Since January 1, 2015, the Affordable Care Act (ACA) Employer Mandate has required Applicable Large Employers (ALEs) to ensure compliance with IRS reporting and coverage requirements.

Failure to comply can result in substantial financial penalties, making it critical for organizations to track, document, and report employee status and health coverage accurately.

To meet these obligations, ALEs must evaluate IRS safe harbors and implement the following tracking measures:

• Monitor & Report – Establishing Measurement Periods, Administrative Periods, and Stability Periods to monitor and report employees' status and coverage accurately.
• Full-Time Status – Tracking employees who exceed 130 hours of service per month to identify full-time status and ensure at least 95% of full-time employees are offered health coverage.
• Mitigating Penalties – Mitigating penalties of $2,000 per full-time employee annually for failing to provide adequate coverage.

83% of ACA penalties result from inaccurate employee classification or late filings.

A company with 1,000 employees could face six-figure penalties annually due to ACA non-compliance. Failing to track employee hours correctly or missing IRS reporting deadlines can result in substantial fines. Even minor reporting errors can add up, costing businesses thousands. Proactive compliance measures and expert ACA consulting can help organizations avoid penalties, protect budgets, and maintain regulatory peace of mind.

ACA Compliance Services

Pinnacle Risk Solutions delivers a comprehensive Search & Rescue process to uncover and recover healthcare claims errors.

Our experts leverage in-depth industry knowledge and advanced data analysis to identify overpayments, resolve inaccuracies, and return real savings to your organization.

By balancing flexibility with advocacy, we help you achieve financial clarity while maintaining strong payer relationships.

Historical Payroll Data Analysis Reporting

Initial evaluation

The foundation of compliance begins with analyzing historical payroll data (minimum 12 months) to identify hours of service for each employee. We collaborate with all payroll vendors capable of providing detailed reports in formats like Excel or text files.

Measurement Period Analysis & Optimization

Baseline

Our team identifies the optimal measurement, administrative, and stability periods for ongoing, seasonal, and variable-hour employees based on IRS safe harbors. We ensure employees and staff understand the importance of these periods in maintaining compliance.

Tracking and Periodic Reporting for All Employees

Ongoing

After the initial evaluation and baseline analysis, we provide continuous tracking and periodic reports for all employees, including new hires and variable-hour staff. These reports help organizations adjust hours and maintain compliance under the ACA.

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