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ACA Compliance Guardian

Deploys a coordinated swarm of 10 autonomous AI agents that analyze employee data against current ACA regulations, predict compliance risks using ML models, simulate optimization scenarios, generate IRS forms (1095-C, 1094-C), and create actionable remediation plans. Agents operate with configurable autonomy levels and make real-time decisions while maintaining full audit trails.

10 AI Agents
4 Tech Stack
AI Orchestrated
24/7 Available
Worker ID: aca-compliance-guardian

Problem Statement

The challenge addressed

Employers face significant complexity managing Affordable Care Act (ACA) compliance, including tracking full-time employee status, ensuring coverage affordability, meeting IRS reporting deadlines, and avoiding substantial penalties under IRC Sections...

Solution Architecture

AI orchestration approach

Deploys a coordinated swarm of 10 autonomous AI agents that analyze employee data against current ACA regulations, predict compliance risks using ML models, simulate optimization scenarios, generate IRS forms (1095-C, 1094-C), and create actionable r...
Interface Preview 4 screenshots

Multi-agent compliance analysis dashboard showing 10 AI agents working in parallel with real-time status indicators, agent activity log with benchmark analyst and scenario planner actions, live API calls monitoring, and workflow phase progression from initialization through final report generation

ACA Compliance Report summary displaying Fair Compliance grade (84% score), key metrics including 64% coverage rate, 94% affordability, $36,160 penalty exposure, executive summary with recommendations, analysis quality scores, and data pipeline validation status

Compliance findings detail view showing specific violations with AI agent reasoning traces, including affordability threshold exceedances and full-time employees without coverage offers, with confidence scores and actionable remediation recommendations for each finding

What-If Scenario Analysis interface presenting four AI-generated optimization strategies with compliance impact projections, penalty reduction estimates, implementation costs, and ROI analysis including recommended hybrid optimization approach for maximum cost-benefit ratio

Multi-Agent Orchestration

AI Agents

Specialized autonomous agents working in coordination

10 Agents
Parallel Execution
AI Agent

Orchestrator Agent

Coordinating 10 specialized agents across 9 workflow phases requires intelligent task routing, priority management, and decision escalation to ensure efficient, complete analysis.

Core Logic

Serves as the master coordinator using GPT-4 Turbo for task planning and agent assignment. Operates with full autonomy for workflow routing and priority adjustments. Monitors all agent activities, aggregates results, and escalates decisions requiring human review based on confidence thresholds.

ACTIVE #1
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AI Agent

Data Analyst Agent

Employee datasets contain inconsistencies, missing values, outliers, and format variations that can cause compliance analysis errors if not properly validated and normalized.

Core Logic

Performs comprehensive data validation including schema checking, anomaly detection, and pattern recognition. Uses statistical analysis to identify outliers in hours data, flags data quality issues, and autonomously handles outlier treatment decisions. Calculates employee classification statistics and data quality scores.

ACTIVE #2
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AI Agent

Compliance Expert Agent

ACA regulations are complex, frequently updated, and require expert interpretation. Applying rules like look-back measurement periods, safe harbor calculations, and penalty assessments requires specialized knowledge.

Core Logic

Leverages GPT-4 with RAG (Retrieval Augmented Generation) over IRS publications and regulations. Interprets 2025 ACA requirements including the 9.02% affordability threshold, applies look-back measurement method rules, calculates potential penalties under 4980H(a) and 4980H(b), and classifies compliance findings by severity.

ACTIVE #3
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AI Agent

Risk Predictor Agent

Reactive compliance only catches violations after they occur. Organizations need predictive capabilities to identify employees likely to cross the full-time threshold before it happens.

Core Logic

Runs Monte Carlo simulations with 10,000+ iterations to model hours variability and predict threshold crossing probabilities. Uses custom ML models to analyze hours trends, calculate risk scores for variable-hour employees, and estimate days until potential threshold crossing. Generates proactive alerts for high-risk employees.

ACTIVE #4
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AI Agent

Form Generator Agent

IRS Forms 1095-C and 1094-C require precise code mapping, complex conditional logic, and strict XML schema compliance. Manual form preparation is slow and error-prone.

Core Logic

Automates IRS form generation using rule-based code mapping for Lines 14, 15, and 16. Validates all forms against IRS AIR system XML schemas, generates employee 1095-C forms and the 1094-C transmittal, and flags validation errors. Operates without autonomous decision authority due to regulatory precision requirements.

ACTIVE #5
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AI Agent

Explainer Agent

Compliance findings and technical ACA terminology are difficult for non-specialists to understand. Executives need plain-language summaries and actionable recommendations.

Core Logic

Uses Claude 3.5 Sonnet with higher temperature for natural language generation. Translates technical compliance data into stakeholder-friendly executive summaries, writes clear recommendations, generates communication content for different audiences, and produces the final comprehensive report with key metrics and next steps.

ACTIVE #6
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AI Agent

Regulatory Monitor Agent

ACA thresholds, penalty amounts, and filing deadlines change annually. Organizations need real-time awareness of regulatory updates to maintain compliance.

Core Logic

Simulates connection to IRS regulatory sources to fetch latest ACA guidance, threshold updates, and deadline changes. Autonomously detects regulatory changes, alerts the compliance expert agent, and updates internal reference data. Tracks key dates including Form 1095-C distribution and IRS electronic filing deadlines.

ACTIVE #7
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AI Agent

Remediation Agent Agent

Identifying compliance violations is only half the battle. Organizations need actionable, prioritized remediation steps with clear ownership, deadlines, and cost-benefit analysis.

Core Logic

Analyzes compliance findings to generate prioritized remediation roadmaps based on risk severity and ROI. Creates specific action items with assigned owners, deadlines, automation flags, and estimated savings. Builds phased implementation timelines and autonomously identifies which remediation steps can be automated.

ACTIVE #8
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AI Agent

Benchmark Analyst Agent

Organizations lack visibility into how their compliance posture compares to industry peers, making it difficult to justify investments or identify improvement opportunities.

Core Logic

Compares organizational metrics against industry benchmark data including average compliance scores, coverage rates, and penalty exposure. Calculates percentile rankings, identifies performance gaps versus top quartile performers, and autonomously classifies benchmark results and recommends improvement initiatives.

ACTIVE #9
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AI Agent

Scenario Planner Agent

Organizations need to evaluate different compliance improvement strategies before implementation to understand cost-benefit tradeoffs and choose optimal approaches.

Core Logic

Runs what-if analysis simulations modeling scenarios like extending coverage to all full-time employees, reducing hours for at-risk workers, or adjusting premium contributions. Uses Monte Carlo simulation to project compliance score improvements, penalty reductions, and implementation costs. Autonomously generates optimization recommendations with ROI analysis.

ACTIVE #10
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Technical Details

Worker Overview

Technical specifications, architecture, and interface preview

System Overview

Technical documentation

The ACA Compliance Guardian is an enterprise agentic AI platform that transforms benefits compliance from reactive firefighting to proactive risk management. The system ingests employee hour and coverage data, applies 2025 ACA thresholds (9.02% affordability, 130 hours/month full-time threshold), identifies violations and at-risk employees, benchmarks against industry peers, simulates what-if scenarios for optimization, and generates IRS-ready forms with XML schema validation. Real-time agent collaboration and autonomous decision-making provide unprecedented visibility into compliance posture.

Tech Stack

4 technologies

Support for CSV upload or HRIS API integration for employee data

Mock LLM services simulating GPT-4 Turbo, Claude 3.5 Sonnet, and custom ML models

IRS XML schema validation for Forms 1094-C and 1095-C

Real-time event streaming for agent activity monitoring

Architecture Diagram

System flow visualization

ACA Compliance Guardian Architecture
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