Get the Facts and Know Your Filing Options with the ACA Basics
By now most businesses and insurance companies are familiar with the Patient Protection and Affordable Care Act (PPACA), sometimes referred to as ACA or ObamaCare. To comply, employers and insurers are required to file to the IRS and provide copies to recipients. Greatland has three options, designed to fit your budget and business needs, to file Forms 1095-B and 1095-C to the IRS and send copies to your employees.
Employers with 50 or more full-time employees (including full-time equivalent employees) within the previous year and all self-insured employers regardless of size must report healthcare coverage information to employees and the IRS.
Full-time employees are those who worked an average of 30 hours or more per week for more than 120 days in a year. Using this guideline, you may have less than 50 full-time employees, but meet the requirements for ACA reporting. IRS.gov has a great estimator tool, including a Full-time Equivalent Employee Estimator, to help determine your filing obligation.
If you are an insurance company or business that is required to report healthcare coverage you will need to file one of two form types to the federal government. Both paper and e-file are acceptable filing methods, with the e-file threshold being 250 forms.
Form 1095-B and Form 1095-C will require some or all of the following data: employer ID numbers (EIN), taxpayer identification numbers (TIN) of employees/recipients and their dependents, addresses, and months of coverage.
B - The Internal Revenue Code (IRC) Section 6055 outlines the requirements for 1095-B reporting. Form 1095-B must be issued by the insurance company (or self-insured employer) to the individual and the IRS as proof of coverage. Form 1094-B is the related transmittal sent to the IRS.
C - IRC Section 6056 defines the reporting requirements for large employers (50 or more full-time employees including full-time equivalent employees) to provide their employees with documentation outlining any applicable offer of health coverage. Form 1095-C is a statement issued by employers with 50 or more full time employees (including FTEs) to employees and the IRS. Form 1094-C is the related transmittal sent to the IRS.
There are no state reporting requirements associated with the 1095-B or 1095-C.
It might seem like there is a lot to remember when it comes to ACA reporting. However, when you take a step back, look inside the numbers, you'll find that there are four important numbers to remember.