PPACA Compliance


The Affordable Care Act (ACA) promises more administrative complexities and confusion for your workforce.

You need an accurate and efficient way to manage compliance. The 2016 plan year introduces a whole new set of required reports and employee communication. BenefitHelp™ offers you a single source to manage all your data for reporting and compliance.

InsurancePenaltyWhat is Compliance Worth to You?

Introducing ACAManager

ACAManager provides ACA-Compliance solutions to effectively regulate our clients’ business and is designed to manage, track and determine full-time employee equivalency and benefit eligibility. The software functions to configure, review and analyze multiple look-back and initial measurement, stability, and administrative periods; arming you with data to determine the most cost effective “pay” or “play” strategy.

Your benefits data is essential to manage ACA requirements. Our ACAManager solution provides comprehensive benefits administration technology with a true healthcare reform compliance solution. Maintain data integrity and accuracy with the powerful integration of BenefitHelp™ and ACAManager.


Healthcare reform affects everyone, and explaining health insurance to your employees is more important than ever.

Because ACA provisions can be difficult to interpret, BenefitHelp™ offers a true healthcare reform solution to help explain the ins and outs of new legislation. ACAManager can be accessed anytime, using any web-enabled device, putting your ACA Compliance on Auto-Pilot.


ACAManager features:

ACAManager “Pay or Play” Strategy

  Setup company information

  Interactive “Pay” or “Play” calculator with real-time “Pay” or “Play” assessment

  Determine applicable large group status

  Determine FTE equivalency

  Determine penalties based on transition relief or standard rules

ACAManager Measurement Periods

  Setup multiple measurement, administrative and stability periods  based on employer categories.

  Track, review and manage initial measurement & standard measurement periods.

  Periods can be classified by employee categories and divisions outlined in the BenefitHelp™ system.

ACAManager Analytics

  Review employer affordability ratios..

  Identify company compliance.

  View alerts monitoring employee status changes

   Review real-time statistics of employer “Pay” or “Play” calculator based on hours loaded.

ACAManager Notifications

  Automatic triggering of model exchange notices.

  Track and manage open notice submissions.

  Customize email content.


ACAManager Reporting

  Reporting 6055- Self-Insured (NON-ALE)

  Reporting 6056- ALE not Self-Insured.

  Reporting 6055 & 6056 – ALE who are also Self-Insured.


Reporting Features

Uniform Summary of Benefits & Coverage (SBC)

✓ Gives employers the ability to house all relevant information in the employee portal and set it up so that employees must submit an acknowledgement form to ensure they receive and review the initial SBC, as well as any changes within the 60-day limit.

✓ Mobile capabilities allow the employee to conveniently access these documents on the go from any web-enabled device.

Employer Reporting

✓ Offers a consolidated report that allows employers to provide the IRS with required information about the type of health coverage offered to their full-time employees, the entity providing the coverage and which individuals are enrolled in coverage.

Employee Opt-Out Survey

✓ Identifies and captures the specific reasons employees are declining coverage through an enrollment questionnaire, helping employers avoid the penalties for employees who opt-out of coverage due to receiving a tax credit or cost-sharing subsidy through a public exchange.

Grandfathered Plans

✓ Provides plan and benefit summary information to comply with information transparency requirements, allowing consumers to compare plan benefits, cost-sharing requirements, renewability and continuation of coverage provisions.

Employee Notifications for Public Exchanges

✓ Enables HR staff to send mandatory notifications about public exchanges, whether or not the employer’s plan meets minimum coverage requirements, and explains how to access information regarding premium subsidies that may be available for exchange-based coverage.

Employer Shared Responsibility

✓ Enforces eligibility rules to account for new “safe harbor” classifications and other categories needed by employers to ensure eligible employees are able to enroll in the appropriate plan options.

✓ Calculates Look-Back and Stability periods along with providing eligibility tools to assist employers in ensuring employees are getting the coverage for which they are eligible in the proper time-frame.

✓ Incorporates employee opt-out surveys to help employers determine which employees plan to purchase coverage through a public exchange so they can message them accordingly.

Wait Periods

✓ Configures wait periods to comply with the new requirement of 90 days, while proactively identifying all existing sponsors whose medical new hire rules have a wait period of greater than 90 days.

Essential Health Benefits

✓ Supports complex business rules and a variety of plans with the ability to incorporate new essential benefit packages designed by employers.

✓ Features customized workflows to require employee acknowledgement in the case that they can only be covered in certain situations. For example, if they do not have coverage elsewhere.

Cadillac Tax

✓ Provides a suite of data analytics and communication tools to assist with the impact of necessary plan design changes in advance of January 1, 2018.

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