ACA Questionnaire

Time & Pay requires your assistance with the completion of the following questionnaire so we can understand what level of ACA service(s) you would like us to perform. Specific data collection requirements will be necessary for the completion of the 1094/95-c ACA tax documents.

If you need assistance regarding ACA terms, please refer to the ACA Definitions in the red menu to the left. 

This questionnaire will only take you a couple of minutes. It is required that you answer all questions. Please provide only 1 answer per question. Completion of this questionnaire will help you/us determine your ACA requirements.  

Company Name (required)

Contact Name (required)

Phone (required)

Your Email (required)

1. Are you an Applicable Large Employer (ALE)? (required)
 Yes No Not Sure

1b. Are you an Aggregated ALE, through common ownership of multiple companies. (These are treated as a single employer for determining ALE status.) (required)
 Yes No Not Sure

2. Do you need assistance with determining your Applicable Large Employer Status? (required)
 Yes No

2a. Are you a PayEntry or Millennium Onsite User? (required)
 Yes No

2b. If you are a PayEntry or M3 user, do you need assistance utilizing the new ACA Status Bulk Update/Audit tabs for assigning employee status, which in turn helps determine your ALE status/evaluation. (required)
 Yes No

2c. Do all of your employees have hire/rehire and terminations dates? This is required for the Bulk Update and Audit tabs to accurately update and report. (required)
 Yes No

2d. Have you assigned all your employees an ACA status (Full-Time, Part-Time, etc)? This is also required for accuracy of the Bulk update. (required)
 Yes No

Will Time & Pay be preparing your 2015 1094/95C returns? If yes, ACA data input and maintenance into our system is required. (required)
 Yes No Not Sure

Are you Self-Insured? (required)
 Yes No Not Sure

Have you determined your IRS Offer of Coverage Code based on your health insurance plans and it's compliance with Affordable, Minimum Essential Coverage for employees and dependents? (required)
 Yes No Not Sure

Have you determined your IRS Safe Harbor codes, based on Employer Shared Responsibility and affordability requirements? (required)
 Yes No Not Sure

Do you need assistance determining either your Offer of Coverage codes or Safe Harbor codes? (required)
 Yes No

Do you want Time & Pay to provide data input and maintenance services of required ACA information based on data provided by you? (required)
 Yes No

If you do not currently use PayEntry, would you be interested in utilizing the system in order to help you manage the date requirements of the ACA as well as other payroll and HR functions? (required)
 Yes No Maybe

Would you be interested in utilizing our timekeeping system that will generate very accurate ACA requirement reports for ALE determination as well as other features to manage your workforce? (required)
 Yes No Maybe

Please let us know if you have any other questions or comments here.

Please feel free to contact our ACA team if you need assistance with your ACA requirments at [email protected]