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Are You Covered? Managing ACA Compliance and Benefits Administration

Posted by David LaMontagne at 26 Apr 2019

ACA compliance remains one of the most talked about and confusing processes for HR professionals, as well as people outside of the HR field. From passing the law under President Obama, to trying to repeal the law under President Trump, many people have been left confused as to the current status of the ACA. In short, the ACA remained in full force for 2018, especially as it relates to US employers, and for now, remains in effect for 2019 and beyond.


Healthcare and medical coverage is a benefit for employees, providing them with the level of care they need, and giving them affordable options when seeking medical care. With the Affordable Care Act (ACA) enacted in 2010, companies employing more than 50 Full Time Employees (FTE) are required to provide some form of medical insurance for employees.


Over the years, there have been shifts in the ACA, making it critical for businesses to be aware of the current laws so that compliance can be met, in order to protect employee and company alike.


The IRS increased several penalties for the year 2018.

  • The Employer Shared Responsibility Payment (ESRP) for Failure to Offer Minimum Essential Coverage (MEC), increased from $2,260 per employee in 2017 to $2,320 per employee in 2018.
  • The Employer Shared Responsibility Payment (ESRP) for Failure to Offer Coverage that Meets Affordability and Minimum Value (MV), increased from $3,390 per employee in 2017 to $3,480 per employee in 2018.
  • The Failure to File Penalty applies to employers who did not file correct information returns for 2018. That penalty increased from $260 per return in 2017 to $270 per return in 2018.
  • The Failure to Furnish Penalty applies to employers who fail to provide correct 1095-Cpayee statements to employees. The penalty increased from $260 per return in 2017 to $270 per return in 2018.


We’re already into the second quarter of 2019, and before long, open enrollment for 2020 will be upon us, along with any additional changes to the benefits code. Maintaining ACA compliance, educating employees on benefits options, and gathering enrollment information are time intensive tasks. But failing to meet ACA compliance is costly business, as The Congressional Budget Office & Joint Committee on Taxation (CBO) projects employer responsibility penalties totaling $200+ Billion over a 10-year period.


Here are examples of some of the fines that have been levied by the IRS:

  • December 2017, a 3,500 person company was charged an ESRP penalty of $1,423,066.64
  • May 2018, a 500 person company was charged an ESRP penalty of $46,0202
  • October 2018, a 78-person company was charged an ESRP penalty of $103,653.29.


These are just a few examples of potential fines and issues related to not meeting ACA and benefits compliance. And no company that falls within the regulation standards is exempt, as seen in the respective range of 78 employees up to 3500.


For many organizations, tracking these requirements is often manual and inefficient, and prone to risk of errors, which can result in enormous penalties and fines. Without question, the solution to maintaining ACA compliance is by leveraging a content-centric, workforce management system that provides both employees and employers the necessary information for choosing proper benefits, along with the right tools for tracking and reporting.


Essium works with businesses to create intuitive material describing benefit plans and building dynamic enrollment workflows to ensure all necessary information is collected and conveyed to the designated carriers. We’d love to show you what our Xenqu management system can do to help you achieve and maintain ACA compliance and benefits administration. Contact us today for a demo!



David LaMontagne is the CISO at Essium, a premiere software company that has developed a revolutionary, customizable, workforce management solution named Xenqu. Essium’s Xenqu Software leverages our Smart Content Technology to organize everything related to your workforce in one secure, digital file using the latest cloud-computing technologies and architectures.