As an employer, there are many questions you need to answer in order to satisfy these complicated Affordable Care Act provisions. Paychex can help. Visit http://bit./ly/payx-esr for more information.

1. not!
One Size Fits All
Employer Shared Responsibility Is

2. Determining how your business could be affected by Employer Shared Responsibility
(ESR) provision will be a complex and very difficult task – unless you take advantage
of the ESR solutions offered by Paychex. By looking at your business structure and
examining your business’ payroll, HR and benefits needs, we can provide you a variety
of solutions that best fits your needs – because ESR solutions are not “one size fits all.”

3. As an employer, there are many questions
you need to answer in order to satisfy these
complicated Affordable Care Act provisions.
“Am I an Applicable
Large Employer?”
“How many full
time equivalents
do I have?”
“Who are
considered
my full time
employees?” “Does my plan
meet minimum
essential
coverage?”
“Do I qualify for
the transition
relief in 2015?”

4. BUSINESSES WITH
MIXED FULL-/PART-TIME
SIMPLE COMPLEX
Basic payroll needs
Fixed hours for part-time employees
Small office, manufacturing,
professional office
Next Step?
Stay up-to-date with ESR provision details,
and learn about the services available to you.
BUSINESS REQUIREMENTS TYPICAL INDUSTRIES
“I’m not an applicable large
employer (ALE) now,
but how will I know if I’m
approaching the threshold?”
ESR
NEEDS
20-40
EMPLOYEES

5. Hours Worked Report
This is a basic service if you do not need Paychex to provide calculations. The service provides:
• Employee work hours reported to Paychex payroll to assist in calculating the number
of full-time employees and full-time equivalents (FTEs).
• You can run this report to help determine which employees work full time.
Instruction Manual
Paychex provides this handy instruction manual, which shows how to use the Hours Worked
Report to calculate your employer status. It also contains valuable information about ESR
provisions, including tips on complying with the requirements.
Paychex Solution: Essential Payroll Data
*For employers with 50-99 full-time employees, including full-time equivalents (FTEs), there will be a one-year delay in enforcement of the ESR provisions until 2016.
Employers must meet certain conditions to qualify for the transition relief and must certify in ESR reporting that they have met these conditions.
Companies with 100 or more full-time employees, including FTEs, are still subject to enforcement of the ESR provisions in 2015.
However, those employers who offer minimum essential health coverage to at least 70% of their workforce can avoid one of the potential ESR penalties.
The relief may extend into 2016 for employers who have non-calendar-year plans in effect prior to February 10, 2014.

6. Variable hours for part-time employees
Needs time and attendance solution
Retail, food service,
construction
BUSINESS REQUIREMENTS TYPICAL INDUSTRIES
BUSINESSES WITH
MIXED FULL-/PART-TIME
SIMPLE COMPLEX
“I think I’m not an ALE, but
with my variable-hour employees,
I’m worried I may cross the
threshold and not know it.”
ESR
NEEDS
40-60
EMPLOYEES
Next Step?
Learn how to track your employees’ monthly hours
to help determine your status an as ALE.

7. Applicable Large Employer Scheduled Report
The Applicable Large Employer Scheduled Report calculates the total projected
number of full-time employees and FTEs based on your monthly schedules. It is
available if you are a Time and Labor Online client.
Paychex Solution: Workforce Management
Applicable Large Employer Report
This report, available if you are a Time and Labor Online client, helps calculate
the total number of full-time employees and FTEs an employer has per month,
measured by punch-card entries. It lists the employees’ actual total paid and
unpaid hours (including work, sick, personal, and vacation pay types) and average
hours per month, so it shows the most accurate data for monthly hours.
Approaching Threshold Hours Report
This report, which is also available if you are a Time and Labor Online client, lists
employees who have time-card entries or punches within a set number of hours
of the employer-defined threshold. It also lists employees and the number of hours.

8. SIMPLE COMPLEX
BUSINESSES WITH
MIXED FULL-/PART-TIME
CONTROLLED AND NON-CONTROLLED
OWNERSHIP GROUPS
BUSINESS REQUIREMENTS TYPICAL INDUSTRIES
Doesn’t need time tracking/punch-in solution
Qualifies as applicable large employer
Offers health insurance to employees
Multi-site (franchise), fast food,
hospitality, seasonal workers
“I’m an ALE, but I don’t
know which employees
put me at risk of penalties
if I don’t offer them
health coverage.”
ESR
NEEDS
EMPLOYEES
50+

9. Paychex Solution: Data Analytics
Data analytics from Paychex can:
• Help you determine if a provision of the Affordable Care Act (ACA) applies to you.
• Perform needed calculations on various forms of data (e.g., employee information, benefits levels, tax rates).
• Estimate potential fines and penalties resulting from not offering adequate and affordable coverage
to full-time employees and their dependents.
Applicable Large Employer (ALE) Analysis and Monitoring
Automated calculations and tracking on your behalf.
Full-Time Employee
Analysis and Monitoring
Automated calculations
and tracking on your behalf.

10. BUSINESSES WITH
CONTROLLED AND NON-CONTROLLED
OWNERSHIP GROUPS
Qualifies as applicable large employer
Offers health insurance to employees
Needs benefits administration
Any industry
BUSINESS REQUIREMENTS TYPICAL INDUSTRIES
SIMPLE COMPLEX
ESR
NEEDS
“I’m an ALE, but I don’t know
if the coverage I’m offering meets
the requirements of minimum
essential coverage and
affordability.”
50+
EMPLOYEES
Next Steps?
Get the facts about adequate and affordable coverage.

11. Paychex Solution: Data Analytics
Coverage Adequacy and Affordability Analysis and Monitoring*
This service ­— unique to Paychex because of its coordination between payroll and
benefits systems — conducts tracking of coverage by employee for evaluation of
adequacy, value, and affordability.
* Available only to Paychex Insurance Agency clients and Paychex PEO clients. Check with your Paychex
representative for availability in your area.
Insurance sold and serviced by Paychex Insurance Agency, Inc., 150 Sawgrass Drive, Rochester, NY 14620.
California license 0C28207.

12. End of Year Reporting
We’ve gone through the major steps in the ESR provisions – determining if the ESR provisions
apply to you, identifying the full-time employees to offer coverage to, and whether your coverage
is adequate and affordable. There’s one more responsibility in ESR – end of year reporting.
The Treasury Department instituted end-of-year reporting requirements for applicable large
employers – these requirements begin in January 2016 for the 2015 tax year.
There are two IRS forms that you need to complete:
• Form 1094-C - this form is for you to fill out for your business.
• Form 1095-C – this form is for you to complete on behalf of your employees.
Paychex is uniquely situated to help you meet these reporting requirements – our ability to coordinate employee data
across multiple categories allows us to facilitate the reporting of data you need to complete these forms efficiently and
accurately. With Paychex’s help, your burden in completing these forms is reduced to answer a couple easy questions.
DO NOT FILE
October 15, 2014
DRAFT AS OF
120115
CORRECTED
Form1094-C
Department of the Treasury
Internal Revenue Service
Transmittal of Employer-Provided Health Insurance Offer and
Coverage Information Returns
▶ Information about Form 1094-C and its separate instructions is at www.irs.gov/f1094c.
OMB No. 1545-2251
2014
Part I Applicable Large Employer Member (ALE Member)
1 Name of ALE Member (Employer) 2 Employer identification number (EIN)
3 Street address (including room or suite no.)
4 City or town 5 State or province 6 Country and ZIP or foreign postal code
7 Name of person to contact 8 Contact telephone number
9 Name of Designated Government Entity (only if applicable) 10 Employer identification number (EIN)
11 Street address (including room or suite no.)
12 City or town 13 State or province 14 Country and ZIP or foreign postal code
15 Name of person to contact 16 Contact telephone number
For Official Use Only
17 Reserved . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18 Total number of Forms 1095-C submitted with this transmittal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ▶
Part II ALE Member Information
19 Is this the authoritative transmittal for this ALE Member? If “Yes,” check the box and continue. If “No,” see instructions . . . . . . . . . . . . . . . .
20 Total number of Forms 1095-C filed by and/or on behalf of ALE Member . . . . . . . . . . . . . . . . . . . . . . . . . . ▶
21 Is ALE Member a member of an Aggregated ALE Group? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No
If “No,” do not complete Part IV.
22 Certifications of Eligibility (select all that apply):
A. Qualifying Offer Method B. Qualifying Offer Method Transition Relief C. Section 4980H Transition Relief D. 98% Offer Method
Under penalties of perjury, I declare that I have examined this return and accompanying documents, and to the best of my knowledge and belief, they are true, correct, and complete.
▲
Signature
▲
Title
▲
Date
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 61571A Form 1094-C (2014)
1094-C
DO NOT FILE
October 15, 2014
DRAFT AS OF
600115VOID
CORRECTED
Form 1095-CDepartment of the Treasury
Internal Revenue Service
Employer-Provided Health Insurance Offer and Coverage
▶ Information about Form 1095-C and its separate instructions is at www.irs.gov/f1095c.
OMB No. 1545-2251
2014
Part I Employee
1 Name of employee 2 Social security number (SSN)
3 Street address (including apartment no.)
4 City or town 5 State or province 6 Country and ZIP or foreign postal code
Applicable Large Employer Member (Employer)
7 Name of employer 8 Employer identification number (EIN)
9 Street address (including room or suite no.) 10 Contact telephone number
11 City or town 12 State or province 13 Country and ZIP or foreign postal code
Part II Employee Offer and Coverage
All 12 Months Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec
14 Offer of
Coverage (enter
required code)
15 Employee Share
of Lowest Cost
Monthly Premium,
for Self-Only
Minimum Value
Coverage $ $ $ $ $ $ $ $ $ $ $ $ $
16 Applicable
Section 4980H Safe
Harbor (enter code,
if applicable)
Part III Covered Individuals
If Employer provided self-insured coverage, check the box and enter the information for each covered individual.
(a) Name of covered individual(s) (b) SSN
(c) DOB (If SSN is
not available)
(d) Covered
all 12 months
(e) Months of Coverage
Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec
17
18
19
20
21
22
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 60705M Form 1095-C (2014)
1095-C

13. To learn how Paychex can help your business navigate the ESR provisions,
call 877-388-3530 or visit www.paychex.com/health-reform/esr/
For more information on health care reform, visit
www.paychex.com/health-reform/
Paychex offers a wide range of solutions to help your
business take action on complex health regulations,
including Employer Shared Responsibility.
Copyright 2015 Paychex, Inc. All rights reserved. All information believed accurate at time of release.