1095 Filing
Essential 1095 Filing Guidelines
Most businesses and insurance companies are familiar with the Patient Protection and Affordable Care Act (PPACA), also known as ACA or ObamaCare. Under this law, employers and insurers must file required forms with the IRS.
If filing more than 250 forms, electronic filing is mandatory. Copies must also be provided to employees or recipients to ensure compliance.
1095-B
IRC Section 6055 requires insurers or self-insured employers to file Form 1095-B as proof of coverage with individuals and the IRS, along with transmittal Form 1094-B.
What is Form 1095-B?
Form 1095-B reports information to the IRS and taxpayers about individuals with minimum essential health coverage, confirming they aren’t subject to the individual shared responsibility payment. This coverage includes government, employer, individual market, and other HHS-designated plans.
Who Needs to File?
Entities that provide minimum essential coverage must file Form 1095-B and a transmittal with the IRS. Self-insured large employers use Form 1095-C, while self-insured small employers use Forms 1094-B and 1095-B. Refer to IRS instructions or use the IRS tool to confirm filing requirements.
1095-C
IRC Section 6056 requires large employers (50+ full-time or equivalent employees) to report offers of health coverage. They use Form 1095-C to report to employees and the IRS, and Form 1094-C as the transmittal to the IRS.
What is Form 1095-C?
Form 1095-C reports employee and employer information to the IRS to determine potential employer shared responsibility payments and employee eligibility for the premium tax credit. Applicable Large Employers, including those with self-insured plans, use it to report individuals with minimum essential coverage.
Who Needs to File?
Employers subject to Section 4980H must file Form 1095-C for each full-time employee and submit one or more 1094-C forms (including an Authoritative Transmittal). They must also provide each employee with a copy of Form 1095-C.
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