This article, Understand ACA Reporting Requirements, recently published in BenefitsPro, outlines the basics for ACA reporting. We recommend checking it out as a guideline!
Let’s explore a few of the details:
What are we talking about? The requirement mandates applicable large employers (those with 50 or more full-time equivalent employees) and small employers (under 50 full-time equivalent employees) sponsoring self-funded health plans to report on group health coverage offered to employees or to disclose that health coverage was not offered to employees in 2015.
There are two reports employers must prepare: (1) an annual information return that is filed with the Internal Revenue Service (IRS), and (2) statements to provide to full-time employees about the group health plan coverage offered. As such:
- Internal Revenue Code § 6056 requires applicable large employers with fully-funded health insurance to provide the annual statement (IRS Form 1095-C) to each full-time employee detailing the employer’s health coverage offer.
- Internal Revenue Code § 6055 requires employers that provide minimum essential coverage under a self-funded (uninsured) plan to provide the annual statement to covered employees (either IRS Form 1095-B or 1095-C, based on company size
When must these be filed?
- 2015 Form 1095 (employee statement): Due February 1, 2016.
- 2015 Form 1094 (transmittal form with copies of Forms 1095-C): Due February 29, 2016 (or March 31, 2016, if filing electronically).
What information should employers be collecting? Employers will need the following information in order to complete the reports:
- Identifying information for the employer and employee, such as name and address.
- Names of full-time employees for each month of the year.
- Information about the health coverage offered by month, if any.
- The employees’ share of the monthly premium for the lowest-cost self-only minimum value coverage.
- Months each employee was enrolled in the coverage.
- Months the employer met an affordability safe harbor with respect to an employee and whether other relief applied for an employee.
If the employer offers a self-funded plan, information about the covered individuals enrolled in the plan, by month.
- Information about whether the employer offered coverage to 70 percent of full-time employees and their dependents in 2015 (after 2015, this threshold changes to 95 percent).
- Total number of Forms 1095-C the employer issued to employees.
- Information about members of the aggregated applicable large employer group, if any.
- Full-time employee counts by month.
- Total employee counts by month.
- Whether employers are eligible for certain transition relief
To check out the full article by BenefitsPro author, Laura Kerekes, please click here.