Employer GROUP Benefit Plans Under the “AFFORDABLE CARE ACT” (“ACA/Obamacare”)

IRS FILING DEADLINES to file the 1095-B and 1095-C reporting under section 6055 and 6056 of the IRS code.

Section 6055 requires health insurance issuers, self-insuring employers, government agencies, and other providers of minimum essential coverage to file and furnish annual information returns and statements regarding coverage provided. Section 6056 requires applicable large employers (generally those with 50 or more full-time employees, including full-time equivalent employees, in the previous year) to file and furnish any annual information returns and statements relating to health insurance that the employer offers to its full-time employees.

Both fully insured ALEs (Applicable Large Employers) and all self-funded plans must complete these forms annually in order to avoid the potential non-filing penalties.

For questions, please contact Paul@LeagueFinancial.com or call: 800-482-5347


Small GROUP Plans 1-49 Employees (via SHOP, Private Marketplaces or Direct Insurers), please complete the CENSUS and scan and email that back to us for processing, which will be followed with a full Proposal that compares plans, benefits and rates.

Large GROUP Plans with 50+ Employees, we also design Self-Funded, Level-Funded, ASO (Administrative Services Only) Plans, which are perhaps the most cost effective delivery model for Group Health, Dental, Vision and Life Insurance available in the market today. Please contact us for assistance at: 800.482.5347.

Employer Shared Responsibilities Under the ACA: These rules begin with ALE’s (Applicable Large Employers), and the laws requirement for Large Employer Groups–based upon workforce size–to determine the Employer Responsibility Payment to the IRS, and how to test for Full Time Employees, and include FTE (Full Time Equivalent Employees). Use the following link to understand how to calculate: Calculating AFFORDABILITY under the ACA Employer Mandate in 2020


ALL GROUPS: If you currently already have programs in place and are looking for alternative competitive solutions, then please also include in an email to us your: Company Census, Benefits details on all plans you wish to have quoted, your most recent billing or renewal notice, and your most current Quarterly Wage & Tax Report (this provides necessary “eligibility” criteria).


New strategies exist to handle both Small & Larger Group Benefits like Health, Dental, Vision Insurance coverages. Please consider each of the following:

Level Funded Benefits Plans
Self-Funded Benefits Plans

Cafeteria Section 125 Plans:

Today, most Employers should not install or continue a Group Health Plan without also installing a Cafeteria Section 125-Full Flexible Benefits Program. WHY? In order for Employers to be able to continue in the full or partial support of the costs of these plans for their valued employees cost reduction is a necessity. A “Cafeteria Plan” allows Employers & Employees to move certain eligible expenses from after-tax to PRE-TAX. The result is substantial savings to both parties in Taxes (see here for details of such Plans: “Cafeteria Section 125 Programs.”

Note: for purposes of dependent care FSAs, the child is always treated as the qualifying child of the custodial parent. There are several examples included in the IRS Notice 2006-86 available by clicking here. If the special rule outlined above does not apply, the tie-breaking rule applies to the provisions listed above as a group, rather than on a section-by-section basis. Therefore, if a child is treated as the qualifying child of one taxpayer for one purpose (e.g., earned income credit), the child may not be treated as the qualifying child of any other taxpayer for any other purpose (e.g., child tax credit, the child and dependent care credit, and/or exclusion under a dependent care FSA).

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