This document provides an overview of Affordable Care Act (ACA) reporting requirements under sections 6055 and 6056, which can be met using the DATIS HR and payroll software. Section 6055 requires insurers and self-insured employers to file Forms 1094-B and 1095-B for minimum essential coverage. Section 6056 requires applicable large employers to file Forms 1094-C and 1095-C for full-time employees. DATIS will generate these forms electronically and file them with the IRS as part of its standard unified software, without additional fees.
Complete ACA Reporting Services at No Additional Cost
1. COMPLETE
ACA REPORTING
An overview of 6055 and 6056 reporting
and how DATIS will help your organization
ensure compliance without any additional
fees or modules.
3. Information is general. No legal advice is provided or intended.
6055 REPORTING
§ 6055 Reporting is required to be completed by the provider of insurance –
includes Forms 1094 B and 1095 B
§ Fully insured groups – insurance carrier will complete this reporting
§ Self insured groups – required to complete this reporting with exceptions
§ Combined Reporting for self-insured employers except those who cover non-employees,
multiemployer plans, and small employers with self-insured plans
4. 6056 REPORTING
§ Both fully insured and self funded applicable large employers must complete:
§ 1094-C: Transmittal cover/summary
§ 1095-C: “W-2” Equivalent for Healthcare
§ Required for any employee who was full-time in any month of the calendar year.
§ To be submitted to both the employee and IRS.
§ A full-time employee who works for more than one employer that is a member of
the same aggregated ALE group (works for 2 separate ALE members) must receive
a separate Form 1095-C from each employer.
Information is general. No legal advice is provided or intended.
5. FILING RULES
Information is general. No legal advice is provided or intended.
§ Filing Deadlines:
§ Forms 1094-C and 1095-C
§ Paper Returns: Due to IRS by February 28th of following year.
§ Electronic Returns: Due to IRS by March 31st of following year.
§ Form 1095-C
§ Must be furnished to the employee by January 31 of following year.
§ For the 2015 filing year, the 1095-C forms are due to employees by
February 1, 2016.
6. NO ADDITIONAL COSTS OR MODULES
§ With DATIS, you will not need to purchase any additional features, services, or
modules to complete your 6056 reporting or other ACA requirements
§ DATIS will automatically provide all of the monitoring and reporting tools necessary
to maintain compliance with ACA as part of their fully unified HR and Payroll
Software.
§ The 6056 ACA Reporting will be handled electronically within DATIS’ e3 system,
allowing for a streamlined process and ensured compliance
§ DATIS will generate the pre-filled 1094-C and 1095-C forms and employers will be
able to preview the documents electronically, ensuring all information is correct
§ Electronic submission is processed as soon as employers click the “Approve”
button.
Information is general. No legal advice is provided or intended.
7. ELECTRONIC FORM DISTRIBUTION
§ After the forms are approved by the employer, each employee will have access to
view their 1095-C form from their own Mye3 self-service portal
§ The employees will be able to review and accept the electronic version of the 1095-
C form, instead of a paper version, using our cloud-based solution
§ Upon electronic review and approval, DATIS will file both the 1094-C and 1095-C
forms with the IRS
Information is general. No legal advice is provided or intended.
9. 1094–C : IRS TRANSMITTAL
§ Part I: General employer information and contact information
§ Part II: Total number of 1095–C forms that will be filed
§ Part III
§ Offer minimum essential coverage?
§ Full- time employee count per months (not employees in waiting period)
§ Total number of employee count (FT, PT, waiting period)
§ Transition Relief
Information is general. No legal advice is provided or intended.
12. 1095–C : IRS & EACH EMPLOYEE
§ Part I: General employee information
§ Part II: Employee Offer and Coverage
§ Line 14: Type of coverage offered codes
§ Line 15: Employee only monthly share of lowest costing plan
§ Line 16: Applicable safe harbor codes
Information is general. No legal advice is provided or intended.
13. 1095–C : IRS & EACH EMPLOYEE
§ Line 14 Codes
§ 1A: Qualifying Offer – minimum essential coverage to employee and spouse and
dependents that is equal to or less than 9.5% mainland federal poverty line
§ 1E: Minimum essential coverage providing minimum value to employee and at least
minimum essential coverage to dependents and spouse
§ Line 16 Codes
§ Code 2C: Employee enrolled in coverage: outweighs all other options
§ Code 2A: Not an employee during the month
§ Code 2B: Not a full-time employee
§ Code 2D: Waiting period
§ Code 2F: Affordability W-2 Safe Harbor
§ Code 2G: Federal Poverty Line Safe Harbor
§ Code 2H: Affordability Rate of Pay Safe Harbor
Information is general. No legal advice is provided or intended.
14. 1095–C : IRS & EACH EMPLOYEE
§ Part III: Self insured employers ONLY
§ Covered employee & dependents, SSN, DOB, months they were covered
Information is general. No legal advice is provided or intended.
16. HAVE QUESTIONS?
WE HAVE ANSWERS.
Contact us today to discuss your ACA reporting needs
and learn how DATIS’ fully unified solution can enable
your organization to ensure compliance easily and
seamlessly, without any additional fees or modules.
(877) 386-1355 | info@datis.com |www.datis.com