ACA Reporting Basic*

Option 1: ACA Basic Package

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Forms preparation (no codes analysis) and filing for $4,500 (up to 375 schedules)

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Option 2: ACA Basic Package Plus

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Annual IRS Furnishing & Filing: $6,500 (up to 350 schedules)

Includes:

• 1094/1095-C Forms Preparation with Code Analysis

• 1094/1095-C Forms Filing*

• *No cost for corrections identified via AIRS Reconciliation Report

Additional Cost:

• Distribution of 1095-C Schedules (USPS mailing): $6.00/form*

• *Powered by Trusaic

ACA Reporting Complete*

Monthly Fee (under 500 employees): $1,000 ($12,000/yr)

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One Time Implementation Fee Structure:

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$6,000 with one-year agreement

$3,500 if two-year agreement with auto renewal

Waived with three-year agreement

Services Included:

• Employee Tracking

• Annual Plan Review & ACA Tracking

• Monthly Data Consolidation & Validation

• Monthly ACA IRS Audit Readiness Monitoring

• Monthly GIGO Score Monitoring

• Monthly Health Insurance Overspend Monitoring

• Unlimited Customer Service & Technical Support

• Annual IRS Furnishing & Filing

• 1094/1095-C Forms Preparation

• IRS Audit Defense & Exchange Notice Defense

• IRS Audit Defense/Letter 226J Response Services

Additional cost:

• 1094/1095-C Forms Furnishing (USPS mailing): $4.00 per form*

• 1094/1095-C Forms Filing: $750

• 1094-C/1095-C: IRS E-Filing Corrections No Cost**

• Exchange Notice Appeals $750 (per bundle of 25 appeals)

• Powered by First Capitol Consulting

**No cost for corrections identified via AIRS Reconciliation Report

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