Affordable Care Act Consulting Services

The Vendor is required to provide the program services to existing recipients, obtain recommendations of improvement to ACA compliance and reporting services, and to obtain firm fixed price proposals from qualified vendors to perform services including but not limited to:
• Complete administration for the affordable care act’s (ACA) reporting requirements (internal revenue code (IRC) §§ 6055 / 6056) for calendar year 2026 and thereafter;
• On-line tool to aggregate data from multiple time and labor reporting systems, including employees with multiple jobs with the same employer, assist in the administration of varying measurement periods, administrative and stability periods, and track eligibility status for new and current employees.
• Consulting services related to ACA reporting and compliance to assist for the state in meeting its obligations under ACA.
• Collect necessary human resources, payroll, time and labor, and health plan enrollment and eligibility data from the state PeopleSoft HRMS systems and third party administrators, including data on retirees, cobra beneficiaries, and partnership plan employer groups.
• Analyze data, assign and track correct ACA codes.
• Complete and submit forms electronically to the IRS with detailed information about health plan coverage of all individuals eligible for employer sponsored coverage in accordance with the ACA’s employer mandate and related regulations (IRS forms 1094-c, 1095-c, 1094-b and 1095-b and fully complying with §6055.
• Identify and correct all IRS-identified errors on form 1094 submission.
• Complete and distribute individual written statements, in compliance with IRC § 6055, to all employees, retirees, dependents and other individuals eligible for health benefit coverage, under the state’s plans, and provide reprints or corrections of form 1095 as needed.
• Solution for electronic delivery of form 1095-c to recipients and integration into the PeopleSoft self-service module.
• Identify potential noncompliance issues on a real-time basis including trending information to predict areas of risk.
• Training and on-going data management, reporting, administration and compliance support to the state and the comptroller.
• Upon contract termination or expiration provide data and coordination with any successor vendor, as needed.
• Ensure that contractor’s data center is SOC 2 compliant.
• Ensure that contractor secures and encrypts all sensitive data.
• Website is secured, using latest secure technology.
• Secure audit trail which consisting of but not limited to, data access and changes made to enrollment data.
• Assign a designated account manager with responsibility and authority to take all necessary steps to ensure expectations are met.
• Solve all professional performance, invoicing, and other conflicts that may arise.
• Assign an implementation leader to manage the implementation process and coordinate member communications with comptroller staff.
• Best practices for employee communications and notifications.
• Offer performance guarantees acceptable to the state, and track and reconcile said PGS at the end of each performance period.