Affordable Care Act Reporting - Greatland & Accounting Today Webinar

Affordable Care Act Reporting
Filing Forms 1095-B and 1095-C

Serving small businesses and accountants for 40+ Years aca.greatland.com 800.968.1099

Affordable Care Act Mandates
Individual
• Each individual must have minimum essential healthcare coverage or qualify for an exemption or pay a
penalty (Individual Shared Responsibility Payment)
Employer
• Employers with at least 50 FT employees (including FT equivalents) must offer affordable minimum
essential coverage (MEC). If at least one of its FT employees receives a premium tax credit, the employer
may be subject to a penalty (Employer Shared Responsibility Payment)

Affordable Care Act Definitions
• Full-Time Employee
• Averaged at least 30 hours per week for a calendar month or
• 130 service hours in a calendar month
• Full-Time Equivalent (FTE) Employee
• A combination of employees, each of whom is not treated as a full-time
employee, but in combination are counted as the equivalent of a full-time employee.
• Applicable Large Employer (ALE)
• An employer that employed an average of at least 50 FTEs during the preceding calendar year (2014)
• ACA reporting is a moving target!

Who Needs to File?
1. Applicable Large Employer (ALE)
• Employers with at least 50 FTEs
2. Self-Insured Employers
• Regardless of the number of FTEs
3. Healthcare Insurers
Internal Revenue Code (IRC) Sections 6055 and 6056
outline the requirements for 1095-B and 1095-C reporting.
Do you have more than 50
full-time employees (FTEs)?

Polling Question
• How many clients do you have with at least 50 FTEs?
A. Less than 25
B. Between 25-50
C. More than 50
D. I don’t know

ACA Filing Requirements
• The Big Two:
1. Send copies to recipients/employees
2. File to IRS
• 250 E-file threshold
• The Forms:
A. 1095-A (Exchange)
B. 1095-B & 1094-B
C. 1095-C & 1094-C

1095-B Key Points
• Information return filed by Healthcare Insurers and/or Self-Insuring Employers with less than 50 FTEs
• 1094-B – Transmittal to IRS
• Line 8 – Origin of Policy:
• A – Small Business Health Options Program (SHOP)
• B – Employer-sponsored coverage
• C – Government-sponsored program
• D – Individual market insurance
• E – Multiemployer plan
• F – Other designated MEC
• Line 9 – SHOP identifier should be left blank for 2015
• If a self-insured employer is filing Form 1095-B, Part II should be left blank and Part III should include the self-insured employer’s
information
• “Self-Insured = Provider”

1095-C Key Points
• Information return filed by Applicable Large Employers
• 1094-C – Transmittal to IRS
• For each FT employee of an employer, there must be only one 1095-C filed
• Part II vs. Part III
• Part II is about the offer of coverage
• Part III is about the coverage that was supplied
• Part II
• “Plan Start Month” is optional for 2015
• “All 12 Months” vs. Individual Monthly boxes
• Use one or the other, not both for the same line
• It is acceptable to use “All 12 Months” on one line and month-by-month on another
• Part III
• Only completed if the employer is self-insured
• If entering data in Part III, employee entered on Line 1 must be included

Lines 14-16 Codes (1095-C)
• A whole webinar in itself
• Decoding the codes!
• Line 14
• 1A – Qualifying Offer: MEC providing MV offered to FT employee with employee contribution for self-only coverage equal to or less
than 9.5% mainland single federal poverty line and at least MEC offered to spouse & dependents
• 1B – MEC providing MV offered to employee only
• 1C – MEC providing MV offered to employee and at least MEC to dependents (not spouse)
• 1D – MEC providing MV offered to employee and at least MEC to spouse (not dependents)
• 1E – MEC providing MV offered to employee and at least MEC to spouse and dependents
• 1F – MEC NOT providing MV
• 1G – Coverage offered to a non full-time employee who enrolled in self-insured coverage for one or more months
• 1H – No offer of coverage
• 1I – Qualifying Offer Transition Relief 2015

Lines 14-16 Codes (1095-C)
• Line 15
• Enter amount of the employee share of the lowest-cost monthly premium for self-only MEC providing MV that is offered to employee; include cents
• Line 16
• 2A – Employee is not employed on any day during the month
• 2B – Employee is not a FT employee
• 2C – Employee enrolled in coverage offered
• 2D – Employee is in a limited non-assessment period
• 2E – Multiemployer interim rule relief
• 2F – Section 4980H affordability Form W-2 safe harbor
• 2G – Section 4980H affordability federal poverty line safe harbor
• 2H – Section 4980H affordability rate of pay safe harbor
• 2I – Non-calendar year transition relief applies to this employee

Covered Individuals
• Enter names of those individuals enrolled in coverage
• Check monthly box if individual was covered at least one day during the month

Polling Question
• How many self-insured clients do you represent?
A. Less than 25
B. Between 25-50
C. More than 50
D. I don’t know

Filing Deadlines
Due Date Requirements
February 1, 2016 Form 1095 copies to Recipients/Employees
February 29, 2016 Paper copies of Form 1095/1094 to IRS
March 31, 2016 E-file Form 1095/1094 to IRS
*Due dates represent 2015 calendar year reporting

Penalties
In 2016 (for reporting on calendar year 2015) employers and insurers are expected to be compliant with ACA reporting requirements.
• Penalties apply for:
• Failure to file
• Failure to furnish recipient statements
• Failure to file timely
• Failure to file electronically when required to do so
• Section 4980H(a) & (b) penalties for employers with 100+ FTEs in 2014
• Incorrect filings will not be penalized for calendar year 2015 filing (reported in 2016) if employers/insurers make a good faith effort to
comply

Penalties
Beginning January 1, 2016, Internal Revenue Code (IRC) section 6721 imposes a:
• $50 per information return if you correctly file within 30 days of the due date.
• $100 per information return if you correctly file more than 30 days after the due date but by August 1.
• $250 per information return if you file after August 1 or you do not file required information returns.
Maximum penalties to employer/healthcare insurer for failure to file correct information returns:
• $3 million/year ($1 million for small businesses)
• $500 per return for intentional disregard with no maximum penalty

Filing Options

About Greatland
• Over 40 Years in Business
• 135 Employees + additional seasonal staff
• Specialize in W2/1099/1095 – Wage, Income and Information Reporting
• Federal
• State
• Recipient Print and Mail
• Team of full-time compliance experts
• Support: Phone|Chat|Email + Extended Hours
• Security – SSAE 16 SOC II
We work hard to develop secure, compliance-driven products on the
frontend and excellent, industry-leading support on the backend.

About Yearli - Simple five-step process
1. Create Account Online or Purchase & Install Software
2. Import or Enter Data
3. Complete Transmittal (If Applicable)
4. Edit and/or Review Data
5. Submit – E-File to IRS and Mail copies to recipients/employees

Electronic Filing Comparison
• Software vs. Online Filing
• Chat, Email, Phone Support + Extended Hours
• Print and Mail Service
• Filing Fees - Calculator
• Data Entry or Import
• À la carte options
• Many Printing Options
• Additional Form Types
• Full 94X Library
• 80 State Forms
December-January will be busy!

Special Offer
$100 Off Yearli Desktop Subscription + 10% Off Filing Fees
OR
Free Trial of Yearli Performance 2014
OR
10% Off Filing Fees with Yearli Performance 15 Subscription
Offers Expire 10/30/15
Contact Greatland at 800.968.1099 and Reference Promo Code Z93

Polling Question
• Have you determined your ACA filing process for this year?
A. Yes, I have a solution.
B. No, I do not have a solution yet
C. I do not need an ACA reporting solution for 2015 reporting

Questions?

Affordable Care Act Reporting - Greatland & Accounting Today Webinar

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