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ACA Compliance
Applicable large employer status, full-time equivalents, affordability and the safe harbors, § 4980H penalties and reporting. The rules that decide whether an offer of coverage actually protects you.
Benefits answers organized by the decision in front of you
This is the informational side of 4J’s employee benefits practice. Everything here exists to answer one of four employer questions: does this rule apply to us, how do we calculate it, what are our options, and what do we do next?
The content is written for the people who actually carry the obligation: HR directors, controllers, CFOs, benefits administrators, superintendents and business owners, not for a search engine. Where a page states a penalty amount, an affordability percentage or a filing deadline, it links to the controlling IRS, DOL or CMS source and records the date we reviewed it.
Four clusters are live below: ACA compliance, health plan funding, tools, and the newest set covering compliance, accounts and plan strategy beyond the ACA. Additional resources on Section 125 cafeteria plans, PCORI, RxDC, gag clause attestation, Medicare Part D creditable coverage and the annual compliance calendar are being added as each one is published.
- ERISA Employer Responsibilities
Plan documents, summary plan descriptions, Form 5500 and the gaps most employers have. - COBRA and Texas State Continuation
Who must offer continuation coverage, for how long, and where employers get hurt. - HSA, FSA and Account-Based Plans
Three account types, three rulebooks, and the pairing rules that trip people up. - Dental, Vision, Life and Disability
Which lines to fund, which to offer voluntary, and where participation rules bite. - Open Enrollment Strategy
The working-backwards timeline, active versus passive enrollment, and what to measure. - Pharmacy Benefits and Rx Cost
Why prescriptions drive renewals and the questions that make the carrier show its work. - Benefits Benchmarking
The five numbers a CFO should compare before accepting a renewal. - Benefits, Recruiting and Retention
Where benefits actually move hiring and turnover, and where more spend does not help.
Three guides sit alongside the clusters: the 120-day group health renewal preparation timeline for employers heading into renewal season, the 12-item renewal review checklist of what to bring, with its companion 4J Friday podcast episode, and the employee benefits strategy page for North Texas employers with 50 to 500 employees, which describes how the advisory practice itself works.
Definitions for the terms used across these clusters are collected in the group health and employee benefits glossary, which supports the ACA, funding and tools material alike.
4J Insurance is an independent commercial insurance brokerage, powered by PGI, based in Frisco, Texas. We are not attorneys, accountants, actuaries or a third-party administrator, and nothing on these pages is legal, tax or actuarial advice.
Where employers start
Health Plan Funding
Fully insured, level-funded and self-funded structures compared, stop-loss contract terms, and what has to be true before changing funding model is justified.
Tools and Decision Support
Screen your ALE status, aggregate commonly owned businesses, and test whether your current employee contribution is likely to clear the affordability threshold — plus the counting rules behind the result.
An employer rarely gets into trouble because it chose the wrong plan. It gets into trouble because nobody checked whether the rule applied to them this year.
Guides employers use most
What is an ICHRA?
Individual coverage HRAs let an employer fund individual-market premiums instead of sponsoring a group plan. Where that works, where it does not, and what it does to ACA affordability.
Lowering health plan costs
Seven levers Texas employers actually have on plan cost, ordered by how much control the employer holds over each one, and what each requires in data or administration.
Choosing a benefits consultant
Written for Texas school districts and public entities, where procurement rules, TRS-ActiveCare and board oversight change how a benefits consultant should be evaluated.
Want someone to read your plan the way a claim will read it?
A benefits program review covers the plan documents, the contribution structure, the compliance filings and the funding model, and produces a written list of the gaps between what you are obligated to do and what your program currently does.