Understanding Affordable Care Act (ACA) Reporting

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. As the leader in W-2 & 1099 reporting, Greatland has many options to help you complete your ACA reporting. Whether you are looking for paper forms or e-file solutions, we'll help guide you through the filing process.

What Is ACA Reporting?

Affordable Care Act reporting is the action of filing required information to the Internal Revenue Service (IRS) and sending copies to recipients/employees. The Affordable Care Act requires employers to file annual information returns with the IRS and furnish statements to employees on healthcare plan coverage information.

  • Employees: The federal filing deadlines for ACA reporting are consistent with W-2 & 1099 reporting. Form 1095-B or form 1095-C, as applicable, must be provided to recipients/employees by January 31, similar to W-2's. This means that statements for 2017 must be provided no later that January 31, 2018.
  • Insurance Company: For calendar 2017, employers with 50 or more full-time employees (including full-time equivalent employees), all self-insured employers (regardless of size) and insurance companies (where applicable) must report healthcare coverage information to employees and the IRS. Reporting is mandatory for 2017 and is the responsibility of the businesses, not the insurance company.
  • IRS: If you are an insurance company or business that is required to report healthcare coverage you will need to file one or two form types to the federal government. Both paper and e-file are acceptable filing methods, with the e-file threshold being 250 forms.

Who Needs To File?

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.

What Do I File?

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.

  • 1095-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.
  • 1095-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.

What Should I Know?

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.

Form 1095

  • Form 1095-A: Individuals enrolled in health insurance coverage through the Health Insurance Marketplace will receive this form.
  • Form 1095-B: Insurers and employers that sponsor self-insured health plans are required to report on the individuals who are covered by their health plans.
  • Form 1095-C: Employers with more that 50 full-time employees (including full-time equivalent employees) are required to report whether or not they offered health coverage to their employees by providing each full-time employee with form 1095-C. This form asks for information such as whether the employee was offered coverage and for which months. It also asks for the employee's share of the lowest cost monthly premium for the self-only minimum value coverage.

Inside The Numbers

  • January 31: Recipient due date.
  • 50 Employees: number of full-time employees (including full-time equivalent employees.
  • 40 Years: We've been in business for more than 40 years. So it's safe to say that, when it comes to IRS rules and regulations, we've been there and done that. Greatland has a full-time team of dedicated IRS compliance experts, monitoring changes and regulations all year long. When you work with Greatland, you'll rest assured that our products meet all ACA reporting requirements. You'll also have the assurance that our experts will be here for you, through online chat, email and phone support. We even have extended hours in January to help get you through the busy ACA reporting season.
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