Affordable Care Act (ACA) Code Determination in Oracle Standard Benefits (OSB) (Doc ID 2174006.1)

Last updated on JUNE 05, 2017

Applies to:

Oracle HRMS (US) - Version 12.1 HRMS RUP6 and later
Oracle Advanced Benefits - Version 12.1 HRMS RUP6 and later
Information in this document applies to any platform.

Symptoms

Two Examples in Oracle Standard Benefits (NOT Advanced Benefits);

I. Mid Year Eligibility Change in Benefit Groups

Actual Behavior:

Employee switches from one group plan eligibility to another during a mid-year Unrestricted event
- Line 14 shows $0 rate from January to month following event
- Line 14 shows full rate from month following life event to end of year

Expected Behavior:

As plans and options are offered without restrictions (showing all options for all employees at enrollment) expecting to see 1E or 1A depending on the plan they are in, and the form should be showing appropriate rates for each period, before and after the event

STEPS
The issue can be reproduced at will with the following steps:
1. Take person eligible for one plan
2. Enroll them in that plan coverage from January on
3. Mid-year - make changes to make them eligible for second plan with different rates
4. Enroll them in the new plan
5. Purge and rerun archive process
6. Review 1095-C test form to see the Actual Behavior noted above

 

II. Mid-Year Termination While in Waived Medical Coverage

Actual Behavior:

Employee is in waived coverage when they terminate via a mid-year Unrestricted event

- Line 14 shows '1H'

Expected Behavior:

As plans and options were offered, the history of the offer should remain intact even though the person is terminated

STEPS
The issue can be reproduced at will with the following steps:
1. Take person who is in waived coverage as an employee, but is eligible for an ACA-eligible plan
2. Terminate them mid-year - process a unrestricted event
3. Purge and rerun archive process
4. Review 1095-C test form to see the Actual Behavior noted above

Cause

Sign In with your My Oracle Support account

Don't have a My Oracle Support account? Click to get started

My Oracle Support provides customers with access to over a
Million Knowledge Articles and hundreds of Community platforms