ACA Reporting Requirements—Part Two

Learn what forms to use, how to file, deadlines, and more for ACA reporting requirements under Internal Revenue Codes 6055 and 6056.
(Published Jan 25, 2016)

With the Affordable Care Act (ACA) comes increased compliance reporting responsibilities—including reporting requirements for Internal Revenue Codes 6055 and 6056. This article will outline the forms to use for these reports, how to file them, deadlines, and more.

In our earlier article, ACA Reporting Requirements—Part One, we discussed the difference between 6055 and 6056 and who is responsible for reporting.

Background
Section 6055 requires insurers, self-insured health plan sponsors, certain governmental agencies, and any other entity that provides “minimum essential coverage” (MEC) to report information on that coverage to the IRS and to covered individuals.

Section 6056 requires “applicable large employers” (ALEs) subject to the employer shared responsibility mandate under ACA to report information about coverage offered to full-time employees to the IRS and to those covered individuals.

The goal of both of these reporting requirements is to assist the IRS in determining:

  • Which individuals have complied with the individual mandate.
  • Which employers have complied with the employer shared responsibility mandate.
  • Which individuals are eligible for premium tax credits.

Purpose of the forms

1094-B and 1095-B (Section 6055 forms)
The general purpose of Forms 1094-B and 1095-B is to report information related to whether individuals are covered under MEC in fulfillment of Section 6055 requirements. Insurance carriers and small employers with self-insured health coverage are required to use Forms 1094-B and 1095-B to report applicable information. Additionally, Forms 1094-B and 1095-B may be used by applicable large employers providing MEC to non-employees (i.e., COBRA qualified beneficiaries, participants in post-employment healthcare savings plans).

Form 1094-B is the “transmittal form” that is sent to the IRS for the entity that provides MEC (e.g., a carrier if the plan is fully-insured or a plan sponsor if the plan is self-funded) and will be used to provide the IRS with summary demographic information about the provider (e.g., name, EIN, etc.).

Unlike the Form 1094-B, the Form 1095-B focuses on the individuals who are enrolled in the plan. Form 1095-B does this by listing the persons who have MEC because they are enrolled in the plan. Form 1095-B has two purposes. A copy of the Form 1095-B is provided to the IRS and to the employee or participant who is enrolled in the plan.

1094-C and 1095-C (Section 6056 Forms)
The general purpose of Forms 1094-C and 1095-C is for employers with 50 or more full-time and full-time equivalent employees (i.e., ALEs) to report information required under Section 6056 about offers of, and enrollment in, health coverage to employees who have either full-time status or have averaged 30 hours or more as based upon the applicable look-back period.

Similar to the Form 1094-B, the Form 1094-C is the “transmittal form” that is sent to the IRS. The Form 1094-C provides summary demographic information about the ALE (e.g., name, EIN, etc.), but also requires for the ALE to identify any transitional relief from the employer mandate for which they may be eligible, an accounting for their employee numbers during the calendar year, and their controlled group status, if applicable.

The Form 1095-C is also similar to the Form 1095-B in that it focuses on the individual employee, and a copy must be provided to both the employee and to the IRS. However, Form 1095-C’s purpose is greatly different in that it seeks to establish an employer’s compliance with the employer shared responsibility mandate and to assist the IRS in determining whether an individual is eligible for premium assistance should they obtain coverage through a Marketplace.

What forms to use
Here is a quick summary to help you remember which forms relate to their specific IRS sections and who gets a copy of the forms:

FOR INDIVIDUAL MANDATE—6055, USE:

  • Form 1094-B (fully insured carrier transmittal to the IRS)
  • Form 1095-B (fully insured carrier statements to employees and reports to IRS)
  • Part III of Form 1095-C (self-insured statements to employees and reports to IRS)

FOR EMPLOYER MANDATE—6056, USE:

  • Form 1094-C (ALE transmittal to the IRS)
  • Form 1095-C* (ALE statements to employees and reports to IRS)

*Premium tax credit information is on the same form as the employer mandate information.

How to file
Employers that are required to file 250 or more employee/participant statements (either B or C) are required to file these information returns with the IRS electronically. Employers required to file fewer than 250 of these statements are permitted, but not required, to file electronically.

Employers that file electronically may choose to file the forms themselves or use an outside vendor. Those who choose to file the forms themselves will want to review IRS Publication 5165 for information about the IRS electronic filing requirements.

Employers may mail statements to full-time employees and for self-insured health to covered individuals who are not full-time employees. Employers may also provide statements electronically as long as the IRS rules are followed. IRS rules require individual notice and consent before statements may be provided electronically.

Deadlines

Recently, the IRS released notice 2016-4 which extended the deadlines for 6055-6056 reporting filings. It is important to note than the new deadlines only apply to 2015 reports (due in 2016). The 2016 reporting due in 2017 will return to the original deadline schedules. Here is a summary of this year’s deadlines:

FORMS 1095-B AND 1095-C

  • Old deadline: Feb. 1, 2016
  • New deadline: March 31, 2016

FORMS 1094-B AND 1094-C (MANUAL FILING DEADLINE)

  • Old deadline: Feb. 29, 2016
  • New deadline: May 31, 2016

FORMS 1094-B AND 1094-C (ELECTRONIC FILING DEADLINE)

  • Old deadline: March 31, 2016
  • New deadline: June 30, 2016

Resources for more information

Access final versions of 2015 forms

To learn more about ACA reporting requirements, listen to the Gallagher webinar ACA Reporting—Challenges, Strategies, Solutions, Examples.
Learn more and register for the webinar on the Gallagher site
(Note: When registering, you will be asked to provide the name of an "AJG Consultant." Enter the name: Yvonne Johnson.)

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