| Trigger | Timing | Notes |
|---|---|---|
| Annual ACA Applicable Large Employer (ALE) determination | Annually (look-back measurement across aggregated group) | Aggregate full-time + FTE counts across all commonly owned entities. |
| COBRA applicability and plan administration | Ongoing; reassess upon ownership changes | Common control affects who is treated as the employer and where notice obligations lie. |
| Medicare Secondary Payer (MSP) group-size determination | Each calendar year (and upon ownership changes) | Headcount aggregation determines whether the group health plan is primary or secondary to Medicare. |
- Organizational chart across all related entities, with ownership percentages, voting rights, and any control agreements.
- Entity details: type (LLC, C-corp, S-corp), EIN, and principal business activity for each entity.
- Headcount data: full-time, part-time, and variable-hour employee counts; average hours worked; and measurement period methodology across entities.
- Plan sponsorship details: which entity sponsors each plan and which employees across entities participate.
- Prior determinations: any existing counsel memos or workpapers supporting prior aggregation conclusions.
- No disclosure to employees is triggered by the aggregation analysis itself.
- Ensure downstream notices (SBC, SMM, COBRA) reflect the correct plan sponsor and covered entities based on the determination.
- Notify vendors and TPAs of the aggregated group structure so they administer the plan accurately.
- Analysis workpapersOwnership analysis workpapers, org charts, cap tables, and the final aggregation determination.
- Headcount calculationsHeadcount and FTE calculations with measurement-period methodology across all entities.
- Plan sponsor decisionsPlan sponsor decisions, participation by entity, and any intercompany agreements.
- Annual confirmationAnnual confirmation of group status and a change log documenting when ownership shifts occurred and how the analysis was updated.
Common traps
FAQs
What counts as "common ownership" under these rules?
The federal rules look to IRC §414: principally parent-subsidiary groups (one entity owns 80%+ of another), brother-sister groups (five or fewer common owners collectively control 80%+), and affiliated service groups (entities linked by service relationships under §414(m)). The analysis is entity-type-specific and can be complex; legal or accounting review is recommended before finalizing.
Why does this matter for health benefits specifically?
Aggregated headcount determines ACA ALE status (50+ full-time equivalent employees triggers the employer mandate), COBRA applicability (20+ employees for group health plans), and MSP group-size rules (20+ for working-aged individuals; 100+ for disability-based Medicare). Miscounting across entities means a wrong compliance determination on all three.
What are the consequences of getting it wrong?
For ACA: employer shared responsibility penalties. For COBRA: excise taxes under IRC §4980B and potential liability for COBRA benefits. For MSP: liability for claims paid in the wrong order. The stakes are high enough that the cost of professional review is almost always less than the cost of an error.
Do we reassess every year even if nothing changed?
Yes. Ownership percentages, headcounts, and measurement periods can shift in ways that change the analysis even without a formal transaction. An annual review also creates a paper trail showing you stayed current.
- IRS: ACA Employer Shared Responsibility Provisions: includes ALE determination and aggregation rules for ACA purposes.
- IRS: Determining if an Employer is an Applicable Large Employer: covers the §414(b), (c), and (m) aggregation rules as they apply to ACA ALE status specifically.
- IRS: Controlled and Affiliated Service Groups, IRC §414 (PDF): comprehensive IRS technical guide to parent-subsidiary, brother-sister, and affiliated service group definitions; the same §414 rules apply across benefit contexts.
- CMS: Medicare Secondary Payer: group-size rules and employer obligations under MSP.
Use this questionnaire to gather everything you need before performing, or commissioning, a controlled group analysis.
Entity Information (complete for each potentially related entity)
| Field | Details |
|---|---|
| Legal entity name | |
| EIN | |
| Entity type (C-corp, S-corp, LLC, partnership, and so on) | |
| Principal business activity | |
| All owners: name, ownership %, and whether interest is voting or non-voting | |
| Any management agreements, control agreements, or shared officers/directors | |
| Any shared services provided to or received from other entities |
Headcount Data (complete for each entity, for the prior calendar year)
| Field | Details |
|---|---|
| Number of full-time employees (30+ hours/week or 130+ hours/month) | |
| Number of part-time employees and average weekly hours worked | |
| Any variable-hour or seasonal employees and how hours are tracked | |
| Measurement period methodology used (monthly, look-back, and so on) |
Plan & Benefits Details
| Field | Details |
|---|---|
| Which entity is the named plan sponsor for each group health plan | |
| Which employees across entities are eligible for and enrolled in each plan | |
| Any intercompany cost-sharing or administrative agreements related to benefits | |
| Prior aggregation determinations, counsel memos, or workpapers (if any) |