Setting up Employer/Benefits

You must enter required details in the following areas about the employer (your company) and the medical benefit plans imported from your Sage program. This information is used to prepare the 1095-C Employer Provided Health Insurance Offer and Coverage and 1094-C Transmittal of Employer Provided Health Insurance Offer and Coverage Information Returns.

Choosing your employer and benefit defaults

Select Yes if your company offers healthcare that meets the ACA requirements for minimum essential coverage. Your healthcare provider can tell you if your plan(s) qualify. This information is reported on the 1095-C Employer Provided Health Insurance Offer and Coverage.

Note: If you do not have at least one plan that meets minimum essential coverage, My Workforce Forms prepares the ACA forms as if you are not offering affordable (qualified) healthcare coverage to your full-time employees.
From the Benefits list, select only those benefit codes from your Sage program that represent medical healthcare benefits. All benefits you select here are used to determine the affordability of your healthcare options.
Select the appropriate Offer of Coverage code. This alphanumeric list is directly from the Form 1095-C. A list of Offer of Coverage codes is provided to you in the help glossary, but because these codes are subject to change by the IRS, you must verify the codes on the IRS document, Instructions for Forms 1094-C and 1095-C.
Within the section for Lowest Cost Self-Only Minimum Value Coverage:
1. For Benefit Plan, use the drop-down menu to specify which of your qualified healthcare plans is the lowest cost, employee-only (not employee plus spouse or dependents) plan.
2. For Employee Contribution of Monthly Premium, enter the monthly employee contribution (for employee-only coverage, which is most likely the lowest rate for the plan) for your primary healthcare plan.
3. For Employer Contribution of Monthly Premium, enter the monthly employer contribution (also for employee-only coverage) for your primary healthcare plan.
If your company provides self-insured healthcare benefits, select the check box next to If Employer provided self-insurance coverage, check the box. This selection is directly from Part III of the Form 1095-C. Your healthcare provider can tell you if your company's coverage is self-insured.

Note: If you select No, your company is not required to provide information about covered individuals on the 1095-C Employer Provided Health Insurance Offer and Coverage and those pages will be left blank.