Feature
ACA Compliance Modeler
Planlined's built-in affordability calculator ensures your benefit recommendations meet IRS requirements and helps clients avoid costly penalties.
Page 1 of 3Per-paycheck deductions by tier on the actual pay schedule.
What you get
Why ACA Compliance Modeler?
- Affordability CalculatorAutomatically calculate if plans meet ACA affordability requirements based on current IRS thresholds.
- Penalty Exposure AnalysisSee potential 4980H(b) penalty exposure if plans don't meet affordability requirements.
- Annual UpdatesPenalty amounts are automatically adjusted annually based on IRS guidelines.
- Full-Time Employee TrackingTrack total full-time employees and those expected to receive subsidies for accurate calculations.
- Compliance ReportsExport compliance analysis as PDF or JSON for client records and documentation.
- Real-Time ValidationGet instant feedback on whether contribution strategies meet affordability thresholds.
What the ACA Modeler Calculates
Inputs and outputs
What goes in, what comes out.
You bring
- The plans and the contribution strategy already modeled in the Planlined case.
- Plan rates by coverage tier, read from the carrier quotes, SBCs and rate sheets you uploaded.
- The group's total full-time employee count, and how many employees are expected to receive a premium subsidy.
You get back
- An affordability percentage for each plan, measured against household income, with a pass or fail status.
- The potential 4980H(b) penalty exposure when a plan does not meet the affordability requirement.
- A compliance analysis you can export as PDF or JSON for the client file.
Every accepted file type and export format is listed on the integrations, exports and API page, and the one-page summary of what Planlined is and is not lives on Planlined product facts.
When to use it
Where it fits in a renewal.
- Before shifting cost to employeesWhen a renewal pushes the employer toward a bigger employee share, check affordability on the new split before it goes into the proposal.
- When the committee asks about penaltiesPut the 4980H(b) exposure next to the savings from a cheaper contribution strategy, so the trade-off is on one page.
- Keeping a record of the decisionExport the analysis as PDF or JSON and keep it with the case, beside the recommendation it supported.
What it does not do
- It is not a benefits administration or enrollment system. It models affordability for the plans in the case; employee elections happen elsewhere.
- It does not quote plans. Rates come from the carrier documents you upload, not from carrier rate feeds.
- It is one input to a recommendation, not a replacement for the employer's own compliance review or legal advice.
ACA affordability modeling questions
What does the ACA Compliance Modeler calculate?
Whether each plan meets ACA affordability requirements based on current IRS thresholds, shown as an affordability percentage against household income with a pass or fail status, plus the potential 4980H(b) penalty exposure when a plan falls short.
Where do the contribution figures in the affordability check come from?
From the contribution model in the same Planlined case. Adjust the employer and employee split and the affordability result updates, so there is no separate spreadsheet to keep in step.
Can the affordability analysis go to the client?
Yes. Export it as PDF or JSON for client records. The per-paycheck cost page in the proposal book is built from the same case, so the two agree.
Run your next renewal through Planlined.
Upload the carrier packet. Walk out with the comparison, the proposal book and the employee guide.