about TriClor and TELONE TM or to schedule an application contact TriCal, Inc.
669-327-5076 www.TriCal.com
*TriClor and TEONE TM are federally Restricted Use Pesticides.
SEPTEMBER | OCTOBER 2023
15
Western Grower & Shipper | www.wga.com
Made with FlippingBook Digital Publishing Software