This page has moved and will no longer be updated. To access the current page, click the Online Help 
icon in PrismHR or navigate to the new help docs site and search for your topic.
Configuring Client ACA Parameters
Note: Client Access Group Security is enabled on this form.
You can use the client-level ACA parameters to override system-level ACA parameters (see Configuring Global ACA Parameters). You can also specify other client-specific information on this form.
Basic Parameters
Review the information below for details about some of these override settings.
Safe Harbor Compensation Basis Types
The system provides three basis type options to determine employee compensation and, by extension, the affordability of offered ACA coverage:
|
Basis Type
|
Description
|
|
Federal Poverty Level
|
Affordability is based on annual household income, factored by household size; you can set annual federal poverty level overrides in the table below.
|
|
Rate of Pay
|
Affordability is based on a multiple of the lowest pay rate for the employee.
|
|
Form W-2 Wages
|
Affordability is based on a multiple of the employee's Form W-2 wages for the calendar year.
|
About the Rate of Pay Safe Harbor
The Rate of Pay safe harbor looks at the monthly pay of salaried employees. It also excludes any salaried employee whose rate of pay dropped, during the calendar year, from the safe harbor consideration.
Rate of pay is determined differently for salaried and hourly employees:
|
•
|
For salaried employees, the system uses the rate of pay on the first day of the plan year. |
|
•
|
For hourly employees, the safe harbor uses the lesser of: either the rate of pay at the start of the year or the rate of pay as of the first of each month. |
As documented on the form and in the official ACA guidance, each of these basis types is also associated with its own ACA series 2 offer code:
|
•
|
2G – The coverage offered is affordable based on the Federal Poverty Level safe harbor |
|
•
|
2H – The coverage is affordable based on the Rate of Pay safe harbor |
|
•
|
2F – The coverage is affordable based on employee Form W-2 Wages |
Federal Poverty Level Overrides
If you set the client basis type to Federal Poverty Level/2G, you can also specify override values for this metric. The Federal Poverty Amount and Percent of Federal Poverty Amount fields are assigned based on plan years, not calendar years.
For example, if the plan year runs from June 1, 2019 through May 31, 2020, the system users the amounts entered for Plan Year 2019. If the plan year starts on January 1, then the plan year matches the calendar year.
Use the table on this form to specify yearly poverty level overrides, as needed:
|
•
|
First, select the appropriate calendar Year. |
|
•
|
Enter the Federal Poverty Amount for a household of one. |
|
•
|
Finally, enter the % of Poverty Level used to calculate affordability. |
Procedure
To establish general client-level override parameters for the ACA:
|
1.
|
Go to Work Centers > ACA Processing > ACA Setup > Client ACA Parameters (Overrides). |
|
2.
|
Select a Safe Harbor Compensation Basis Type (see above for details). |
|
3.
|
Select the Benefit Plan Year Start Month and Day if the plans are not on a calendar year cycle and you need to override the system-level date settings. |
|
4.
|
Specify whether Cafe Plans Are For Medical Only – this only applies to clients who have cafeteria plans. This determines whether the system takes into account the client cafeteria plan contribution when calculating the cost of insurance for applicable employees and benefit plans. |
|
5.
|
If necessary, specify any annual overrides related to the Federal Poverty Level (see the sections above for details). |
Setting Up Look-back Periods
Use the Periods panel to set up measurement, administration, and stability periods for new and ongoing employees at the client level. These settings override the settings at the system level.
About Look-back Periods
The ACA specifies three periods for determining employee eligibility: Measurement, Administration, and Stability.
|
•
|
Measurement Period: This look-back period determines whether new variable hour/seasonal employees are full-time (working 130 hours or more within the period). For Ongoing Employees, who have worked one full standard measurement period, this determines the average number of hours they work (130 or more = full-time). |
|
•
|
Administration Period: This is the period between the Measurement Period and implementation of benefits. 90 days maximum. |
|
•
|
Stability Period: This is the coverage "lock-in" period for employees identified by the system as full-time (based on the results from the Measurement Period). Must be 6-12 months long. |
On this form, you can configure these periods for both new and existing employees.
Procedure
To configure look-back and eligibility periods on the client level:
|
1.
|
Specify the number of Months or Days in the Measurement Period. For Ongoing Employees, specify the period Start Month/Day. |
|
2.
|
Specify the number of Months or Days in the Administration Period, and indicate whether the period Starts First of the Month. |
|
3.
|
Specify the number of Months or Days in the Stability Period. |
|
4.
|
Indicate the Break-In Service Term. This field specifies maximum number of weeks (default is 13) where the employee is not employed but remains eligible for healthcare if they are rehired. After this period, the system counts the employee as "starting new" instead of as ongoing. For example, you might enter 26 weeks for an educational institution. |
Setting Up ALE Members
Use this panel to enter any control group clients (Applicable Large Employers, or ALEs) besides those specified at the system level, who will use the same FEIN that your organization uses in other parts of PrismHR.
To configure ALE members for this client:
|
1.
|
Expand the Applicable Large Employer (ALE) Members panel. |
|
2.
|
Enter or select an ALE Group ID. All the clients in PrismHR who have the same Control Group populate on the form. |
|
•
|
This data is dynamically displayed as clients under this group change. |
|
•
|
You can edit this information as you may need to list members that are not stored in PrismHR. |
|
•
|
This data populates using the Client Legal Name and FEIN. |
|
3.
|
Edit the entries as necessary. |
Configuring the Lowest Cost Calculation Table
Note: This table does not allow you to enter values in both the Benefit Plan ID and Amount fields. You can only use one or the other.
If your organization cannot pull the lowest-cost plans from your database, enter the data in the Lowest Cost Plan Calculation Table. You do not need to use this form unless accurate reporting absolutely depends on it.
The system uses this information when some employees are not eligible for any medical plans under either standard or ACA benefit rules (for example, if there are no medical plans set up for the client, or if employees are not eligible for any medical plans based on their benefit rules).
The system checks each line item in the grid, for each affected employee, to determine whether the employee meets the criteria specified on that line. If so, the system uses the information on that line and does not check any more lines. With this in mind, ensure that you dedicate the top of the list for the plans with the most criteria.
To set up the Lowest Cost Plan Calculation Table:
|
1.
|
Expand the Lowest Cost Calculation Table panel. |
|
2.
|
Enter the eligibility information as appropriate (all fields are optional): |
