Affordable Care Act

PrismHR Gives You the Insight You Need to Address the Affordable Care Act

With calculations and reporting that specifically address Affordable Care Act requirements, PrismHR provides the business intelligence you need to adapt to constantly changing healthcare regulations.

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Employee Classification Analysis

Ensure data accuracy and completeness by verifying that anyone categorized as a full-time employee is truly working enough hours to be categorized as such. Analyze and verify your data so you can make any adjustments before running the “large employer” test.

Large Employer Test

A “large employer” averages at least 50 full-time equivalent employees for the previous calendar year. The PrismHR Large Employer Test report lets you easily analyze each client (including control group clients) across any date range so you can make predictions and understand where each client sits.

Identifying Full-Time Equivalent Employees

Some variable-hour employees are eligible for coverage under the ACA if they work an average of 130+ hours per month over a 6-12 month time period (established per client). PrismHR lets you set a custom time-frame and quickly see if there are part-time employees who are eligible for coverage under the ACA.

Health Care Tax Credit Report for Small Employers

See which clients are eligible for this credit and then explore client level detail to discover how much that credit is worth.

Affordability Test (The 9.5% Test)

To be affordable according to the ACA, the employee’s cost of the employee-only coverage of the lowest-cost ACA-compliant plan available to that employee must be 9.5 percent or less of annual household income. Regulations allow three safe harbor options to use in lieu of the annual household income. Those three options are: Annualized pay, the box-1 W-2 wages, or federal poverty level (FPL). The PrismHR Affordability Test report displays Annualized Pay and box-1 W-2 calculations for employee’s currently elected health plan, so the employer can decide which form of wages will determine affordability.

Family Rated Plan Option

The Family Rated Plan option provides that the premium rate charged by a health insurance issuer for non-grandfathered coverage in the individual or small group market may vary based on age and a tobacco-use surcharge. Manually calculating coverage for this plan can be tedious and time-consuming, but PrismHR automatically recalculates these rates each pay cycle based on data in the system. The rate per covered person is based on the number of covered family members (a maximum of three children under age 21 can be counted in this plan), their ages, and if they are tobacco users.

More Resources

PrismHR Benefits Administration