Overview

Updated 2/23/2023

An ACA declination is the term used to describe an employee's refusal of an employer's health insurance offer. This Advanced Query looks at the 1095-Cs produced and creates a list of employees that are showing no offer of insurance for a month.  Based on this criteria, clients can review the list of employees and use it to mass insert declinations into the ACA Companion for those employees that declined health insurance.

Why is this AQ useful?
    Process Summary
Tutorial Video

Why is this AQ useful?

The declination export allows users to perform a mass update rather than manually entry of insurance declination information. This reduces the effort it takes to create declinations during year-end review of the 1095-C forms. 

Process Summary

View the tutorial video below for specific steps

1. Ensure that all insurance enrollments are entered into the ACA Companion. ACA Companion > Employee Plan Details
   
   
2. From the Reports tab in the Companion app, 1095-Cs are generated. ACA Companion > Report Preparation
   
   
3. Run the ACA Companion Declination Export AQ.
   
   
4. The AQ looks at the 1095-Cs generated from the Companion app and helps to identify those employees that may have declined coverage.
   • Logic 

     • Identifies employees who have a 1H on line 14 of the 1095-C (means they were not offered insurance), with any line 16 code that wasn't 2A, 2B, or 2D.

       • If an employee has a 1H on line 14 and a blank or some other value in line 16, the employee will be included on the export list.

       • If an employee has a 1H on line 14 of the 1095-C and line 14's value =2A, the employee will not be included on the export list because the employee didn't work.  
         
         

5. The export is generated as a spreadsheet which should be saved to the user's computer.
   

   Month Codes	Definition
   Y	Yes- the employee was offered coverage and enrolled in insurance This will create an enrollment in the ACA Companion where the start date is the first day of the month and the end date is the last day of the month.
   N	No – the employee had no offer of coverage for the month This will not create any offer in the ACA Companion for the month.
   D	Decline - the employee was offered coverage and declined insurance This will create an insurance declination in the ACA Companion where the start date is the first day of the month and the end date is the last day of the month.

6. The spreadsheet is reviewed by user to ensure the employees listed should have a declination entered for the months listed. 
   Note: it is the responsibility of the client to review the list and ensure accuracy. 
   
   
7. The spreadsheet containing the declinations is then pulled back into the ACA Companion using the ACA Import in the core application.  Importing the spreadsheet will create declinations in the ACA Companion for the employees and months listed. Complete the import mapping in Admin Tools, then complete the import. 

• Click here for more information on the Application ACA Import

Tutorial Video

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