✓ Q1 Does the employer sponsor a Grandfathered health plan ? Yes
Q2
Is the employer considered an "Applicable large Employer" (ALE) under the ACA? (ALE = Generally 50+ FT employees plus FT equivalents in prior calendar year) Yes No Not sure Not currently, but may be an ALE within the next year
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✓ Q3 Does the ALE track variable hour employees in a look-back measurement period ? Yes
✓ Q4 Does the ALE offer minimum essential coverage (MEC) to at least 95% of all FT eligible employees and their dependents to age 26? Yes
✓ Q5 Which of the 3 affordability safe harbors does the ALE use? Rate of Pay
✓ Q6 Does the ALE complete Section 6056 ACA reporting (1095/1094-C forms)? Yes
1 question not applicable ⌄
✓ Q8 Does the employer remit the PCORI fee each year to the IRS on Form 720 for self-insured plans (including level-funded & HRAs)? Yes
✓ Q9 Are the number of actual days an employee has to wait in the waiting period 90 days or less for major medical coverage? Yes