Part 1 – Intro + ACA Risk Exposures
Closing ACA Compliance Gaps Before They Become Expensive Problems
For self-funded employers, ACA compliance isn’t just another HR task, it’s a legal requirement with serious financial consequences. Over the past year, the IRS has stepped up enforcement, sending out more Letter 226J penalty notices than in prior years. Many of these letters go to employers who genuinely believed they were in full compliance.
In a self-funded structure, you control both the plan design and the administration. That means if a compliance gap occurs, the liability falls directly on you.
For self-funded employers, ACA compliance isn’t just another HR task, it’s a legal requirement with serious financial consequences. Over the past year, the IRS has stepped up enforcement, sending out more Letter 226J penalty notices than in prior years. Many of these letters go to employers who genuinely believed they were in full compliance.
In a self-funded structure, you control both the plan design and the administration. That means if a compliance gap occurs, the liability falls directly on you.
ACA-Track (www.aca-track.com) works with self-funded employers, TPAs and brokers to simplify compliance and eliminate guesswork. Our model combines robust software with white-glove service – every client is paired with a dedicated ACA compliance specialist who intimately understands their plan and operations. This ensures potential issues are caught early, explained clearly and resolved quickly.
Common issues that create penalty risk include:
- Failing to capture eligibility for variable-hour, seasonal or rehire employees
- Falling short of the 95% minimum essential coverage (MEC) offer requirement
- Incorrect application of measurement and stability periods under the look-back method
- Late or inaccurate IRS filings
- Employee data mismatches with IRS or SSA records
We’ve seen each of these trigger a 226J penalty notice in recent years – often for groups that thought they had processes in place to prevent them.
For self-funded employers, these are not small administrative mistakes. They are potential six-figure liabilities. In the next article, you’ll see how one employer faced over $130,000 in exposure and avoided it with ACA-Track for about $3,000.
