Data Dictionary and Standards

Year End IRS Data

Updated: September 29, 2016

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TABLE OF CONTENTS

ACA-Track Data Groups 7

ACA Required Data status descriptions 8

ACA Data Type definitions 8

Employee Data 9

EmpNo 9

SSN 9

LastName 9

FirstName 9

MiddleInit 9

SuffixName 9

PrimeBUDesc 10

PrimeJobDesc 10

PrimeLocDesc 10

EmploymentStatus 10

Active 10

OrigHireDate 10

HireDate 10

TermDate 10

Addr1 11

Addr2 11

City 11

State 11

CountryCode 11

Postal 11

EffectiveDate 11

IRS Employee Offer of Coverage 13

EmpSSN 13

AllMonths 13

Jan 13

Feb 13

Mar 13

Apr 13

May 14

Jun 14

Jul 14

Aug 14

Sep 14

Oct 14

Nov 14

Dec 15

IRS Employee Share Lowest Coverage 16

EmpSSN 16

AllMonths 16

Jan 16

Feb 16

Mar 16

Apr 16

May 17

Jun 17

Jul 17

Aug 17

Sep 17

Oct 17

Nov 17

Dec 17

IRS Section 4980H Safe Harbor 18

EmpSSN 18

AllMonths 18

Jan 18

Feb 18

Mar 18

Apr 18

May 19

Jun 19

Jul 19

Aug 19

Sep 19

Oct 19

Nov 19

Dec 20

IRS Covered Individuals 21

EmpSSN 21

CoveredLastName 21

CoveredFirstName 21

CoveredMiddleName 21

CoveredSuffixName 21

CoveredSSN 22

CoveredDOB 22

StartDate 22

EndDate 22

AllMonths 22

Jan 22

Feb 22

Mar 22

Apr 23

May 23

Jun 23

Jul 23

Aug 23

Sep 23

Oct 23

Nov 24

Dec 24

TaxYear 24

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ACA-Track Data Groups

Within ACA-Track, there are multiple data groups, shown below, which are necessary in to fulfill IRS reporting requirements. Each group is defined below, with a field-by-field explanation contained later in this document.

Employee Data: Current demographic or employee/employer related data is stored in the employee data. Each data element occurs one time per employee.

IRS Employee Offer of Coverage (IRS 1095 Part II Line 14): This data is used to populate to IRS Form 1095 Part II Line 14. It describes the coverage that the employer offered to the employee and the employee’s spouse and dependent(s), if any.

IRS Employee Share Lowest Coverage (IRS 1095 Part II Line 15): This data is used to populate to IRS Form 1095 Part II Line 15. This line reports the employee share of the lowest-cost monthly premium for self-only minimum essential coverage providing minimum value that the employer offered the employee. Line 15 will show an amount only if the minimum essential coverage the employer offered provided minimum value.

IRS 4980 Safe Harbor (IRS 1095 Part II Line 16): This data is used to populate to IRS Form 1095 Part II Line 15. This line provides the IRS information to administer the employer shared responsibility provisions.

IRS Covered Individuals (IRS 1095 Part III): This data is used to populate to IRS Form 1095 Part III. Part III reports the name, social security number, and coverage information about each individual (including any full-time employee and non-full-time employee, and any employee's family members) covered under the employer's health plan, if the plan is "self-insured." A date of birth will be entered in column (c) only if an SSN is not entered in column (b). Column (d) will be checked if the individual was covered for at least one day in every month of the year. For individuals who were covered for some but not all months, information will be entered in column (e) indicating the months for which these individuals were covered. If there are more than 6 covered individuals, you will receive one or more additional Forms 1095-C that continue Part III.

ACA Required Data status descriptions

· Required = Yes: The data for the respective field is required for minimal operations of ACA Track.

· Required = Conditional: The data for the respective field is conditionally required, usually dependent on another field in the system.

· Required = Functionality: The data for the respective field is not required, however not supplying the data may reduce certain functionality within ACA–Track.

· Required = Optional: The data should be provided if available, but is not required for ACA compliance.

ACA Data Type definitions

· Char – Character string which may contain different types of characters, i.e. numeric, alpha, or special characters. These data elements have a predefined structure, such as a social security number format of ###-##-####.

· Date – format will be MM/DD/YYYY.

· VarChar – Variable Character string which can accept any combination of any type of character.

· Decimal – Numeric character string with specified number of decimal places.

Year End: This set of templates allows the user to provide data elements required for ACA-Track to produce 1095 forms and 1094 submission to the IRS that may not be available from tracking data. This should be user by tracking clients at the end of the year.

Employee Data

Purpose: Employee data is used to store all employees that are being reported for the current reporting year.

If more than one record in a submission batch has the same EmpNo, then each entry must have a different Effective Date. (see page 13 for Effective Date rules)

EmpNo

Data Type: VarChar (50)

Required: Yes

Purpose: Unique identifier for an employee. Only one value can be used per employee. SSN cannot be used since this field is not encrypted.

SSN

Data Type: Char (11)

Required: Yes

Purpose: Unique Social Security Number for an employee. SSN is used for reporting purposes and does not appear in the grid or spreadsheet output. It is encrypted in ACA-Track database.

Format: XXX-XX-XXXX

LastName

Data Type: VarChar (100)

Required: Yes

Purpose: Employee’s last name. Appears in reporting and is available in the grid. It is encrypted in ACA-Track database.

FirstName

Data Type: VarChar (100)

Required: Yes

Purpose: Employee’s first name. Appears in reporting and is available in the grid. It is encrypted in ACA-Track database.

MiddleInit

Data Type: VarChar (1)

Required: Conditional (If exists, supply)

Purpose: Documents employees’ middle initial. Appears in reporting and is available in the grid. It is encrypted in ACA-Track database.

SuffixName

Data Type: VarChar (10)

Required: Conditional (If exists, supply)

Purpose: Documents employees’ suffix (Jr., Sr., III). Appears in reporting and is available in the grid. It is encrypted in ACA-Track database.

PrimeBUDesc

Data Type: VarChar (100)

Required: Functionality

Purpose: Primary Bargaining Unit descriptions are used in identifying specific agency or labor organizations. If an employee has multiple Bargain Units assigned to them, PrimeBUDesc is the one with the highest FTE if identifiable.

PrimeJobDesc

Data Type: VarChar (100)

Required: Functionality

Purpose: PrimeJobDesc describe the Prime Job code provided.

PrimeLocDesc

Data Type: VarChar (100)

Required: Functionality

Purpose: PrimeLocDesc describe the PrimeLoc code provided.

EmploymentStatus

Data Type: VarChar (30)

Required: Yes

Purpose: EmploymentStatus identifies the status of the employee’s employment. ACA Track configuration must identify which employees are considered full-time for calculation purposes.

Example Data: (FT, PT, Retired, Cobra)

Active

Data Type: VarChar (1)

Required: Yes

Purpose: Identifies if the employee is currently actively employed on the Effective Date of the record. If employee is not currently receiving pay, for example a seasonal employee, they should still be tracked in the event they were to return during the current measurement period. ACA-Track allows the user to map their internally used status code to Active or Inactive for snapshots and reporting.

Example Data: A: Active/ I: Inactive

OrigHireDate

Data Type: Date

Required: Yes, but when not provided, ACA-Track uses HireDate.

Purpose: If employee was previously employed and then rehired, use this field to supply their original hire date. If employee was not previously employed, then use HireDate for this value.

HireDate

Data Type: Date

Required: Yes

Purpose: HireDate is the date an employee was hired.

TermDate

Data Type: Date

Required: Conditional, if exists

Purpose: TermDate is the date an employee’s employment was terminated. NOTE: If a person has a TermDate, their Active value would be expected to be “I” – Inactive.

Addr1

Data Type: VarChar (100)

Required: Yes

Purpose: Employee’s mailing address line 1. Required for 1095 Reporting.

Addr2

Data Type: VarChar (100)

Required: Conditional, if exists.

Purpose: Employee’s mailing address line 2. Used for 1095 Reporting.

City

Data Type: VarChar (100)

Required: Yes

Purpose: Employee’s city mailing address. Required for 1095 Reporting.

State

Data Type: VarChar (2)

Required: Yes

Purpose: Employee’s 2-character state or province code for mailing address. Required for 1095 Reporting.

CountryCode

Data Type: VarChar (2)

Required: Yes

Purpose: Employee’s 2-character country code for mailing address. Required for 1095 Reporting.

Postal

Data Type: VarChar (10)

Required: Yes

Purpose: Employee’s postal (zip) mailing address. Required for 1095 Reporting.

EffectiveDate

Data Type: Date

Required: Yes

Purpose: Effective Date indicates when the most recent change to a record occurred.

Format: MM/DD/YYYY

Effective Date Rules:

· The submitted effective date carries through to the employee master table.

· If the Employee record is new to ACA-Track™, then a record will be created with the Effective Date = Hire/Start Date

· If the Employee record includes a Term Date, then a record will be created with the Effective Date = Term Date unless the start date is greater than the Term Date, then the start date will be used

· If the Employee record exists in ACA-Track™, then a full comparison is done to determine if any field value is different from the most recent (based on Effective Date) Employee record loaded into ACA-Track™.

o If the only change is the addition of the Term Date, then the Effective Date = Term Date

IRS Employee Offer of Coverage

Purpose: IRS_1095C_II_Line14 provides placeholder to collect needed data for IRS Report 1095C, Section II, Line 14, Offer of Coverage

Process Method: (Replace – all existing data records are removed from the database and then incoming records are added creating an entirely new data set).

Special Note: Either “All Months” must be completed or “All Months” left blank and columns Jan through Dec must be completed.

EmpSSN

Data Type: VarChar (50)

Required: Yes

Purpose: Employee Social Security Number

AllMonths

Data Type: Char (2)

Required: Conditional

Purpose: If same code value applies for all 12 calendar months, supply Code Series in this field. Example Data: (1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1I)

Jan

Data Type: Char (2)

Required: Conditional

Purpose: If type of coverage applied to this month only or was different from other months, supply Code Series in this field.