Affordable Care Act (ACA) – Minimum Required

Setup in Oracle Fusion Benefits

OR AC LE WHI TE P AP E R | N OVEMBER 2015
Table of Contents

Introduction 1

Minimum Essential Coverage and Minimum Value 1

Primary Funding Method 1

Lowest Cost Option 2

Conclusion 2

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Introduction
This paper explains the minimum setup required to support the US Affordable Care Act (ACA) forms 1094c and
1095c. Correspondingly, the document describes how to set up the following fields that exist in the Create or Edit
Plan pages in the Plan Configuration work area:
» Minimum Essential Coverage
» Minimum Value
» Primary Funding Method

Minimum Essential Coverage and Minimum Value

Evaluate your program or plan to check whether they meet minimum essential coverage and minimum value
requirements under ACA. If they do, select Yes for the following fields in the Create or Edit Plan: Additional
Configuration page:

» Minimum Essential Coverage

» Minimum Value
Full navigation: Navigator – Plan Configuration – Plans tab – Search for and open plan – Edit Plan page –
Additional Configuration step

Figure 1. The Minimum Essential Coverage and Minimum Value fields.

Primary Funding Method

If you want to self fund your benefits, you select Self insured from the Primary Funding Method list. This field is
available on the Create or Edit Plan: Additional Configuration page. You can set a value to this field at the program
or plan level depending on your program configuration.

Full navigation: Navigator – Plan Configuration – Plans tab – Search for and open plan – Edit Plan page –
Additional Configuration step

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Figure 2. The Self Insured value in the Primary Funding Method list

Lowest Cost Option

When you add an option to a plan, you can designate the option as the lowest cost option; select Yes from the
Minimum Value list. This field is available on the Create or Edit Plan page, Options section.

Important: Ensure that you designate only one option as the lowest cost option.

Full navigation: Navigator – Plan Configuration – Plans tab – Search for and open plan – Edit Plan page – Basic
Details step – Options section – Select and add, or edit – Select and Add: Option window.

Figure 3. The Minimum Value list.

Conclusion
The recommendations in this document explain the benefits setup required at a minimum to enable ACA
functionality for 1094c and 1095c forms.

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Affordable Care Act (ACA) – Minimum Required Setup in Oracle Fusion Benefits
November 2015
Author: Benefits Product Management
Contributing Authors: [OPTIONAL]