Affordable Care Act - Self Insured - Partial Year Coverage

The Affordable Care Act - Self Insured - Partial Year Coverage report is a variation of the Affordable Care Act - Year End Self Insured Individuals report. It uses the Affordable Care Act - Year End topic to display monthly details for covered individuals where either the employee or dependent had partial year coverage for the selected filing year using data from the 1095-C forms.

Fields

Fields included in the report template

Field Name	Group by	Sort Order	Totals
Coverage	Yes	A to Z
Name Number	Yes	A to Z
Dependent Birth Date		Oldest to Newest
Hire Date
Termination Date
Dependent Name
Relationship
Is Covered Jan-Is Covered Dec

Custom Fields

Coverage

The Coverage custom field displays the partial year coverage. It uses the following expression:

CASE
    WHEN (BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered12 = 1
          AND BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered11 = 1
          AND BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered10 = 1
          AND BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered9 = 1
          AND BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered8 = 1
          AND BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered7 = 1
          AND BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered6 = 1
          AND BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered5 = 1
          AND BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered4 = 1
          AND BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered3 = 1
          AND BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered2 = 1
          AND BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered1 = 1) THEN 'Full Year Coverage'
    ELSE (CASE
              WHEN (BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered12 = 1
                    OR BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered11 = 1
                    OR BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered10 = 1
                    OR BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered9 = 1
                    OR BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered8 = 1
                    OR BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered7 = 1
                    OR BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered6 = 1
                    OR BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered5 = 1
                    OR BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered4 = 1
                    OR BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered3 = 1
                    OR BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered2 = 1
                    OR BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered1 = 1) THEN 'Partial Year Coverage'
              ELSE 'Not Covered'
          END)
END

Dependent Name

The Dependent Name custom field displays the dependent's name. It uses the following expression:

CASE
    WHEN (EmployeeDependentBeneficiary.FirstName + ' ' + EmployeeDependentBeneficiary.LastName) IS NULL THEN '(Employee)'
    ELSE EmployeeDependentBeneficiary.FirstName + ' ' + EmployeeDependentBeneficiary.LastName
END

Relationship

The Relationship custom field displays the relationship to the individual. It uses the following expression:

CASE
    WHEN RelationshipType.ShortName IS NULL THEN 'Self'
    ELSE RelationshipType.ShortName
END

Is Covered Jan to Is Covered Dec

The Is Covered Jan field indicates whether the individual is covered during January. It uses the following expression:

CASE
    WHEN BenefitsACAYearEndEmployee1095CoveredIndividual.IsCovered1 = 0 THEN 'No'
    ELSE 'Yes'
END

Note: The Is Covered Feb to Is Covered Dec fields have similar expressions.

Filters

The template includes the following filters: