United States: Final Information Reporting Requirements For Employers

The time and cost of complying with any additional reporting requirement is never good news. However, the final regulations issued on March 10, 2014, regarding employer information reporting under the Affordable Care Act, provide a more streamlined process for reporting than initially anticipated. This Alert focuses on the Section 6055 and Section 6056 reporting requirements applicable to employers. Additional requirements apply to insurers, and those requirements are not addressed in this Alert.

Overview of Employer Reporting Requirement

The Affordable Care Act added information reporting requirements to the Internal Revenue Code under Sections 6055 and 6056. Section 6056 reporting requires applicable large employers (generally those with at least 50 full-time employees) to report to the IRS information about the health coverage they provided to their employees. This reporting is necessary for the IRS to determine if the employer penalties under Code Section 4980H apply (i.e., the penalties for failing to offer coverage or failing to offer affordable, minimum value coverage). Employers are also required to provide statements to employees regarding their health coverage, primarily so they can determine if they are eligible for a premium tax credit for the purchase of health insurance through the Marketplace.

Section 6055 reporting requires information be provided by any person that provides minimum essential coverage to an individual, including insurers and self-insured employers. This reporting is necessary to assist the IRS in enforcing the individual mandate which imposes a tax to individuals under Code Section 5000A for failure to maintain minimum essential coverage ("MEC").

The final regulations allow reporting under both these sections on the same form. This is of some help to employers, but the extent of the required information that is to be reported has not been significantly changed from the proposed regulations. The forms are not yet available, but the regulations include details on what will be reported.

Reporting Requirements

Each member of a controlled group of companies must file its own information return. For simplicity, we refer to each separate member as the "employer" in this Alert. While this is consistent with how the employer penalties under Code Section 4980H are assessed, it creates complications for corporations with multiple subsidiaries. However, the final regulations permit a third party to submit the filing on an employer's behalf. For example, the health plan sponsor (which is typically the corporate parent in a multiple subsidiary situation) or third party administrator may submit the filing on behalf of each participating employer.

General Method

All employers may utilize the general method for the required reporting, even if an alternative method of reporting is available. A separate return is required for each full-time employee, just as is the case with Forms W-2. There is also a single combined form that is used for the Sections 6055 and 6056 reporting (two separate forms are not required). The reporting is done by using Form 1094-C (a transmittal) and Form 1095-C (an employee statement), or other forms the IRS may designate. Alternatively, a substitute form is also available. In general, the forms would be completed as follows:

  • Self-Insured Medical Plan: Reports on Form 1095-C, completing both sections for the required information under both Sections 6055 and 6056.
  • Insured Medical Plan: Reports on Form 1095-C, but the employer completes only the Section 6056 reporting. Health insurers, self-insured multi-employer plans, and providers of government-sponsored coverage report the required Section 6055 information on Form 1095-B.

Overview of Information to be Reported under Section 6056

Required information for Section 6056 reporting:

  • Name, address and EIN of the employer (which is each separate employer in a multiple subsidiary situation)
  • Address and telephone number for the employer's contact person (can be a third party)
  • Certification as to whether full-time employees (and dependents) were offered the ability to enroll in minimum essential coverage ("MEC")
  • For each full-time employee:
    • the months for which MEC was available
    • the employee's share of the lowest cost monthly premium for self-only coverage providing minimum value available to that employee (by month)
    • name, address and social security number and the months, if any, during which such employee was covered under an eligible employer-sponsored health plan

In addition, there will be indicator codes to report the following information:

  • Whether coverage provides minimum value and whether the employee was permitted to enroll his/her spouse
  • Total number of employees, by month
  • Whether an employee's effective date of coverage was affected by a permissible waiting period, by month
  • Whether employer had no employees or otherwise credited hours of service, by month
  • Whether employer is part of a controlled group and, if so, the name and EIN of each member that is part of the applicable large employer on any day of the year
  • For those that contribute to a multi-employer plan (such as a union plan), whether the employer is not subject to the employer penalty due to the employer's contribution to that plan
  • If a third party is reporting for the employer, the name, address and ID number of the third party
  • With respect to each full-time employee, it is anticipated that the following will be reported:
  • Whether MEC was offered to the employee only, employee and dependents only, employee and spouse only, or employee and family
  • If coverage was not offered, whether no penalty will apply, whether the employee was not full-time or not employed by the employer during that month or whether no other code or exception applies
  • Coverage was offered even though the employee was not full-time
  • Whether the employer met the affordability safe harbor

The required statement to the employee may be made by providing a copy on Form 1095-C or a substitute statement.

Method and Timing for Filing Section 6056 Returns and Employee Statements

Electronic filing of Forms 1094-C and 1095-C is required, except for employers filing fewer than 250 returns under Section 6056 during the calendar year. The required employee statements can be provided electronically if the rules that apply to the electronic furnishing of Forms W-2 are met, including that the employee's consent to electronic disclosure of this specific form is obtained first.

Annual filings are due no later than February 28 of the year following the year to which the information relates or, if filed electronically, by March 31. Employee statements must be provided annually on or before January 31 (these are the same filing due dates as apply for Forms W-2). These deadlines apply even to plans that are not calendar year plans. This means that the first filings and statements will be due in early 2016 with respect to 2015 coverage.

Alternative Methods for Reporting

The reason for Section 6056 reporting is to assist the IRS in administering the penalties under Section 4980H and the premium tax credit. After reviewing comments, the IRS agreed that there are groups of employees for whom more streamlined, alternative reporting would provide a sufficient amount of information. Each employer can decide whether to use the alternative method of reporting for the employees for whom this simplified reporting is available and the general method for others, or instead to use the general method for all employees.

A. Reporting by Certification of Qualifying Offers

Under this alternative, the employer certifies on the Section 6056 transmittal form that it offered a qualifying offer of coverage to the employee and can provide a simplified statement to the employee (as opposed to providing a Form 1095-C). An employer is eligible for this reporting with respect to an employee if for all months during the applicable year in which the employee is a full-time employee with respect to a Section 4980H employer penalty could apply, the employer makes a qualifying offer which means it:

  • Offered MEC providing minimum value at a cost for employee-only coverage for not more than 9.5% of the single mainland federal poverty line to one or more of its full-time employees
  • Offered MEC to the employee's spouse and dependents (or would have if the employee had a spouse and/or dependents)

An employer that takes advantage of the transition relief and does not offer dependent coverage in 2015 will not be eligible for this alternative reporting. In addition, this reporting method is not available with respect to an employee who receives a qualifying offer for less than 12 months, such as because the employee was hired or terminate during the year or was in a waiting period or look-back measurement period.

B. 2015 Transition Reporting by Certification of Qualifying Offers

Solely for 2015, this option is available to an employer that can certify that it made a qualifying offer of coverage to at least 95% of its full-time employees and to their spouses and dependents and that provides a simplified statement to the employee about the coverage by the following January 31. Providing coverage for all 12 months is not a requirement for this transition reporting method. The IRS will prescribe the required statement that is to be provided to employees. Under this method, the IRS filing requirement is satisfied by simply filing the Form 1095-C and providing the employee's name, social security number and address and an indicator code that either a qualifying offer was made for all 12 months, the specific months for which it was made, or that such an offer was not made. Future forms and instructions will provide further information on this alternative option.

C. Reporting without Separate Identification of Full Time Employees

This method is available to an employer making an offer of MEC to at least 98% of the employees on whom it reports information under Code Section 6056. For this purpose, affordability can be determined under any of the applicable safe harbors.

D. Transition Reporting for Mid-Size Employers (50-99 Full-Time Employees)

Employers eligible for the transition relief from the employer penalties must still report for 2015. However, under this reporting method, the employer certifies that it meets the eligibility requirements for the "under 100" transition relief.

It will be important to review the forms and instructions once they are available for a more complete understanding of each of the above reporting requirements and options.


Failure to comply with the Section 6056 reporting requirement can result in penalties under Section 6721 for failure to file correct returns and Section 6722 for failure to provide employee statements. However, the IRS will not impose penalties for reports and statements provided in 2016 to report offers of coverage in 2015 for incorrect or incomplete reporting, if the employer can show it made good faith efforts to comply. In addition, if an employer fails to timely meet the requirements, it may be eligible for penalty relief if the IRS determines the failure was due to reasonable cause as provided in the standards for relief under Section 6724.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

To print this article, all you need is to be registered on Mondaq.com.

Click to Login as an existing user or Register so you can print this article.

Similar Articles
Relevancy Powered by MondaqAI
Foley & Lardner
In association with
Related Topics
Similar Articles
Relevancy Powered by MondaqAI
Foley & Lardner
Related Articles
Related Video
Up-coming Events Search
Font Size:
Mondaq on Twitter
Register for Access and our Free Biweekly Alert for
This service is completely free. Access 250,000 archived articles from 100+ countries and get a personalised email twice a week covering developments (and yes, our lawyers like to think you’ve read our Disclaimer).
Email Address
Company Name
Confirm Password
Mondaq Topics -- Select your Interests
 Law Performance
 Law Practice
 Media & IT
 Real Estate
 Wealth Mgt
Asia Pacific
European Union
Latin America
Middle East
United States
Worldwide Updates
Registration (you must scroll down to set your data preferences)

Mondaq Ltd requires you to register and provide information that personally identifies you, including your content preferences, for three primary purposes (full details of Mondaq’s use of your personal data can be found in our Privacy and Cookies Notice):

  • To allow you to personalize the Mondaq websites you are visiting to show content ("Content") relevant to your interests.
  • To enable features such as password reminder, news alerts, email a colleague, and linking from Mondaq (and its affiliate sites) to your website.
  • To produce demographic feedback for our content providers ("Contributors") who contribute Content for free for your use.

Mondaq hopes that our registered users will support us in maintaining our free to view business model by consenting to our use of your personal data as described below.

Mondaq has a "free to view" business model. Our services are paid for by Contributors in exchange for Mondaq providing them with access to information about who accesses their content. Once personal data is transferred to our Contributors they become a data controller of this personal data. They use it to measure the response that their articles are receiving, as a form of market research. They may also use it to provide Mondaq users with information about their products and services.

Details of each Contributor to which your personal data will be transferred is clearly stated within the Content that you access. For full details of how this Contributor will use your personal data, you should review the Contributor’s own Privacy Notice.

Please indicate your preference below:

Yes, I am happy to support Mondaq in maintaining its free to view business model by agreeing to allow Mondaq to share my personal data with Contributors whose Content I access
No, I do not want Mondaq to share my personal data with Contributors

Also please let us know whether you are happy to receive communications promoting products and services offered by Mondaq:

Yes, I am happy to received promotional communications from Mondaq
No, please do not send me promotional communications from Mondaq
Terms & Conditions

Mondaq.com (the Website) is owned and managed by Mondaq Ltd (Mondaq). Mondaq grants you a non-exclusive, revocable licence to access the Website and associated services, such as the Mondaq News Alerts (Services), subject to and in consideration of your compliance with the following terms and conditions of use (Terms). Your use of the Website and/or Services constitutes your agreement to the Terms. Mondaq may terminate your use of the Website and Services if you are in breach of these Terms or if Mondaq decides to terminate the licence granted hereunder for any reason whatsoever.

Use of www.mondaq.com

To Use Mondaq.com you must be: eighteen (18) years old or over; legally capable of entering into binding contracts; and not in any way prohibited by the applicable law to enter into these Terms in the jurisdiction which you are currently located.

You may use the Website as an unregistered user, however, you are required to register as a user if you wish to read the full text of the Content or to receive the Services.

You may not modify, publish, transmit, transfer or sell, reproduce, create derivative works from, distribute, perform, link, display, or in any way exploit any of the Content, in whole or in part, except as expressly permitted in these Terms or with the prior written consent of Mondaq. You may not use electronic or other means to extract details or information from the Content. Nor shall you extract information about users or Contributors in order to offer them any services or products.

In your use of the Website and/or Services you shall: comply with all applicable laws, regulations, directives and legislations which apply to your Use of the Website and/or Services in whatever country you are physically located including without limitation any and all consumer law, export control laws and regulations; provide to us true, correct and accurate information and promptly inform us in the event that any information that you have provided to us changes or becomes inaccurate; notify Mondaq immediately of any circumstances where you have reason to believe that any Intellectual Property Rights or any other rights of any third party may have been infringed; co-operate with reasonable security or other checks or requests for information made by Mondaq from time to time; and at all times be fully liable for the breach of any of these Terms by a third party using your login details to access the Website and/or Services

however, you shall not: do anything likely to impair, interfere with or damage or cause harm or distress to any persons, or the network; do anything that will infringe any Intellectual Property Rights or other rights of Mondaq or any third party; or use the Website, Services and/or Content otherwise than in accordance with these Terms; use any trade marks or service marks of Mondaq or the Contributors, or do anything which may be seen to take unfair advantage of the reputation and goodwill of Mondaq or the Contributors, or the Website, Services and/or Content.

Mondaq reserves the right, in its sole discretion, to take any action that it deems necessary and appropriate in the event it considers that there is a breach or threatened breach of the Terms.

Mondaq’s Rights and Obligations

Unless otherwise expressly set out to the contrary, nothing in these Terms shall serve to transfer from Mondaq to you, any Intellectual Property Rights owned by and/or licensed to Mondaq and all rights, title and interest in and to such Intellectual Property Rights will remain exclusively with Mondaq and/or its licensors.

Mondaq shall use its reasonable endeavours to make the Website and Services available to you at all times, but we cannot guarantee an uninterrupted and fault free service.

Mondaq reserves the right to make changes to the services and/or the Website or part thereof, from time to time, and we may add, remove, modify and/or vary any elements of features and functionalities of the Website or the services.

Mondaq also reserves the right from time to time to monitor your Use of the Website and/or services.


The Content is general information only. It is not intended to constitute legal advice or seek to be the complete and comprehensive statement of the law, nor is it intended to address your specific requirements or provide advice on which reliance should be placed. Mondaq and/or its Contributors and other suppliers make no representations about the suitability of the information contained in the Content for any purpose. All Content provided "as is" without warranty of any kind. Mondaq and/or its Contributors and other suppliers hereby exclude and disclaim all representations, warranties or guarantees with regard to the Content, including all implied warranties and conditions of merchantability, fitness for a particular purpose, title and non-infringement. To the maximum extent permitted by law, Mondaq expressly excludes all representations, warranties, obligations, and liabilities arising out of or in connection with all Content. In no event shall Mondaq and/or its respective suppliers be liable for any special, indirect or consequential damages or any damages whatsoever resulting from loss of use, data or profits, whether in an action of contract, negligence or other tortious action, arising out of or in connection with the use of the Content or performance of Mondaq’s Services.


Mondaq may alter or amend these Terms by amending them on the Website. By continuing to Use the Services and/or the Website after such amendment, you will be deemed to have accepted any amendment to these Terms.

These Terms shall be governed by and construed in accordance with the laws of England and Wales and you irrevocably submit to the exclusive jurisdiction of the courts of England and Wales to settle any dispute which may arise out of or in connection with these Terms. If you live outside the United Kingdom, English law shall apply only to the extent that English law shall not deprive you of any legal protection accorded in accordance with the law of the place where you are habitually resident ("Local Law"). In the event English law deprives you of any legal protection which is accorded to you under Local Law, then these terms shall be governed by Local Law and any dispute or claim arising out of or in connection with these Terms shall be subject to the non-exclusive jurisdiction of the courts where you are habitually resident.

You may print and keep a copy of these Terms, which form the entire agreement between you and Mondaq and supersede any other communications or advertising in respect of the Service and/or the Website.

No delay in exercising or non-exercise by you and/or Mondaq of any of its rights under or in connection with these Terms shall operate as a waiver or release of each of your or Mondaq’s right. Rather, any such waiver or release must be specifically granted in writing signed by the party granting it.

If any part of these Terms is held unenforceable, that part shall be enforced to the maximum extent permissible so as to give effect to the intent of the parties, and the Terms shall continue in full force and effect.

Mondaq shall not incur any liability to you on account of any loss or damage resulting from any delay or failure to perform all or any part of these Terms if such delay or failure is caused, in whole or in part, by events, occurrences, or causes beyond the control of Mondaq. Such events, occurrences or causes will include, without limitation, acts of God, strikes, lockouts, server and network failure, riots, acts of war, earthquakes, fire and explosions.

By clicking Register you state you have read and agree to our Terms and Conditions