26 U.S.C. 4980H and 26 C.F.R. 54.4980H-1

Misclassified workers can change your ACA headcount and your penalty exposure.

Large employers subject to the mandate must make a coverage offer to full-time employees, and the common-law test determines who falls in that group. We trace how classification carries through to the mandate and to reporting.

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What It Requires

How classification feeds the mandate.

Use this guide as a starting orientation, not as an opinion. The ACA regulations and IRS guidance are periodically revised, so consult the latest text.

Large Employer Threshold

An employer with an average of 50 or more full-time employees, including full-time equivalents, in the prior year is an applicable large employer.

Offer to 95 Percent

To avoid the main penalty, an employer must offer minimum essential coverage to at least 95 percent of its full-time employees and their dependent children.

Common-Law Employee Standard

Employee status under the regulations follows the common-law test, and a few narrow safe harbors exist for workers whose status is uncertain.

In Practice

What this means in practice.

If workers treated as contractors are really employees, they should be counted for the headcount and offered coverage, or the employer may face penalty exposure. Penalty amounts are indexed each year, so use the current IRS figures.

The Treasury regulations contain a rule for staffing firm workers and a rule about when an employer may rely on contractor status for others; neither removes the duty to analyze each relationship.

Forms 1094-C and 1095-C must report accurately; misclassification can create mismatches that trigger IRS letters.

Benefits Angle

Where this shows up in your plan.

Measurement Method

For workers with variable hours, adopt a look-back measurement period and apply it the same way every time.

Reporting Accuracy

Make sure the worker list used for 1095-C reporting matches payroll.

Affordability

Offers must meet minimum value and affordability tests to avoid the second penalty.

First Steps

Setting it up.

Count full-time employees using the monthly or look-back method.

Review contractor lists for common-law employees.

Test offer rates against 95 percent.

Check affordability each year.

Reconcile reporting with payroll.

Watch Outs

Mistakes to avoid.

Dropping a worker from the count because of the label.

Missing the 95 percent test due to unoffered misclassified workers.

Using outdated penalty figures.

Skipping the 1095-C review.

Keep Going

Other rules employers work with.

Sources

Laws and Rules Referenced

Penalties under 26 U.S.C. 4980H — Establishes the two payments an employer can owe for missing the mandate.

26 C.F.R. 54.4980H-1 (employee and full-time) — Defines employee status and full-time status.

26 C.F.R. 54.4980H-4 (offer rules) — Shows when the penalty amounts apply and how they are worked out.

IRS: Employer Shared Responsibility — Plain-language page from the agency.

Common Questions

Quick answers.

The mandate and misclassification questions clients ask most appear below, and each answer leads to the full guide.

Do contractors count toward 50?

Yes, if the common-law test treats them as employees.

What if a worker is reclassified mid-year?

Count them as of the date of employee status and review the offer; get advice on past months.

Is the penalty fixed?

No. It is indexed annually.

More On This Topic

More guides in this series.

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