The Look-Back Measurement Method Can Help Prevent ACA Penalties

Determining the accurate full-time employee count during a calendar year is important for Affordable Care Act compliance. Classifying employees incorrectly can lead to inaccurate information being submitted to the IRS in annual information filings. This can result in receiving an ACA penalty notice from the IRS.

When trying to determine whether employees are considered to be?full-time under the ACA, employers must use one of two measurement methods mandated by the IRS:?the Monthly Measurement Method or the Look-Back Measurement Method.

Under the ACA’s?Employer Mandate, Applicable Large Employers (ALEs) are employers with 50 or more full-time employees and full-time equivalent employees. ALEs are required to offer Minimum Essential Coverage (MEC) to at least 95% of their full-time workforce (and their dependents) whereby such coverage meets Minimum Value (MV) and is Affordable. Failure to do so subjects them to?Internal Revenue Code (IRC) Section 4980H penalties.

Section 4980H penalties are assessed by the IRS via?Letter 226J penalty notices. The tax agency is currently issuing these penalty notices to employers identified as having failed to comply with the ACA for the 2018 tax year as well as previous reporting years. It is anticipated that the agency will begin issuing Letter 226J penalty notices for the 2019 tax year shortly, as it has already begun?issuing Letters 5699,?which lead to IRC 6721/6722 penalties for the failure to properly file and furnish Forms 1095-C and file Form 1094-C.?.

A good place to start with minimizing ACA penalty risk starts with implementation of the best suited measurement method. If your workforce is primarily composed of variable-hour workers, with fluctuating hours of service, the Look-Back Measurement Method will be the best measurement method to use for ACA compliance.

The Look-Back Measurement Method allows employers to monitor and track their employee’s hours of service in the past to determine if they are full-time under the ACA. This informs employers on when to extend an offer of coverage to employees who are considered to be full-time under the ACA. The Look-Back Measurement Method has three parts:

• The measurement period
• The administrative period
• The stability period

Each employee’s hours are tracked and averaged over the measurement period, which can be as short as three months to as long as 12 months. The longer the measurement period, the better it provides a more accurate representation of each employee’s status.

Following the measurement period, an optional administration period may be applied. Although there is a maximum allowable administration period of 90 days, as a practical matter, employers typically choose between 30 to 60 days. This administrative period is typically used for gathering and collecting all the paperwork necessary to ensure that an offer can be made on time.

Next is the stability period. The beginning of the stability period should align with the beginning of the offer coverage effective date. The stability period is the period in which the application of the employee’s classification as either full-time or not full-time as determined by the results of the preceding measurement period. During this stability period, regardless of the hours they are currently working, employees are locked in as either full-time or not full-time. Of course, even if the employee is “locked” into a non-full-time position, that doesn’t mean that the employer can’t offer coverage.

Here’s an example:

Johnny Sprite has been working at the pizzeria for almost one year. During that time, his hours fluctuated on a weekly basis. Some weeks he worked 15 hours and other weeks he worked over 50 hours. Johnny’s manager was unsure if he was full-time under the ACA because of his irregular hours. Luckily, his manager started recording his hours utilizing the Look-Back Measurement Method from his first day of work.

As it turns out, during Johnny’s initial measurement period, Johnny averaged 142 hours a month. As Johnny’s one-year at the pizzeria approaches, the manager reviewed his 12-month initial measurement period. The manager determined he was full-time due to his averaging 142 hours a month over the 12-month initial measurement period. The manager took the next 30 days to prepare and coordinate Johnny’s offer of health coverage. This 30-day window is the initial administration period.

Johnny received an offer of coverage with an effective start date at the expiration of the administrative period. Because the Look-Back Measurement Method was used, the pizzeria can’t be assessed any penalties for the period of his employment prior to his offer of coverage because Johnny was “in measurement.” This scenario is called a?limited non-assessment period.

Following Johnny’s offer of coverage, his hours are cut significantly and he ends up only working 12 hours a week, most weeks. Despite the drastic cut in hours, because Johnny averaged 142 hours a month during his initial measurement period, his subsequent stability period has him “locked” in as an ACA full-time employee for the next 12 months. Therefore, the pizzeria should not rescind the offer of coverage because Johnny is working part-time hours.

The bottom line is that understanding the Look-Back Measurement Method can be difficult. Some?third-party organizations?will implement this process and monitor upcoming offers as a part of their ACA compliance process. Whichever solution your organization settles on, make sure it abides by the?Triangle of Trust. Trust in data, trust in regulatory expertise, and trust in software are all key to ACA compliance.?

If you need further assistance navigating the Look-Back Measurement Method, or another Employer Mandate related responsibility, download the?2021 ACA Essential Guides for Employers.

For information on ACA penalty amounts, affordability percentages, important filing deadlines, steps for responding to penalty notices, and best practices for minimizing IRS penalty risk,?download the ACA 101 Toolkit.

*Article Written By JOANNA KIM-BRUNETTI