Employers with ACA reporting obligations have only 3 months left—the first deadlines hit on February 1, 2016. One reporting obligation belongs to large employers. Another belongs to employers that sponsor self-funded plans that constitute minimum essential coverage.
Large Employer Reporting
A large employer must send an individual report (Form 1095-C) to each employee who was full-time for at least one month in 2015. The deadline for this year is February 1, 2016. The employer must also file the individual reports, together with a transmittal report (Form 1094-C), with the IRS. The deadline for paper filings is February 29, 2016, and the deadline for electronic filings is March 31, 2016. Employers who issue 250 or more individual reports must file electronically.
A large employer has this obligation no matter whether it offered health coverage or not, and no matter whether the coverage was fully-insured or self-funded.
Minimum Essential Coverage Reporting
Any entity that provided minimum essential coverage to any individual in 2015—including an employer of any size that provided self-funded health coverage to its employees—must send an individual report (Form 1095-B) to each person who was covered for at least one month in 2015. The deadline for this year is February 1, 2016. The entity must also file the individual reports, together with a transmittal report (Form 1094-B), with the IRS. The deadline for paper filings is February 29, 2016, and the deadline for electronic filings is March 31, 2016. Entities that issue 250 or more individual reports must file electronically.
The Intersection of These Two
If a large employer provided self-funded health coverage to its employees, it will have both reporting obligations. In these instances, the employer is not required to send out two sets of forms. Instead, the employer will generally be permitted to include all of the coverage information on the large-employer reporting forms.
The View from Venable
The forms are complicated and employers have a lot of questions about them! The questions tend to fall into three broad categories:
- Which entity has the reporting obligation and for which
This question tends to come from employers that are part of a group of related entities (such as a controlled group of corporations), are contributors to multiemployer health plans (union or Taft-Hartley plans), are participants in a multiple employer welfare arrangement (MEWA), or were involved in an asset or stock sale or purchase during the year.
- What's the right code for...?
Much like the W-2, the 1095-C has various lines that are to be completed using codes. The codes indicate whether an individual, in a given month, was employed, was full-time, was enrolled, was in a particular "affordability safe harbor," or was in a "limited non-assessment period."
- How do I know which of my employees are full-time?
Most employers have a pretty good idea of roughly how many full-time employees they have. However, the reporting obligations require the data to be analyzed using a much more detailed understanding of the rules and regulations.
Employers need help. They need answers to these questions that are not overviews and generalizations. They need answers based on their specific workforce and their specific benefit offerings. Most employers have purchased software or engaged a service provider to help with ACA reporting obligations. Some of these products/services both analyze the employer's data and generate the required forms. Other products/services only generate the forms, which leaves the employer in need of a separate solution for the data analysis.
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.