ACA REPORTING - FULL SERVICE AGREEMENT
HR Service, Inc. agrees to: 1) complete the below client’s 1095-C-or B and 1094-C or B reports for 2017 ACA Reporting, 2) provide 1095 forms to client for distribution and 3) to mail form 1094 with copies of forms 1095 to the IRS.
If Optional IRS E-Filing or mailing to employees is elected, HR Service will facilitate the completion of the E- filing and mailing through our partner firm, Nelco. Applicable charges will apply as indicated on page two.
Client Agreements
The below listed client agrees to the following:
1) To provide HR Service with requested employee, and if applicable, dependent spreadsheet information in a timely fashion, and to follow all distribution instructions before deadlines.
2) Pay 50% of the initial fee:
B Forms (self-funded or level-funded plans)
1-25 employees - $350.00 initial fee 26-49 employees - $499.00 initial fee
C Forms
50-99 employees - $1600.00 initial fee, includes one EIN 100+ employees - $2000.00 initial fee, includes one EIN
$3.00 per form after the initial 249 forms
3) Pay the following additional cost(s), if applicable: (Additional costs will be invoiced upon completion and must be paid within 20 days of invoicing.)
-
- $3.00 per form after the initial 249 forms
- If more than one class of employees for insurance rates – Plus $100 per additional class
- If banded rates based on Age, Territory, Tenure or Gender – $350.00 for first band, then $50 per Band
- If multiple EINs – starting at $75.00
- If submitted spreadsheet is not done as requested and must be reconfigured – Plus $600
- If 250+ forms, client must use the E-file per IRS regulations – Plus Chart Rates on next page.
DUE DATES:
December 15th – All initial reporting (data from January to October/November) and company information must be submitted to HR Service to guarantee that forms will be completed within IRS required timelines (postmarked/distributed to employees by 1/31/17)
January 12th 2018 – All remaining information (data from Nov/Dec) due to HR Service to guarantee that forms will be completed within IRS required timelines.
HR Service will guarantee that forms will be completed by the first IRS deadline of January 31, 2017 if information is submitted before the above noted due dates.)
The below client acknowledges that the services rendered by HR Service, Inc. are not legal service or legal advice. HR Service, Inc., along with our legal advisors, uses our best efforts to assist in complying with the Affordable Care Act and IRS regulations. However, the below client is and remains ultimately responsible for complying with all applicable laws and regulations.
Optional E-Filing and/or Mailing to Participants (Pricing is per form)
Service
|
1-50 ees
|
51-100
|
101-250
|
251-500
|
501-1000
|
1001+
|
A La Carte Federal E-file
|
1.82
|
1.49
|
1.27
|
1.11
|
1.05
|
1.00
|
MAIL ONLY TO Recipient Print/ Mail/ Online Retrieval
|
5.01
|
3.97
|
3.20
|
2.70
|
2.10
|
1.77
|
MAIL ONLY Recipient Print/ Mail/ Online Retrieval ($1 Peak=on due date)
|
6.01
|
4.97
|
4.20
|
3.70
|
3.10
|
2.77
|
BUNDLED Federal E-file &
Print/ Mail/ Online Retrieval
|
5.73
|
4.85
|
3.97
|
3.25
|
2.48
|
2.04
|
BUNDLED: Federal E-file & Print/ Mail/ Online Retrieval ($1 Peak)
|
6.73
|
5.85
|
4.97
|
4.25
|
3.48
|
3.04
|
*Appropriate charges will apply for any necessary corrections in E-file forms that error and require validation and resubmission due to data errors*