1. Populating Form 1095-C for the Affordable Care Act September, 2015 Melissa Bilyeu Senior Learning Consultant

2. Goal 2 Understand how to store employee and dependent data in Ceridian’s ACA spreadsheets for populating Form1095-C.

3. Agenda Documentation2015 ACA Solutions Spreadsheets Action Plan

4. Handout – Links to More Information 4 www.ceridian.com/myceridian ACA Compliance page Employer Shared Responsibility Under ACA WBT IRS Reporting for the Affordable Care Act Analyzing Your Workforce for the Shared Responsibility Provisions of the Affordable Care Act Gathering Information for Forms 1094-C and 1095-C

5. 2015 ACA Solutions Ceridian Payroll System to house ACA data and print Form 1095-C Electronic filing of IRS C- Series forms for Ceridian Tax Service customers Data file for non-CTS customers or those filing directly with the IRS Spreadsheets for storing required monthly data Standard import formats for importing spreadsheet data in a.csv file Direct data entry of required monthly data in HR/Payroll

6. Populating Form 1095-C 6 Part I comes from EPayrollBase and CardFile Part II comes from Employee Information Spreadsheet (EPPACA table) Part III comes from Covered Individuals Spreadsheet (CPPACA table)

7. Employee Information Spreadsheet Columns A-H 1095-C

8. Employee Information Spreadsheet – cont. 8 Columns I-N 1095-C

9. Scenario 1: Employee has qualified offer/enrolled all year

10. 10

11. Scenario 2: Part-time Employee Transitions to Full-time Employee received a qualified offer effective February 1 st and was enrolled in the plan the rest of the year Try It!

12. Scenario 2: Part-time Employee Transitions to Full-time Employee received a qualified offer effective February 1 st and was enrolled in the plan the rest of the year

13. Scenario 2: Part-time Employee Transitions to Full-time 13

14. Entering Information for Non-Employees Examples Include - Employee who has two records for a consolidated Form W-2 (the 2nd record is the non-employee) - Individual was a Form 1099 employee for the entire year - COBRA recipient in a self-insured plan for the entire year - Retiree in a self-insured plan for the entire year Enter non-employees directly into HR/Payroll instead of using the spreadsheet - Instructions included in the fall releases Individuals no longer on the Payroll System may need to be rehired - KB Article “Rehiring Terminated Employees”

15. Covered Individuals Spreadsheet 15 Covered dependents must have records in HPx Dependents – name, SSN or DOB List everyone covered by the policy – employee, spouse, children, etc Only required for self-insured employers

16. Covered Individuals Spreadsheet 16 Columns A-I 1095-C

17. Covered Individuals Spreadsheet – cont. 17 Columns J-Y 1095-C

18. Dependent FlxID SQL Statement

19. Scenario 1: Covered Employees

20. Scenario 2: Covered Dependents 20

21. Action Plan Populate appropriate spreadsheet(s) - Employee Information, Covered Individuals Set up dependents if using self-insured plans - Enter or import into HR/Payroll Import spreadsheets and enter additional data in GUI - Functionality available in Q4 releases Audit your data - Now and later – additional reporting available Q4 Need Help? 1 st /2 nd Level Support Project Portal – Professional Services Watch for further announcements

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