Configure Benefits for Affordable Care Act Reporting
You must configure the following on Oracle Fusion Cloud Human Resources Benefits.
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Each benefits plan or program
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ACA eligibility profiles
Configure your benefits plans or programs
You can define benefit plans specific to the Affordable Care Act (ACA) or use qualifying existing plans.
Set the following for each plan.
What you need to do |
How you do it |
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Define the minimum essential coverage and minimum value |
For each plan or program:
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Set the primary funding method |
To self-fund your benefits:
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Set the lowest cost option |
When adding an option to a plan, to designate it as the lowest cost option:
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These are the minimum instructions for configuring benefits for ACA compliance. For further info, see the Oracle Global Human Resources Cloud Implementing Benefits guide on the Help Center.
Configure your ACA eligibility profiles
An ACA eligibility profile is associated with an ACA eligibility. When you run the ACA Eligibility Process flow, it:
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Assigns the appropriate eligibility to employees belonging to that profile.
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Updates the ACA fields on the employee assignments.
You must define a profile for each ACA eligibility you support in your organization, and you must ensure all employees belong to one of them. Available eligibilities are:
ACA eligibility |
What it means |
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Always |
Person is always eligible for benefits. |
Exclude |
Person is excluded from eligibility evaluation. You are determining their eligibility elsewhere. |
Never |
Person is never eligible. |
No-monthly |
Person is an hourly employee who is initially ineligible for benefits at time of hire. Their eligibility is reevaluated at the end of a monthly measurement period. For example, if an employee is hired as No-monthly, but they work full-time hours after their initial measurement period, they would become Yes-monthly. |
No-weekly |
Person is an hourly employee who is initially ineligible for benefits at time of hire. Their eligibility is reevaluated at the end of a weekly measurement period. |
Yes-monthly |
Person is an hourly employee who is initially eligible for benefits at time of hire. Their eligibility is reevaluated at the end of a monthly measurement period. |
Yes-weekly |
Person is an hourly employee who is initially eligible for benefits at time of hire. Their eligibility is reevaluated at the end of a weekly measurement period. |
For further info, see Eligibility Profiles in the Help Center.
To define an eligibility profile:
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From Benefits, click Eligibility Profiles.
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Select Create, and click Create Participant Profile.
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Set the following.
Field name
What you do
Name
Provide a meaningful name for the profile.
Description
Provide any additional info on the profile.
Assignment to Use
Select Primary employee assignment only - legal employer.
Profile Usage
Select Benefits.
Status
Select Active.
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Use the tabs under Eligibility Criteria to define general employee eligibility rules.
Each tab offers different kinds of eligibility criteria.
An employee is considered eligible if they meet the criteria on at least one.
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Use the Legal Entities tab if you have multiple legal employers, and you want to define different eligibility for each.
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Once you defined the criteria for your general employee population, you can define rules that set eligibility for specific employees.
To grant eligibility to an employee that doesn't already meet the eligibility criteria, include them on the profile.
Note:You can also set their eligibility directly on their assignment. However, running the ACA Eligibility Process flow clears these overrides, so you must set their eligibility to Exclude.
For further info, see Configure Employee Assignments for Affordable Care Act Reporting in the Help Center.
To exclude employees, you have two options.
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Exclude their assignment category from the eligibility profile.
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Under Eligibility Criteria, click Employment.
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Click Assignment Category.
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Click Exclude for the assignment category.
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Add them to an exclusion profile.
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Save your changes.