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Background:

Sections 6055 and 6056 of the Internal Revenue Code (the “Code”) require employers and health insurance providers to report certain information to the IRS each year.  The Section 6055 requirements apply to health insurance providers, such as insurance companies and employers that sponsor self-insured group health plans.

The Section 6056 requirements apply to “applicable large employers” or “ALEs” and require reporting of health care coverage offered to the employer’s full-time employees (an ALE is an employer that employed 50 or more full-time equivalent employees, on average, in the prior calendar year).

Reporting involves Forms 1095-B and and 1095-C.  Each set of forms includes a transmittal form (Forms 1094-B and 1094-C), which serves as a cover page.  The B-Series forms are used to report whether individuals have minimum essential coverage.  The C-Series forms are used to report information about offers of health coverage and enrollment for employees, to determine whether an employer owes a shared responsibility payment, and to determine the eligibility of employees for the premium tax credit.

 

Filing and distribution requirements for ACA Reporting:

 

Fully Insured Plan Self-Insured Plan
Non-ALE (small employer) Not required to file.

Insurance provider/carrier provides 1095-B for employees.

Forms 1094-B and 1095-B Forms are filed.

Employer (or reporting vendor) provides 1095-B for employees.

ALE Forms 1094-C and 1095-C are filed (Part III will not be completed).

1095-B provided to employees by the insurance provider.

1095-C is provided to employees by the employer (or reporting vendor).

Forms 1094-C and 1095-C are filed (with parts I, II, and III completed).

Employer (or reporting vendor) provides 1095-C to employees.

Insurance Providers Forms 1094-B and 1095-B N/A

 

Reporting Information:

 

Self-insured small employers must complete the following by the deadlines listed in the chart below:

  • File Forms 1095-B and 1094-B with the IRS.
  • Provide full-time employees with a copy of Form 1095-B.
  • Small employers are also required to file Forms 1095-C and 1094-C if they are members of a controlled group that collectively has at least 50 full-time employees.

 

ALEs must do the following by the deadlines listed in the chart below:

  • Provide Form 1095-C to each full-time employee.
  • File Forms 1095-C and 1094-C with the IRS.

 

2018 ACA Reporting Deadlines
ACA Requirement Deadline
Distribution of 1095-C forms to employees (or 1095-B forms for non-ALE, self-insured employers) March 2, 2018 (extension was granted)
Paper filing with IRS Feb. 28, 2018
e-Filing with IRS April 2, 2018 (March 31st falls on a weekend)


Please note
: Employers that file 250 or more information returns with the IRS must file electronically with the IRS.

 

Additional Information:

IRS Q&A

 

 

The information and materials on this blog are provided for informational purposes only and are not intended to constitute legal or tax advice. Information provided in this blog may not reflect the most current legal developments and may vary by jurisdiction. The content on this blog is for general informational purposes only and does not apply to any particular facts or circumstances. The use of this blog does not in any way establish an attorney-client relationship, nor should any such relationship be implied, and the contents do not constitute legal or tax advice. If you require legal or tax advice, please consult with a licensed attorney or tax professional in your jurisdiction. The contributing authors expressly disclaim all liability to any persons or entities with respect to any action or inaction based on the contents of this blog.

Joanna Castillo– Joanna is the Client Compliance Manager for Sequoia, where she works with our clients to optimize and streamline benefits compliance. In her free time, Joanna enjoys live music, college football, travel, and walking her dog in Golden Gate Park.