The IRS has finalized the forms and instructions that employers will use for 2019 reporting under the Affordable Care Act (ACA).
Applicable large employers (ALEs) will use the following:
Employers that self-fund a minimum essential coverage (MEC) plan will use the following:
Applicable large employers (ALEs), which generally are entities that employed 50 or more full-time and full-time-equivalent employees in the year before the reporting year, must report information about the health coverage they offered or did not offer to full-time employees. To meet this reporting requirement, the ALE furnishes Form 1095-C to the employee or former employee and files copies, along with transmittal Form 1094-C, with the IRS.
If the ALE sponsored a self-funded (self-insured) health plan providing MEC, the ALE also must report coverage information about the plan’s enrollees. If the primary enrollee was a full-time employee, the ALE will report the coverage information on Form 1095-C (and file copies with transmittal Form 1094-C to the IRS). If the primary enrollee was not a full-time employee, the ALE has the option of using the “B” forms (1095-B and 1094-B) instead of the “C” forms to report the coverage information.
Small employers who are not ALEs are exempt from the reporting requirements – unless they self-funded a MEC plan. A non-ALE employer must report coverage information about its self-funded plan’s enrollees using Form 1095-B (and file copies with transmittal Form 1094-B to the IRS).
Lastly, when Form 1095-C is required, it must be delivered to the individual who is named in Part I (along with filing copies with the IRS). If Form 1095-B applies, however, the employer may be able to avoid having to print and mail forms to individuals (although copies still must be filed with the IRS). The IRS will not penalize the employer for failing to deliver Form 1095-B to individuals provided it meets two conditions:
The due date to furnish 2019 forms to individuals is March 2, 2020, while the due date to file copies with the IRS, including the appropriate transmittal form, depends on whether the employer files electronically or by paper. Entities that provide 250 or more forms to individuals are required to file electronically with the IRS.
Employers are encouraged to work with experienced vendors, tax advisors, and payroll administrators to review how the ACA reporting requirements apply to their situation. The required forms are important IRS documents and preparers should use the same level of care that would apply to employee W-2s.
ThinkHR customers can find a wealth of information about the employer reporting rules and other ACA requirements by logging on to Comply.