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Self-insured plans are required to include spouses and children in the Covered Individual section of the 1095-C.  Not surprisingly, many employers with less than 1,000 employees were not able to provide this data as easily as expected as dependent data was not maintained in the respective HR system.  Often times, employers had to rely upon carrier enrollment data to fill the void.  Employers assumed the data was complete and accurate.  As they say “never make assumptions.”

Once the data was obtained, the next step was to integrate it.  And that process was prone to creating errors primarily because at times, the carrier’s enrollment data used a different employee ID than the employer’s HR or payroll system.  As a result, many dependents were simply not linked (to the respective employee) or were linked to the wrong employee.  Not only this translate into incorrect forms, but this also raised employee relations issues.  After all, how could John Doe who is enrolled with a spouse and children not have any dependents in his respective Covered Individual section and how could Mary Smith, who is single, have John Doe’s dependents.  Clearly this is not a good situation.

In order to mitigate future risks employers should thoroughly review dependent information and also put controls in place to further ensure the right dependents were in fact associated with the respective employee.  Employers have the opportunity to ensure all dependents are handled correctly and penalties are avoided.  As they say, “there’s no time like the present – do it now!”


About The Author: Howard Gerver, of ACA Managed Services, is an authority on 1095 compliance. He and his team of ACA experts are the go-to specialists for companies who wish to avoid trouble with the IRS. They offer a range of ACA services, including ACA audits (also known as 1095 audits)