Annual Rate and Census Reconciliation Form
It is anticipated that all Participating Employers will complete the Annual Rate and Census Reconciliation form when enrolling and at the end of each plan year. This provides confirmation the Participating Employer still qualifies under SOCA Benefit Plan Underwriting Regulations. In addition, Employers should upload their most recent Quarterly Wage and Tax Statement to their Document Centers.
The Annual Rate and Census Reconciliation form can be generated by both the HR Manager and the Broker via Manage Documents.
Sample Census Reconciliation Form:
- Total Employee on Wage and Tax Statement. It is estimated that the Wage and Tax for December 31st will be available for the Plan Year submission. The most recent Wage and Tax Statement can be used if that statement is not available. See A refers to the Employer's most recent Quarterly Wage and Tax Statement.
- Employees On or (Off) as of Census Date. It is understood this will be the net change in employed individuals compared to the date of the census being reconciled.
- Employees Not Working 30 Hours a Week.
- Total Full Time Eligible Employees (Line 4 = Lines 1 + 2 - 3)
- Less Those Employees with Qualified Waivers. Employees with qualified waivers for other coverage are deducted at this time.
- Plus Continuants. Continuants not on the Wage and Tax Statement are identified and added back in this step.
- Net Eligible Employees. (Line 7 = Lines 4 - 5 + 6)
- Enter the number of Eligible Employees on the Census.
- Number of FTEs in past calendar year for over 50% of work days. Divide the number of hours worked for those part time employees under the FTE Hour limit and add to full time employees for 20 or more weeks in preceding calendar year. This is the number that must be over 20 to be in the COBRA program, otherwise it's State Continuation.
- Total number of Full and Part Time Employees in 20 or more weeks in current or preceding year. This calculation looks at the number of employees for determining if Medicare can be primary. If line one is less than 20 and it is representative of employment for 20 weeks, then the group can benefit if they have someone full time at work who doesn't waive coverage and who is full time and eligible for health benefits.
- Participation Rate. This is calculated line 8 divided by line 7.
- Continuation Program in Effect. If line 9 is over for over 50% of the work days in the preceding year, the group qualifies for COBRA treatment, else State Continuation.
- Medicare Primary. If line 10 is under 20 and the Participating Employer has employees over 65 and otherwise eligible, they may want to apply for the Medicare Primary exemption.
The Employer Certification should be signed and dated by the HR Representative for the Employer for all groups who meet the criteria listed underneath the Employer Certification portion of the form. Employers who do not meet these criteria do not need to sign this portion of the Census Reconciliation Form.