ACA Reporting Overview
Why do I need to report ACA Forms?
Section 6056 of the Internal Revenue Code was added to the Affordable Care Act (ACA) in 2014, and requires employers with at least 50 full-time employees to File information returns about health insurance coverage. Information from the return is then used by the IRS to manage employer shared responsibility provisions, and to determine employees that are eligible for Premium Tax Credit (PTC).
Who needs to file ACA Forms?
Insurance providers, small businesses, and government entities or tax-exempt organizations who provide health insurance coverage are required to file under Section 6055. Likewise, all Applicable Large Employers (ALE) must file under Section 6056. ALEs are employers with 50 or more full-time employees (or full-time equivalents) and are required to offer at least the minimum essential coverage (MEC) of health insurance to their employees.
Form 1095-B, Health Coverage
ACA Reporting Form 1095-B is used to report certain information to the IRS and to taxpayers about those who are covered with the minimum essential health care coverage, and therefore, are not accountable for individual shared responsibility payments. minimum essential coverage includes eligible employer-sponsored plans, government-sponsored plans, individual market plans, and other coverage identified as minimum by the Department of Health and Human Services. Anyone who provides the minimum essential health care coverage to a person during a calendar tax year is required to file an information return for that recipient.
Form 1094-B, Transmittal of Health Coverage Information Returns
IRS Form 1094-B is used by certain providers of health insurance coverage to submit Form 1095-B when filing each year. it is a required addition, as it reports a summary of the information found on your Form 1095-B to the IRS.
ACA Reporting Deadlines for 2018 TY
IRS Extended Deadline For Form 1095-B due to recipients/employees is March 4th, 2019
Forms 1094-B & 1095-B due to the IRS, if you are Paper Filing
Forms 1094-B & 1095-B due to the IRS, if you are Filing Electronically
Form 1095-C - Employer-Provided Health Insurance Offer and Coverage
Affordable Care Act (ACA) reporting Form 1095-C is an information return used by Applicable Large Employers (ALEs) to report certain information to the IRS and to employees about health coverage offered and health care enrollment. ALEs are employers with at least 50 full-time employees during the qualifying tax year. The IRS uses Form 1095-C to determine if an employer owes payment under the employer shared responsibility provisions, and if an employee is eligible for premium tax credit (PTC). Employers that offer sponsored, self-insured coverage are also required to file Form 1095-C with the IRS.
Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns
Form 1094-C is used by employers that had at least 50 full-time employees to submit Form 1095-C, and discloses information about offering health coverage and health care enrollment to employees. Form 1094-C is required to report a summary of this information to the IRS.
Note: 1095-C electronic filing is mandated by the IRS, if the employer is filing more than 250 returns.
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ACA Reporting Deadlines for 2018 TY
IRS Extended Deadline For Form 1095-C due to recipients/employees is March 4th, 2019
Forms 1094-C & 1095-C due to the IRS, if you are Paper Filing
Forms 1094-C & 1095-C due to the IRS, if you are Filing Electronically
- Total count of employees and a count of full-time employees.
- Each employee ID, name, and address.
- Information about the offered healthcare coverage.
- Employee's share of monthly premiums for the lowest-cost, self-only, minimum coverage.
- Months in which the employee was enrolled in the employer's coverage.
- Information about safe harbor affordability.
- Information about self-insured, covered individuals within the employer's plan.
- March 04, 2019 - Form 1095-B/C copies are due to recipients/employees
- February 28, 2019 - Form 1094-B/C & 1095-B/C paper filings are due to the IRS
- April 01, 2019 - Form 1094-B/C & 1095-B/C e-filings are due to the IRS
- Name, address, and Social Security Number (SSN) for each covered individual, including their spouse and any dependents
- Month(s) in which the individual was enrolled in coverage for at least one day
- For fully insured group health care coverage, issuers are required to provide the employer's name, address, and Employer Identification Number (EIN)
- ACA Form 1094-B and Form 1095-B are required for insurers, self-funded plans, and other providers of Minimum Essential Coverage (MEC). Both are to inform the IRS about the individuals covered by MEC. The requirement is applied regardless of plan size.
- ACA Form 1094-C and Parts I, II, and III of Form 1095-C are required to be completed by a self-funded plan sponsor that is accountable for employer shared responsibility requirements. Self-funded plans that are not susceptible to shared responsibility requirements must be filed on Form 1095-B.
- For insured health care coverage, the insurer is responsible for MEC reporting with ACA Forms 1094-B and 1095-B. Form 1095-B is provided to the list of insured individuals from Form 1094-B.
- The Health Care Marketplace is responsible for MEC reporting with ACA Form 1095-A for health care coverage that is obtained through the marketplace.