1095c Line 15 - Lowest Cost Calculation

The calculation of Line 15 on the 1095c (Employee Share of Lowest Cost Monthly Premium, for Self-Only Minimum Wage Coverage) is calculated as follows:

Example #1 - the health plan is using Chapter 78 calculations:

In this example, the health plans run from July thru June.  We will be using the month of July as our example.  

Step 1 - Take the employee's Base Contracted Salary for the month in question.  In this example, the salary on July 1st is 43,531.00.

Step 2 - On the Personnel > Setup > Health Plans > Member Contributions screen, locate the row in which the salary falls in the SINGLE section, and go to Year 4.  The only time it would be something different than year 4 is if your district has negotiated that your staff uses another tier/year.  Then, you should use that negotiated column instead.  In this example, our rate is 12.00 (12%) for year/tier 4.

Step 3 - Go to your Personnel > Setup > Health Plans screen and find the lowest cost plan as of the date in question.  In this example, as of July 1st.  

•   In the "Plans Active On" field enter the July 1st date.  
•   The green highlighted row is the plan that is set as the lowest plan cost for 1095c.
•   Click the Edit button.
  

Step 4 - You will see that the lowest plan check box is checked off ensuring you are in the correct plan/lowest plan.  You will be using the premium amount in the Single field for your calculation.

The Calculation Based on the Example -

789.00     (Single plan premium from lowest cost plan)

x 12%      (Single member contribution for the salary)

94.68       (The amount that shows in Line 15 for July)

Example #2 - the health plan is using GSHP or NJEHP  Contribution Group calculations:

In this example, the plan runs from July thru June.  We will be using the month of January as our example.

Step 1 - Take the employee's Base Contracted Salary for the month in question.  In this example, the salary on January 1st is $66,502.44.

Step 2 - Go to your Personnel > Setup > Health Plans screen and find the lowest cost plan as of the date in question.  In this example, as of January 1st.  

•   In the "Plans Active On" field enter the January 1st date.  
•   The green highlighted row is the plan that is set as the lowest plan cost for 1095c.
•   Click the Edit button.
•   In this example the lowest cost plan is the Garden State plan.  So that is the contribution group you will need to use in Step 3.

Step 3 - On the Personnel > Setup > Health Plans > Contribution Groups screen, click on the Edit button for the plan that the employee uses.  In this example it is the Garden State Plan. Then, locate the row in which the salary falls in the SINGLE column. In this example, our rate is 1.5%

The Calculation Based on the Example -

66,502.44     (Employee's salary as of January)

x 1.5%          (Single member contribution for the salary)

997.54           

 / 12                   

83.13            (The amount that shows in Line 15 for January)