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ACA and other Legal Notices

The Summary of Benefits and Coverage is required of all group health plans and insurance carriers. The SBC provides participants a summary of your medical options in a uniform format so that you can easily compare the County plans to one another OR to other benefits you may be eligible for through a spouse, parent or another employer.

The Federal Affordable Care Act (ACA) requires employers with temporary employees who work over 129 hours on average each month in a 12-month measurement period to offer those employees medical insurance.

Resources

More Information

Payroll Coordinators will receive a report after the first payroll of every month listing temporary and seasonal employees and their hours worked in their individual 12 month measurement period. The measurement period begins the first day of the month following employment.

Sample Report

How to Read Your ACA Report

Temporary employees who work an average of 29 hours per week or 129 hours or more per month over their 12 month measurement period qualify for medical benefits. Employees who qualify are offered Traditional PPO or High Deductible Plan medical benefits and an HSA if they elect a High Deductible Plan.

Q&A for Employees

Q&A For Department Directors, Supervisors, and Managers

What is a 1095-C?

The 1095-C details your offer of medical coverage information. It contains your personal information, along with the months you were either offered or enrolled in qualified medical insurance.

Who will receive a 1095-C from the County?

  • Anyone who was employed as Full-Time in 2019, regardless of medical coverage
  • Individuals that were enrolled in county medical coverage in 2019, which includes Part-Time Employees
  • Long-Term Disability participants, COBRA participants, and Retirees under age 65

Who will not receive a 1095-C from the County?

  • Retirees under age 65 who are not covered by the County’s medical insurance
  • Temporary or Seasonal employees who have not qualified for medical coverage
  • Retirees over age 65

Is there personal information on the 1095-C?

Yes. The 1095-C is similar to a W-2 and contains information that should be kept secure. Sections I and III contain the name, Social Security Number and date of birth for you and your dependents.

What information is on the 1095-C?

Section II of the form has a letter and numerical code, which tell the IRS:

  • The months you worked at the county
  • The months you were covered by or offered medical insurance through the county

Will my family members get a 1095-C?

If your dependents are covered under your county medical benefits, they will be included on your 1095-C. You will not receive separate forms for your covered dependents. If your spouse and/or dependents are working, they will likely get a 1095-C from their employer, if they are considered benefit eligible or full-time. You can expect to get a 1095-C from a previous employer if you were employed before working at the county.

How will I get my 1095-C?

Electronic and paper copies are available. The IRS requires you “opt-in” to receive an electronic copy, and if you don’t opt-in, you will automatically receive a paper copy from your Payroll Coordinator or in the mail.

Which is best for me, the electronic copy or the paper copy?

Everyone has different needs, and you can print your electronic copy any time. If you don’t have access to a computer and printer, your payroll coordinator can help you print your form.
Paper copies have their benefits too. If you elect the paper copy option, you will receive one copy of the 1095-C through your Payroll Coordinator. Former employees, including retirees, will receive the 1095-C via postal mail.

What if the information is incorrect?

You are encouraged to review the information listed on your 1095-C for accuracy, and contact your Payroll Coordinator or the Benefits Team if SSN’s or DOB’s are incorrect. Things to review include:

  • Your correct name, address, SSN and DOB
  • Correct names, SSN and DOB for your dependents
  • Correct dates when you were covered under the County’s medical plan

IRS 1095-C Form and Electronic Consent

IRS 1095-C Form Electronic Opt-in