ACA Audit Protection

Section 1

What Triggers an Audit?

Before an ACA Audit:

• Your business will receive an ACA Subsidy Notice from the Healthcare Exchange.

• Why did you receive an Exchange Notice from the Marketplace? 

  • An FTE employee claimed:  
    • He or she was not offered health coverage by your organization.
    • While health coverage was offered, the coverage provided was not affordable and/or did not provide minimum value.
  • Your organization failed to provide the mandatory information required for ACA compliance reporting.
    • An example is filing Date of Births instead of Social Security Numbers on Part III of the 1095-C.
  • Potential red flags to the IRS prompting an Audit:
    • High W-2 counts vs no or low 1095's filed.
    • Inconsistencies in the 1095's and 1094's counts and data.


Businesses have two options once an Exchange Noticed is received:

1. Appeal the Notice

Appealing the Exchange Notice will require the business to submit evidence to challenge or contest the claims.

2. Address the 4980H Penalty

Addressing the Penalty will require the business to either pay the penalty or defend the penalty.

Defending the penalty may trigger an ACA Audit from the IRS!

Section 2

How Will You Defend It?

1. Establish documentation

  • Documentation should include offer of benefits, plans, measurements, administrative, and stability periods.

2. Businesses have two options once an Exchange Noticed is received

  • Processes of hours tracked and calculations for determining eligibility determination must be documented.

3. Methodology must be accurate and applied correctly

  • Proper understanding of the tracking and calculations in the methodology must be conveyed.

4. Data validity

  • Evidence of data extraction from multiple data sources entailed within measurement, tracking, and reporting must exist.


Section 3

What Will It Take to Defend an ACA Audit?

If you are facing an ACA audit, you need to take it very seriously and work with trusted experts to defend yourself.

A proper defense of an ACA Audit will cost your business high unexpected expenditures, and take away valuable hours of time from key personnel from their duties to help move your business forward. The risk and the potential penalties are not a chance you can afford to take.

We assist you in complying with the requirements of the ACA by helping with ACA codes, ACA reporting requirements, and various other hurdles.

If you are not an ALE, we are experts in navigating ACA requirements for employers with less than 50 employees.

ACA reporting requirements for 2017 and beyond could prove to be more complex and onerous than the ACA reporting requirements for 2016. Projected penalties are high, and it is risky to defend an ACA audit on your own.

First Capitol Consulting is here to help.

Section 4

Predict, Prevent, and Protect your Business
from an ACA Audit


First Capitol Consulting drives ACA Compliance for businesses of every size, from Main Street to Wall Street, focusing on:


  • Comprehensive audit review of your prior ACA reporting year.
  • Granular documentation of ACA compliance methodology and calculations.
  • Intelligent and proactive analysis addressing your organization's unique conditions and contingencies.


  • Analysis of your methodology of measurements, administrative, and stability periods.
  • Review of your fiduciary files encompassing time & attendance, benefits, HR files, and personnel files.
  • Dedicated analysts actively addressing any disparity, absence of mandatories, and correction required.


  • Methodology, documentation, and processes are sound and dynamically employed by dedicated analysts.   
  • Comprehensive employer aggregation analysis.  
  • Expert assistance by our seasoned regulatory compliance professionals

Section 5

Progress Begins with First Capitol Consulting


Upon finding disparities in data from the different data sources, the resulting business intelligence can be used to address future issues within the emerging horizon of regulatory compliance.

Our analysts touch all information systems from benefits, payroll, procedures and departments to establish and implement the strong foundations to forge forward.


Section 6

Prevent an ACA Audit

Our regulatory specialists have a 100% success rate and are dedicated to helping your business navigate the ACA.

Your path to prevention, prediction and protection all begins with a free, confidential spot-audit of your methodology and forms.

Schedule your Free Spot-Audit Now.

Or call Gregg at (877) 866-4222

First Capitol Consulting is your regulatory compliance division and partner.