Batts Morrison Wales & Lee - News & Resources - Nonprofit Special Alert

Reminder: ACA Employer Reporting Requirements – Due Dates Extended

post pictureAs outlined in our Nonprofit Special AlertTM released on May 7, 2015, provisions in the Affordable Care Act (and the regulatory guidance issued thereunder) impose additional reporting requirements for employers and insurers.  The first of these reporting requirements, which pertains to reporting the aggregate cost of employer-sponsored healthcare coverage on Forms W-2, is already required for certain employers. The other two reporting requirements, which require completion and submission of new IRS forms, begin with respect to 2015 (with reporting due in 2016).  The IRS has recently extended the reporting deadlines for the reports due in 2016, as outlined further below.

Please click here to access a summary of the applicable forms related to the Nonprofit Special AlertTM released on May 7, 2015 and summarized below.

Minimal Essential Coverage Reporting on Forms 1094-B and 1095-B 

Beginning with respect to 2015 (with reporting due in 2016), all persons providing minimum essential health insurance coverage to individuals, including small employers (i.e., those with fewer than 50 full-time employees) with self-insured health plans, must report such coverage to each individual to whom minimum essential coverage was provided, and to the IRS, using Forms 1094-B and 1095-B.

For fully insured group health plans, the health insurance issuer or carrier, rather than the employer itself, must file the Forms 1094-B and 1095-B.

In contrast, plan sponsors of self-insured group health plan coverage are required to report health insurance coverage for their employees (and their dependents).  Generally, small employers that are not subject to the employer shared responsibility provisions (discussed below) will meet this requirement by filing Forms 1094-B and 1095-B.  Applicable large employers subject to the employer shared responsibility provisions (discussed below) with self-insured health plans will satisfy the reporting requirement by completing Part III of Form 1095-C (discussed below), rather than by filing Forms 1094-B and 1095-B.

A copy of Form 1095-B must generally be provided to each covered individual by January 31st (but extended to March 31, 2016 for the filing due in 2016) of the year following the calendar year in which the minimum essential coverage is provided and filed with the IRS (using a Form 1094-B transmittal form) by February 28th (but extended to May 31, 2016 for the filing due in 2016) of the year following the calendar year in which the minimum essential coverage is provided.  Forms 1094-B and 1095-B are required to be filed electronically with the IRS if the reporting entity is required to file at least 250 Forms 1095-B for the calendar year.  If the forms are filed electronically, the due date is generally extended to March 31st (but has been further extended to June 30, 2016 for the filing due in 2016). If the regular due date falls on a Saturday, Sunday, or legal holiday, then the forms must be filed by the next business day.

Please refer to the full text of our special alert released in May (linked above) for additional information.

Reporting on Forms 1094-C/1095-C by Applicable Large Employers Subject to Employer Shared Responsibility Provisions

Beginning in 2015 (with reporting due in 2016), applicable large employers are generally subject to the employer shared responsibility provisions, and therefore must report certain information to the IRS on Forms 1094-C and 1095-C about offers for and enrollment in health coverage with respect to their employees.

An “applicable large employer” is generally defined as an employer that employed on average at least 50 full-time employees on business days during the preceding calendar year (see our May special alert linked above for more information).

An applicable large employer must prepare a Form 1095-C for each employee who was a full-time employee for any month of a calendar year.  In addition, an applicable large employer must prepare one or more Forms 1094-C, to report to the IRS summary information for the employer and to transmit Forms 1095-C to the IRS.  The information reported on Forms 1094-C and 1095-C must be reported on a calendar-year basis (not a plan-year basis).  Therefore, information from two plan years may need to be taken into account when completing the forms.

A copy of Form 1095-C must generally be provided to each employee by January 31st (but extended to March 31, 2016 for the filing due in 2016) of the year following the calendar year in which the minimum essential coverage is provided and filed with the IRS (along with the Form 1094-C transmittal) by February 28th (but extended to May 31, 2016 for the filing due in 2016) of the year following the calendar year in which the minimum essential coverage is provided.  Forms 1095-C are required to be filed electronically with the IRS if the reporting entity is required to file at least 250 Forms 1095-C for the calendar year.  If the forms are filed electronically, the due date is generally extended to March 31st (but has been further extended to June 30, 2016 for the filing due in 2016).  If the regular due date falls on a Saturday, Sunday, or legal holiday, then the forms must be filed by the next business day.

Please refer to the full text of our special alert released in May (linked above) for additional information.

Professional Assistance
Due to the complexity of these rules, we encourage our clients to contact their healthcare insurance plan provider and/or their employee benefits counsel to address specific questions about the applicability of these new reporting requirements to their organizations.  For any of our clients who may need to retain employee benefits counsel, please reach out to us for contact information for attorneys with whom we have worked who practice in this area.

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