Stay ACA & QMCSO Compliant — Filings, Orders and Notices on Time
The elections your employees make, the hours payroll posts and the orders that arrive in the mail are already in Benefits Reimagined. Compliance reads them: full-time status and offers for the ACA, qualification and enrollment for medical support orders, and the evidence behind both.
Most compliance failures are not judgment calls. They are a variable-hour employee nobody measured, a 1095-C built from a census that was already wrong, a National Medical Support Notice that sat in a mailroom past its 20 business days. Benefits Reimagined removes the export between the benefits record and the compliance record, so the deadline is met by the system that holds the facts. COBRA administration is a roadmap item and is shown on this page as such.
Two Regulations Today, One Failure Mode
ACA and medical support orders fail the same way: the fact that triggers the obligation — hours worked, coverage offered, an order received — lives in one place, and the obligation is tracked in another. Every export between them is a place for an employee, or a child, to fall through. Benefits Reimagined keeps the trigger and the obligation on the same record, with the rule that connected them written down.
Full-time decided in January
Average hours calculated at year end from a payroll extract, so a variable-hour employee who crossed 130 hours in March gets a 1095-C code nobody can defend.
Orders handled as mail
A National Medical Support Notice arrives, is forwarded to whoever handles garnishments, and the employer’s 20-business-day response and the plan’s 40-business-day enrollment window run out in an inbox.
Evidence that lives in an inbox
When Letter 226-J arrives, or a child support agency follows up, the answer is an email thread and a former colleague’s memory rather than a record.
One Record, Four Obligations
Follow an employer through a compliance year: the ACA measured every month and filed once; medical support orders intaken, qualified and enrolled on the statutory clocks; the framework that checks everything else; and COBRA marked where it will join.
Measure the ACA every month, not every January
Each month the engine reads hours from payroll — SAP ECP or any 3rd-party payroll — classifies the employee under the monthly or look-back method, tests the offer for minimum essential coverage, minimum value and affordability under the safe harbor that applies, and writes the Line 14, 15 and 16 codes with the rule behind each. A failed safe harbor is flagged in the month it happens, while there is still time to fix the contribution.
File once from a frozen run, federal and state
When the year is ready, a readiness scan checks the configuration, the run freezes every employee’s monthly facts, and Forms 1094-C and 1095-C are built from that snapshot — PDF and IRS XML from the same record. Lock, review, approve and transmit are desks with named stamps; the IRS AIR upload is its own Test-then-Production action; corrections re-run only the flagged employees; state packets for California, New Jersey, Rhode Island and the District of Columbia follow the same path.
Intake, qualify and enroll medical support orders on the clock
A court order, agency order or National Medical Support Notice is intaken by an administrator with the order dates and the children named. Document-validity, fraud and pre-check engines store their results; a person passes or fails the order; qualification is approved in Workflow; and enrollment is a date-exact gate — NMSN reason, qualified order, event dates equal to order dates, verified child — with Part A and Part B responses generated and the 20- and 40-business-day clocks visible on every case.
Check everything else on a calendar — and add COBRA when it ships
The Compliance Framework runs configured checks against the record and appends the evidence — a masked value and an integrity hash, never raw PHI — with a calendar for the rest of the year: 1095-C, RxDC on June 1, Form 5500 and PCORI on July 31, Medicare Part D notices on October 15, the gag-clause attestation on December 31. COBRA administration — qualifying events from the HR record, election notices, terminations by rule — is on the roadmap and will run on this same record; it is labelled as roadmap wherever it appears on this site.
What You'll Use to Stay Compliant
Compliance in Benefits Reimagined is not a separate product fed by exports — it is these modules reading the same record. COBRA is shown where it will join.
ACA Compliance & 1095-C
Monthly measurement, safe harbors, frozen report runs, IRS AIR e-filing, state packets and a penalty forecast.
Explore ACA Compliance & 1095-CQMCSO & Medical Support Orders
Intake, three verification engines, qualification through Workflow, date-exact enrollment and Part A / Part B responses on the statutory clocks.
Explore QMCSO & Medical Support OrdersCompliance Framework
Configured checks, append-only evidence and the year’s filing calendar — configured by consultants, scanned on a schedule.
Explore Compliance FrameworkDependent Eligibility Audit
The verified child record an order enrolls against — IntelliVerify checks the evidence once and it is reused.
Explore Dependent Eligibility AuditEssential Insights
ACA offer rate, exposure forecast and corrections due; orders on the clock and days remaining — by entity.
Explore Essential Insights RoadmapCOBRA Administration
Qualifying events from HR data, election notices and terminations by rule — on the roadmap. Premium billing for COBRA participants runs in Direct Billing today.
Roadmap detailYear-End Compliance vs. Compliance on the Record
Six moments in a compliance year, and what changes when the trigger and the obligation share one record.
| Moment | The way it usually goes | Benefits Reimagined |
|---|---|---|
| Deciding who is full-time | At year end, from a spreadsheet of averages. | Every month, with the measurement method, the stability lock and the rule recorded. |
| Testing affordability | One safe harbor for everyone, checked at filing. | Three safe harbors, default per tax company, tested per employee per month against the year’s percentage. |
| Building the 1095-C | From a census upload; codes keyed or guessed. | Frozen from the monthly snapshot; Line 14/15/16 from rules; PDF and XML from the same record. |
| An order arrives | Forwarded to garnishments; the clock runs in an inbox. | Intaken with its dates; 20- and 40-business-day clocks on the case; Part A and Part B drafted. |
| Enrolling the child | Someone might refuse; someone might forget. | A date-exact gate as a permitted election change, without regard to enrollment season. |
| An auditor asks why | An email thread and a former colleague’s memory. | A query: rule, version, decision, response and delivery on the employee-month and on the order. |
What Changes When Compliance Reads the Benefits Record
Twelve governed months per employee
Full-time status, offer, contribution and codes are decided every month with the rule behind them; the 1095-C is the evidence frozen, not a fresh calculation.
A case on the clock
Intake stamps the order dates; the 20- and 40-business-day windows count down on the case; nobody discovers the deadline afterwards.
Engines that inform, a person who decides
Document validity, fraud and pre-check results are stored; an administrator passes or fails the order and Workflow approves it.
A date-exact gate the employee cannot block
The child is enrolled on the order dates as a permitted election change — without regard to enrollment season.
One platform, one rulebook, every entity
ACA and orders on the same record as enrollment and billing — for SuccessFactors entities and for the ones on any other HRIS.
An audit trail you can query
Rule, version, decision, response, delivery — on the employee-month and on the order, appended with an integrity hash.
Ask Why Before the IRS or an Agency Asks
The compliance workspace has Athena for Admins. It answers help-first from the ACA configuration, the measurement periods and the order rules; with ‘Include employee data’ it looks up a case or an employee-month read-only and explains it in plain language. It drafts responses and configuration changes for approval — it never files, transmits, enrolls or claims to have re-run anything.
- “Why is this employee 2F in August?” — the offer rule, the safe harbor that failed, the contribution and the percentage it was tested against
- “Which orders run out of time this week?” — the cases by business days remaining, with the Part A or Part B response drafted
- “Is 2026 ready to file?” — the seven readiness sections in words, with a link to each red one
- “Show me everything on this order.” — intake, engine results, decision, responses, enrollment dates — the answer to the agency’s follow-up
Who Usually Starts Here
Compliance is owned by HR, paid for by Finance, and audited by everyone. Each role has its own page.
HR & Benefits Leaders
Measurement, offers, orders and filings from the record you already keep — with the exposure visible before the deadline.
See the role page Owns the penaltiesFinance & Payroll
Penalties forecast from the monthly facts rather than discovered in a letter; withholding limits respected on every order.
See the role page Owns the dataIT & SAP Teams
Hours, wages and events from Employee Central and your payroll as they happen; the same fields from any other HRIS through HRIS Sync.
See the role pageSee Your Exposure Before You Have to Explain It
Bring last year’s 1095-C population, this year’s payroll hours and one medical support order you received recently. In the 45-minute walkthrough we will run a monthly ACA calculation on a sample, show the safe-harbor result per employee, and walk the order from intake to enrollment with the clocks running.
Stay Compliant FAQs
The Filing Is the Receipt. The Record Is the Proof.
ACA and medical support order compliance that lives where the elections, the hours and the dependents already are — on SAP SuccessFactors today and on whichever HRIS your next entity brings.