January 28, 2016
By Salvatore J. Armao, CPA/PFS, CFP, CFE, CGMA
With the New Year also come some more compliance requirements from the Affordable Care Act (ACA).
With the New Year also come some more compliance requirements from the Affordable Care Act (ACA). New filing requirements and new reporting forms will be required to be filed with IRS by certain employers, insurance companies and certain benefit funds including Taft-Hartley multiemployer health and welfare benefit funds.
The new forms are 1095-A, 1095-B and 1095-C. The 1095-A will be issued by the Health Insurance Marketplace to those insured through the Health Insurance Exchange.
The Form 1095-B must be issued by insurance companies to report individuals covered by insured group health plans and by plan sponsors of self-insured health and welfare benefit plans that provide medical insurance coverage.
The Form 1095-C must be issued by “Applicable Large Employers”,(ALE), which are those that had at least 50 full time employees, on average, in the preceding calendar year. Note that even if an ALE does not provide any insurance coverage for its employees, it is still required to file Form 1095-C for each employee.
The 1095-A will be issued by the Health Insurance Marketplace to those insured through the Health Insurance Exchange. Additionally, where an ALE has an insured health plan, its insurance company will file a 1095-B for each insured employee but the ALE will still need to file a 1095-C for each employee. The same rule applies to any provider of self-insured health coverage. The employees will receive both a 1095-B and a 1095-C.
Example: International Brotherhood of Brothers self-insured health plan is required to file Form 1095-B with IRS and distribute copies to each employee. The collectively bargained employers with 50 or more employees will also have to file Form 1095-C with IRS and distribute copies to each of their employees. Consequently, some insured individuals will receive both a 1095-B and a 1095-C.
All of the forms 1095-B and 1095-C that are filed with IRS will require a transmittal form 1094-B and 1094-C to go along with the 1095 forms.
The filing deadlines have been postponed, due to an outcry from the health care industry. Forms 1095-B and 1095-C must be provided to employees and plan participants no later than March 31, 2016. Forms 1094-B and 1094-C must be filed with IRS no later than May 31, 2016 if they are being paper filed. If filed electronically, (250 or more forms), by June 30, 2016 but no Form 1094 is required.
The rules that are applicable will be different for each case. They can be complicated so you should consult with your professional advisors regarding what you need to do.