Trey Tompkins, President of Admin America, Inc., an independent third party administrator, gave a presentation on the new employer reporting requirements under the Patient Protection and Affordable Care Act (PPACA). He discussed who must file reports, what forms and information must be reported, and when the deadlines are. Employers with 50 or more full-time employees generally must file Forms 1094-C and 1095-C annually to report health coverage offerings. Insurance carriers file Forms 1094-B and 1095-B for fully insured plans. Reports are due to the IRS by late February or March and to employees by late January. Penalties apply for noncompliance.
Health Care Reform Reporting: What you need to know to be ready for January 1...Tanya Gonzalez
When the calendar flips over to 2015, health reform’s new data gathering requirements for IRS Code Sections 6055 and 6056 reporting go into effect. Under these new reporting rules, employers with over 50 or over 100 full-time employees must provide information to the IRS about their group size and the health plan coverage they offer (or do not offer) to their employees.
Staying Up to Date on Required Health Care Reportingbenefitexpress
This presentation reviews:
• When temporary employees become your employees
• The factors the government uses to determine employment status
• The steps you can take to avoid these employees becoming your employees
• Consequences under Health Care Reform if it is determined that they are your employees
This webinar covers: information that has to be collected | specific codes to use | pitfalls in completing the forms | changes to the final forms and instructions.
FAQs about the Affordable Care Act’s (ACA) Employer Shared Responsibility Rep...CBIZ, Inc.
The Affordable Care Act (ACA) is a monumental change to our healthcare system, and with new reporting requirements comes new questions. This fact sheet provides answers to the most frequently asked questions to help you better understand the ins and outs of the ACA.
Overwhelmed by ever-changing Affordable Care Act regulations? You aren’t alone. The new wave of requirements are here, and that means new employer shared responsibility reporting rules for your business in 2015...or big fines if you don’t comply.
Check out our ACA presentation with health care reform and employee benefits experts from Arthur J. Gallagher & Co. and PeopleMatter to:
- Find out what the mandatory Section 6055/6056 reporting is, who it applies to in 2015 and why it’s so important
- Learn how to report minimum essential coverage, offers of coverage, full-time employee status and other essential elements of these forms to ensure compliance
- Get actionable tips on how to collect employee information, stay ahead of deadlines, save time and ease administrative burdens
- See hiring/scheduling tools designed to help you plan strategically and avoid reporting fines that can reach $1.5M
Affordable Care Act: Overview of New Requirements for 2015Sikich LLP
2015 is the first year employers can be fined for not complying with the reporting requirements set out by the Affordable Care Act (Obamacare). Get an overview of these new requirements in this eBook
For more information visit https://www.brightpay.co.uk
This is a pivotal moment in time for automatic enrolment as a number of new changes are happening that payroll bureaus need to understand. This year we will see the first increase to the legal total minimum contributions which comes into effect on the 6th of April 2018. The total minimum contributions will increase from 2% to 5%. Both employers and employees will be required to increase their contributions towards the pension pot.
The evolving automatic enrolment landscape
We will see the last employers reaching their auto enrolment staging date. What does this mean for new employers who start to employ staff? Will auto enrolment apply? Automatic re-enrolment is also in full swing where we have seen the larger employers re-enrol employees and complete their re-declaration of compliance.
BrightPay has created this webinar to give you an insight into how these changes will affect your clients and your payroll processing.
Agenda
Auto Enrolment & New Employers
Increasing Minimum Contributions
Integration between payroll & pension providers
Re-Enrolment & Re-Declaration of Compliance
How BrightPay Automates Auto Enrolment
Introduction to BrightPay Connect
Health Care Reform Reporting: What you need to know to be ready for January 1...Tanya Gonzalez
When the calendar flips over to 2015, health reform’s new data gathering requirements for IRS Code Sections 6055 and 6056 reporting go into effect. Under these new reporting rules, employers with over 50 or over 100 full-time employees must provide information to the IRS about their group size and the health plan coverage they offer (or do not offer) to their employees.
Staying Up to Date on Required Health Care Reportingbenefitexpress
This presentation reviews:
• When temporary employees become your employees
• The factors the government uses to determine employment status
• The steps you can take to avoid these employees becoming your employees
• Consequences under Health Care Reform if it is determined that they are your employees
This webinar covers: information that has to be collected | specific codes to use | pitfalls in completing the forms | changes to the final forms and instructions.
FAQs about the Affordable Care Act’s (ACA) Employer Shared Responsibility Rep...CBIZ, Inc.
The Affordable Care Act (ACA) is a monumental change to our healthcare system, and with new reporting requirements comes new questions. This fact sheet provides answers to the most frequently asked questions to help you better understand the ins and outs of the ACA.
Overwhelmed by ever-changing Affordable Care Act regulations? You aren’t alone. The new wave of requirements are here, and that means new employer shared responsibility reporting rules for your business in 2015...or big fines if you don’t comply.
Check out our ACA presentation with health care reform and employee benefits experts from Arthur J. Gallagher & Co. and PeopleMatter to:
- Find out what the mandatory Section 6055/6056 reporting is, who it applies to in 2015 and why it’s so important
- Learn how to report minimum essential coverage, offers of coverage, full-time employee status and other essential elements of these forms to ensure compliance
- Get actionable tips on how to collect employee information, stay ahead of deadlines, save time and ease administrative burdens
- See hiring/scheduling tools designed to help you plan strategically and avoid reporting fines that can reach $1.5M
Affordable Care Act: Overview of New Requirements for 2015Sikich LLP
2015 is the first year employers can be fined for not complying with the reporting requirements set out by the Affordable Care Act (Obamacare). Get an overview of these new requirements in this eBook
For more information visit https://www.brightpay.co.uk
This is a pivotal moment in time for automatic enrolment as a number of new changes are happening that payroll bureaus need to understand. This year we will see the first increase to the legal total minimum contributions which comes into effect on the 6th of April 2018. The total minimum contributions will increase from 2% to 5%. Both employers and employees will be required to increase their contributions towards the pension pot.
The evolving automatic enrolment landscape
We will see the last employers reaching their auto enrolment staging date. What does this mean for new employers who start to employ staff? Will auto enrolment apply? Automatic re-enrolment is also in full swing where we have seen the larger employers re-enrol employees and complete their re-declaration of compliance.
BrightPay has created this webinar to give you an insight into how these changes will affect your clients and your payroll processing.
Agenda
Auto Enrolment & New Employers
Increasing Minimum Contributions
Integration between payroll & pension providers
Re-Enrolment & Re-Declaration of Compliance
How BrightPay Automates Auto Enrolment
Introduction to BrightPay Connect
Health Reform Bulletin Oct, 2015 - Amendments to the small employer definitio...CBIZ, Inc.
The latest Health Reform Bulletin is here! This bulletin is chock full of information from a new law that amends the definition of small employer, finalized ACA reporting forms 1094 and 105 and adjusted PCORI fees and much more. Check out some more in-depth information above.
Health Reform Bulletin 141 | 2018 Forms and Instructions for 1094/1095 Series...CBIZ, Inc.
• 2018 Forms and Instructions for 1094/1095 Series ACA Reporting Forms
o Health Insurance Coverage Reporting by Insurers and Sponsors of Self-funded Plans (IRC Section 6055)
Instructions for 2018 Forms 1094-B and 1095-B
Form 1094-B, Transmittal of Health Coverage Information Returns
Form 1095-B, Health Coverage
o Employer Health Insurance Reporting Requirement (IRC Section 6056)
Instructions for 2018 Forms 1094-C and 1095-C
Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns
Form 1095-C, Employer-Provided Health Insurance Offer and Coverage
• Adjusted Patient Centered Outcome Research (PCORI) fee
Payroll Processing is an important but hectic task for every company. With professional guidance and skills let Ezybiz India Consulting LLP outsource and handle your company’s Payroll Processing.
Also Read: https://ezybizindia.in/payroll-processing-in-india/
Given the ongoing debate about the future of the Affordable Care Act (ACA), many employers are asking themselves, “Is the ACA going away?”… “Is 2017 reporting required?” … “Will the IRS take action if I don’t file?”
Employers who are focused only on the messages coming from Congress and the White House may expect minimal enforcement of the ACA’s employer reporting mandate (which requires covered employers to supply ACA forms to all employees for tax-filing purposes). Meanwhile, over the past few weeks, the IRS has issued statements and taken actions that paint a different picture and provide a clear roadmap for what employers need to do.
If you've been in business long, you know paperwork stacks up fast. Payroll records alone can fill your file cabinets. But do you dare throw anything out and risk running afoul of the law? Do you really need payroll records that go all the way back to the 1990s? Here are some guidelines from two government agencies to set your mind at ease and free up some space.
In this Forbes Bankable webinar, tax attorney and Forbes senior editor Kelly Erb offers the tips and tools that you need to make tax season a lot less painful.
Auto Enrolment: Systems & Schemes
• Your pension arrangements
• Your payroll & IT systems
• The questions you might need to ask to ensure these systems work together
• Who will be involved and what will be their role
Health Reform Bulletin Oct, 2015 - Amendments to the small employer definitio...CBIZ, Inc.
The latest Health Reform Bulletin is here! This bulletin is chock full of information from a new law that amends the definition of small employer, finalized ACA reporting forms 1094 and 105 and adjusted PCORI fees and much more. Check out some more in-depth information above.
Health Reform Bulletin 141 | 2018 Forms and Instructions for 1094/1095 Series...CBIZ, Inc.
• 2018 Forms and Instructions for 1094/1095 Series ACA Reporting Forms
o Health Insurance Coverage Reporting by Insurers and Sponsors of Self-funded Plans (IRC Section 6055)
Instructions for 2018 Forms 1094-B and 1095-B
Form 1094-B, Transmittal of Health Coverage Information Returns
Form 1095-B, Health Coverage
o Employer Health Insurance Reporting Requirement (IRC Section 6056)
Instructions for 2018 Forms 1094-C and 1095-C
Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns
Form 1095-C, Employer-Provided Health Insurance Offer and Coverage
• Adjusted Patient Centered Outcome Research (PCORI) fee
Payroll Processing is an important but hectic task for every company. With professional guidance and skills let Ezybiz India Consulting LLP outsource and handle your company’s Payroll Processing.
Also Read: https://ezybizindia.in/payroll-processing-in-india/
Given the ongoing debate about the future of the Affordable Care Act (ACA), many employers are asking themselves, “Is the ACA going away?”… “Is 2017 reporting required?” … “Will the IRS take action if I don’t file?”
Employers who are focused only on the messages coming from Congress and the White House may expect minimal enforcement of the ACA’s employer reporting mandate (which requires covered employers to supply ACA forms to all employees for tax-filing purposes). Meanwhile, over the past few weeks, the IRS has issued statements and taken actions that paint a different picture and provide a clear roadmap for what employers need to do.
If you've been in business long, you know paperwork stacks up fast. Payroll records alone can fill your file cabinets. But do you dare throw anything out and risk running afoul of the law? Do you really need payroll records that go all the way back to the 1990s? Here are some guidelines from two government agencies to set your mind at ease and free up some space.
In this Forbes Bankable webinar, tax attorney and Forbes senior editor Kelly Erb offers the tips and tools that you need to make tax season a lot less painful.
Auto Enrolment: Systems & Schemes
• Your pension arrangements
• Your payroll & IT systems
• The questions you might need to ask to ensure these systems work together
• Who will be involved and what will be their role
SterlingRisk - Tackling ACA Reporting Feb 2014ntoscano50
February 11, 2015
SterlingRisk and Proskauer Present: ACA Reporting Requirements (Code Sections 6055/6056)
Hosted by SterlingRisk and Presented by Stacy Barrow, Esq. from Proskauer
Stacy Barrow, Esq. from Proskauer reviewed the complex reporting requirements on employers that will be used to determine whether the employer is liable for an employer shared responsibility payment and the required reporting forms. This webinar was geared towards employers with 50 or more full-time equivalent employees or those with self-insured group health plans. The ACA imposes complex reporting requirements on employers that will be used to determine whether the employer is liable for an employer shared responsibility payment (a penalty for failure to offer qualifying coverage to full-time employees).
Piece of Cake: Perfecting the Recipe for ACA Compliancebenefitexpress
Repeal and replace efforts have come and gone - it's time to prepare to comply with the Affordable Care Act for another year.
With chatter and speculation surrounding the ACA, it's easy to lose track of what's required of employers. Our one-hour refresher course covers:
- How to fill out form 1095-C
- Important filing dates
- Common compliance errors
- Penalties for noncompliance
Make this year’s ACA reporting a piece of cake.
Affordable Care Act Reporting - Greatland & Accounting Today WebinarGreatland
By now most businesses and insurance companies are familiar with the Patient Protection and Affordable Care Act (PPACA), sometimes referred to as ACA or ObamaCare. In 2016 (for reporting on calendar year 2015) employers and insurers are expected to be compliant with ACA reporting requirements.
Understanding all of the rules associated with the Affordable Care Act can be confusing. Janice Krueger, from Greatland helps explain everything you need to know about ACA reporting and filing Form 1095-B or Form 1095-C, and applicable 1094 forms for the 2015 reporting year
ADP Totalsource - Affordable Care Act Reporting and ComplianceTom Rehnberg
The Affordable Care Act represents a huge administrative burden this coming year and businesses are looking for a solution. The ADP Totalsource platform has the ability to relieve this new compliance burden to keep companies from risk of audits and penalties.
IRS Issues Draft Forms and Instructions for 2016 ReportingCBIZ, Inc.
On August 6, 2015, the Internal Revenue Service (IRS) issued draft 2015 Forms and Instructions for the annual reporting that will be required in 2016 by employers subject to the Affordable Care Act’s shared responsibility requirements, as well as by plans providing minimum essential coverage (MEC).
Navigate New Legislation: The Road Into 2017benefitexpress
As new regulations kick in for 2017 and ACA reporting season is coming to a close, review all recent legislative changes. This webinar focuses on what you need to know for your 2017 benefits strategy.
Learn about new legislation from DOL, HHS, IRS, and EEOC. ERISA attorney Larry Grudzien will cover all relevant rulings since his previous webinar and host an interactive Q&A with the audience.
The Affordable Care Act (“ACA”) is currently effective for employers who had 100 or more full time equivalent employees (FTEs) in 2014. Employers who have 50 or more FTEs in 2015 will be subject to the ACA on January 1, 2016
Health Reform Bulletin: Finalized ACA Reporting Forms & Employer Appeals to M...CBIZ, Inc.
This bulletin details the release of a number of forms and compliance tools to assist employers subject to the Affordable Care Act’s (ACA) Shared Responsibility Requirements to comply with the law. Of particular note, the finalized version of the forms used to satisfy the IRC Section 6056 and 6055 reporting requirements, together with the related instructions, have been issued. While the forms released last week were for the 2014 calendar year reporting (the voluntary reporting year for all employers), it is presumed the mandatory forms to be released for 2015 reporting later this year will be quite similar to those just issued.
2015 Draft Instructions for 6055 and 6056 Reporting Include Filing Extensionsntoscano50
The Affordable Care Act (ACA) created new reporting requirements under Internal Revenue Code (Code) Sections 6055 and 6056. Under these new reporting rules, certain employers must provide information to the IRS about the health plan coverage they offer (or do not offer) or provide to their employees. Reporting is first required in 2016, related to coverage offered or provided in 2015.
SterlingRisk & ECI Present: Compliance With the ACA 6055 & 6056 Reportingntoscano50
June 25, 2015
Hosted by SterlingRisk and Presented by Jennifer Reed from ECI
During the presentation, Jennifer Reed from ECI will cover the logistics of these requirements. This presentation is unique, because Jennifer has a core benefits and HR Technology consulting background, and as a result she will be focusing on the logistics of the ACA reporting.
Some of you may have seen a webinar or seminar that covers the law, but not many have had the chance to hear someone speak about the details regarding how the reporting will actually happen. Jennifer also has experience presenting nationally on this topic.
How to Successfully Navigate the Latest Changes to the Affordable Care ActNationalUnderwriter
From ALM's National Underwriter comes a timely and necessary ACA presentation covering:
Employer Mandate Penalties
• Reporting Requirements
• Small Business Health Options (SHOP) Changes
• Cadillac Tax Delay
• Delay of Menu Labeling Rule
• Other Affordable Care Act Changes
• Changes to IRS Forms
• Statistics
In follow-up to the March 10, 2015 announcement of the Next Generation Accountable Care Organization (ACO) Model of payment and care delivery, the Center for Medicare and Medicaid Innovation (CMS Innovation Center) hosted the fifth in a series of open door forums on Tuesday, April 14, 2015. This open door forum focused on letter of intent (LOI) and application.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
During this webinar the Direct Contracting Model Options team hosted a webinar on Tuesday, January 7, 2020 from 1:00 p.m.- 2:30 p.m. EST. During this webinar, presenters provided an overview and demonstration of the Direct Contracting application portal and answered questions about the portal from the audience.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Similar to PPACA Employer Reporting Requirements CE Presentation - Client Presentation (20)
Webinar: Direct Contracting Model Options - Application
PPACA Employer Reporting Requirements CE Presentation - Client Presentation
1. An Overview of the New PPACA
Employer Reporting Requirements
By Trey Tompkins, JD, MBA
President, Admin America, Inc.
July 8, 2015
2. About Your Presenter: Trey Tompkins
• President of Admin America, Inc.
• Independent TPA based in Alpharetta, Georgia
• Specializing in FSA, HRA, HSA and COBRA Administration
• Also consults on PPACA, ERISA and HIPAA compliance
• Over 18 Years Employee Benefits Consulting Experience
• Member of NAHU’s Region V Leadership Team
• Former President of NAHU’s Atlanta and Georgia Chapters
• Former Member of NAHU’s National Legislative Council
• Member of the State Bar of Georgia
• Graduate of Vanderbilt University, the University of Georgia School of
Law and Georgia State University College of Business
• President of the Rotary Club of Milton-Windward
3. Employer Reporting Core Concepts
• Who
• Employers subject to the ACA’s Employer Mandate
• Employers who sponsor self-funded group health plans
• What
• Annual filings with the IRS
• Annual distribution of required forms to employees
• When
• Beginning in 2016 (for 2015)
• Why
• Enforcement of the ACA’s Individual and Employer Mandates
• How
• To employees on paper via mail or electronically with advance consent
• To IRS on paper or electronically
• Hot off the presses:
• Increased non-compliance penalties included within the Trade Preferences
Extension Act of 2015 – Signed by President Obama on June 29, 2015
• New IRS guidance on Electronic Filing Requirements issued June 26, 2015
4. Employer Reporting: Who
• Employer’s Subject to the ACA’s Employer Mandate
• Generally Employers with 50 or more Full-Time Equivalent (FTE)
Employees during the prior year (2014) for six or more months
• Special rules apply to new employers
• Control group rules apply so employers must know who their owners
are and what other employers their owners own
• Transitional relief from the Employer Mandate in 2015 for employers
with 50-99 FTE employees is irrelevant
• Employer’s Who Sponsor Self-Funded Group Health Plans
• Partially self-funded plans count as self-funded for this purpose
• Only major medical coverage triggers the requirement
5. Employer Reporting: What -
The Forms
• Form 1094-B Transmittal of Health Coverage Information Returns
• Form 1095-B Health Coverage
• Form 1094-C Transmittal of Employer-Provided Health Insurance Offer
and Coverage Information Returns
• Form 1095-C Employer-Provided Health Insurance Offer and Coverage
• Information included in the returns includes:
• Identification of employees (and dependents) who were eligible for
employer sponsored coverage
• Months of the year when eligible individuals were enrolled in
coverage
6. Employer Reporting: How
• Deliver to Covered Individuals / Employees
• By January 31 (or the first business day if on a non-business day)
• On Paper via mail or electronically with consent
• Consent must be affirmative and in advance
• Consent must be made or confirmed electronically
• File with the IRS
• By February 28 if on paper and by March 31 if electronically
• Or on the first business day if on a non-business day
• Must file electronically if more than 250 information returns
• Electronic filing performed through IRS’s federal E-file system
7. Employer Reporting Requirements for
Various Employer and Coverage Types
Plan Type / Employer Size Non-ALE Members ALE Members
Fully Insured No Employer Reporting 1 1094-C and 1095-C
Self Insured 1094-B and 1095-B 1094-C and 1095-C2
No Coverage No Employer Reporting 1094-C and 1095-C 3
Footnotes
1. Insurance Carrier Files Forms 1094-B and 1095-B
2. Self-Insured ALE Members are permitted to use a single
combined form for Sections 6055 and 6056 reporting
3. Only if the ALE has at least one Full-Time Employee
8. Employer Reporting: When
• Mandatory compliance begins with reporting in 2016
• Reporting 2015 information
• IRS “encouraged” voluntary compliance in 2015
• Forms must be filed with the IRS by the end of March
• If filed on paper, the forms must be filed by the end of February
• Paper filing is not available if employer must file 250 or more forms
• Forms must be delivered to individuals by the end of January
• Delivery includes placing in the U.S. Mail
• All deadlines are subject to one day extensions for weekends
9. Employer Reporting: Why
• To help the government enforce the ACA’s Individual and Employer
Mandates
• To provide employees with information they need to complete their
personal income tax returns
• To avoid non-compliance penalties
• Identical for the penalties for failing to provide W2s
• For 2016 filings, no penalties for “good faith” compliance efforts
• Penalty relief not available for late filings
• Beginning with 2017 submissions, penalties apply for mistakes
10. Employer Reporting
Non-Compliance Penalties
(As modified by the Trade Preferences Extension Act of 2015 (June 2015))
Type of Failure Per Form Penalty
Annual Maximums
Large Business /
Small Business
Filed less than 30 days late $50 $500,000 / $175,000
Filed before August 1 $100 $1,500,000 / $500,000
Filed August 1 or later $250 $3,000,000 / $1,000,000
Intentional Disregard $500 No Cap
Small Businesses are those with less than $5 Million in gross
receipts during each of the previous three years
11. Form 1094-B Overview
• Form Name: Transmittal of Health Coverage Information Returns
• Purpose: Enforcement of the Individual Mandate
• Who Files:Insurance Company (fully insured plans) or self-funded
plan sponsors
• How Many: 1 per insurer or self-insured plan
• How: Paper or Electronically
Note: Entities filing at least 250 returns under Sections
6055 or 6056 are required to file electronically
• When: Due the last day of February (February 29, 2016)
or the last day of March if filed electronically
13. Form 1094-B Line x Line Review
Line 1: Filer’s Name – Insurance Company or Plan Sponsor
Line 3: Name of Person to Contact – Who can answer the IRS’s questions
Line 9: Total Number of Forms 1095-B Submitted With This Transmittal
14. Form 1095-B Overview
• Form Name: Health Coverage
• Purpose: Enforcement of the Individual Mandate
• Who Files:Insurance Company (fully insured plans) or self-funded
plan sponsors
• How Many: 1 each to the IRS and to the covered individual per
employee/individual covered any time during the year
• How: Paper or Electronically
Note: Entities filing at least 250 returns under Sections
6055 or 6056 are required to file electronically
• When: With the IRS on or before the last day of February
(February 29, 2016) or the last day of March if filed
electronically and
To the covered individual on or before the last day of January
(February 1, 2016 because January 31 is a Sunday)
16. Form 1095-B Line x Line Review
Line 1: Name of Responsible Individual – the policy holder or the primary
insured individual for a group plan (not the employer)
Line 8: Enter Letter Indentifying Origin of the Policy
Code List: A. Small Business Health Options Program (SHOP)
B. Employer-Sponsored Coverage
C. Government-sponsored program
D. Individual market insurance
E. Multiemployer plan
F. Miscellaneous minimum essential coverage
Line 9: Small Business Health Options Program (SHOP) Marketplace
Identifier, if applicable – current instructions are to leave blank
Line 16: Name – The insurance carrier, the self-funded plan sponsor or the
government agency
17. Form 1095-B Line x Line Review
(Continued)
Part IV – Covered Individuals (Enter the information for each…)
Column (a): Name of Covered Individuals
Column (b): SSN – groups may not have this for all dependents (birthdays
are okay if SSN is not available – don’t enter both)
Column (d): Covered all 12 months – or list the individual months coverage
was in effect
18. Form 1094-C Overview
• Form Name: Transmittal of Employer-Provided Health Insurance Offer
and Coverage Information Returns
• Purpose: Enforcement of the Employer Mandate
• Who Files:Members of Applicable Large Employers (ALEs) with at least
one full-time employee
• How Many: 1 to the IRS per ALE member
• How: Paper or Electronically
Note: Entities filing at least 250 returns under Sections
6055 or 6056 are required to file electronically
• When: Due the last day of February (February 29, 2016) or
the last day of March if filed electronically
Note: Medium sized ALEs must still file in 2016
20. Form 1094-C Page 1 Line x Line Review
Line 1: Name of ALE Member (Employer) – Employer’s name
Line 9: Name of the Designated Government Entity (only if applicable) –
only if a DGE is filing on behalf of a government employer
Line 18: Total number of Forms 1095-C submitted with this transmittal
Line 19: Is this the authoritative transmittal for this ALE Member?
• If yes, complete the remainder of the Form
• If no, sign the bottom of this page and don’t complete anything else.
Line 21: Is ALE Member a Member of an Aggregated ALE Group – Client
needs to know their status as a member of a Control Group for tax
purposes
21. Form 1094-C Page 1 Line x Line Review
Line 22: Certifications of Eligibility (select all that apply) :
A. Qualifying Offer Method:
• Qualifying offers were made to at least one full-time employee for
all months that the Employer Mandate would apply
• For fully insured plans, allows for possibility of generic reporting to
employees offered coverage all year in lieu of distributing Form
1095-C to them
• Still must file Form 1095-C for those employees with the IRS
B. Qualifying Offer Method Transition Relief:
• Qualifying offers made for one or more months to at least 95% of
full-time employees
• For fully insured plans, allows for possibility of generic reporting to
all full-time employees in lieu of distributing Form 1095-C
• Still must file Form 1095-C for those employees with the IRS
22. Form 1094-C Page 1 Line x Line Review
Line 22: Certifications of Eligibility (select all that apply) : (Continued)
C. Section 4980H Transition Relief (for 2015)
• Relief for ALEs with Fewer than 100 full-time employees
• No employer mandate penalty in 2015
• No employer mandate penalty for off-calendar year plans for
the months of the 2015 Plan Year that fall in 2016
• Not available to ALEs who reduced workforce size or benefit
offerings after 02/09/14 to avail themselves of this rule
• Relief for ALEs with 100 or more full-time employees
• “Sledgehammer penalty” does not apply to first 80 full-time
employees (instead of the standard 30 full-time employees)
• Additional reduction applies for 2015 and for any months of a
2015 Plan Year that fall in 2016 (for off-calendar year plans)
23. Form 1094-C Page 1 Line x Line Review
Line 22: Certifications of Eligibility (select all that apply) : (Continued)
D. 98% Offer Method
• Employer offered Affordable, MV coverage to 98% of full-time
employees for all 12 months (and offered MEC coverage to their
dependents)
• Employer does not have to complete “Full-Time Employee Count”
in Part III, column (b).
Signature Line:
25. Form 1094-C Page 2 Line x Line Review
Part III – ALE Member Information - Monthly
Column (a): Minimum Essential Coverage Offer Indicator
• Generally based on whether coverage was offered to 95% of full-time
employees and their dependents
• Don’t count full-time employees in a waiting period
• For 2015, there is Transition Relief for lesser offerings
• ALEs with 70% coverage offering can check “Yes”
• ALEs who did not historically offer coverage to dependents can
check “Yes” if they take steps in 2015 to extend coverage to
dependents in 2015
• For non-calendar year plans that did not alter their plan years after
12/27/2012:
• ALEs who were not eligible under the Plan terms until the first
day of the Plan Year beginning in 2015 can be treated as having
been offered coverage
26. Form 1094-C Page 2 Line x Line Review
Part III – ALE Member Information – Monthly (Continued)
Column (b): Full-Time Employee Count for ALE Member
• Employees working 130 hours in the month
• May be skipped if 98% Offer Method was selected
Column (c): Total Employee Count for ALE Member – FT and PT Employees
• Based on a monthly snapshot
• Measured on the same day of each month (elected by employer)
• First day
• Last day
• First day of first pay period
• Last day of first pay period
27. Form 1094-C Page 2 Line x Line Review
Part III – ALE Member Information – Monthly (Continued)
Column (d): Aggregated Group Indicator
Column (e): Section 4980H Transition Relief Indicator –
“A” - 50-99 Transition Relief (ALEs with fewer than 100 full-time
employees)
“B” - 100 or more Transition Relief (ALEs with 100 or more full-time
employees)
29. Form 1094-C Page 3 Line x Line Review
• List Names and EINs for other ALE Members of the Aggregated ALE
Group who were members at any time during the calendar year
• Do not attach additional sheets if there are more than 30
• List the first 30 members in descending order based on the highest
average monthly number of full-time employees
30. Form 1095-C Overview
• Form Name: Employer-Provided Health Insurance Offer and Coverage
• Purpose: Enforcement of the Employer Mandate
• Who Files:Members of Applicable Large Employers (ALEs) with at
least one full-time employee
• How Many: 1 each to the IRS and to the Employee per full-time
employee eligible for MEC coverage any time during the
year
• How: Paper or Electronically
Note: Entities filing at least 250 returns under Sections
6055 or 6056 are required to file electronically
• When: With the IRS on or before the last day of February
(February 29, 2016) or the last day of March if filed
electronically and
To the covered individual on or before the last day of January
(February 1, 2016 because January 31 is a Sunday)
33. Form 1095-C Line x Line Review
Part II – Employee Offer and Coverage – If the answers to the below
questions are the same for all 12 months of the calendar year, only one
entry is required. Otherwise, each line must be answered separately for
each month
Line 14: Offer of Coverage (enter required code)
Code List: 1A – MEC, MV, Affordable, Family Eligibility
1B – MEC, MV, Employee Only
1C – MEC, MV for Employee; MEC for Dependents
1D – MEC, MV for Employee; MEC for Spouse
1E – MEC and MV for Employee; MEC for Spouse and Deps.
1F – MEC only
1G – Part-Time Employee Coverage
1H – No offer of coverage
1I – Qualified Offer Transition Relief 2015 – Incomplete
offer of coverage
34. Part II – Employee Offer and Coverage (Continued)
New in June 2015! - Plan Start Month – 2 digit month code
Line 15: Employee Share of Lowest Cost Monthly Premium, for Self-Only
Minimum Value Coverage –
Line 16: Applicable Section 4980H Safe Harbor (enter code, if applicable)
Code List: 2A – Employee not employed during the month
2B – Employee not a full-time employee
2C – Employee enrolled in coverage offered
2D – Employee in a section 4980H(b) 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
Coming for 2016 - new codes for conditional offers of coverage to spouses
Form 1095-C Line x Line Review (Continued)
35. Form 1095-C Line x Line Review
(Continued)
Part III Covered Individuals – Only for Self-Insured Coverage (Fully-Insured
coverages have this information reported by the carrier in Form 1094-C)
Column (a): Name of Covered Individuals
Column (b): SSN – groups may not have this for all dependents (birthdays
are okay if SSN is not available)
Column (d): Covered all 12 months – or list the individual months coverage
was in effect
36. New Electronic Reporting Guidance
(Issued June 26, 2015 by the IRS)
Steps Required To Utilize the ACA Information Return (AIR) System
1. Register with the IRS’s e-services website including submission of personal
information about the person registering on behalf of the entity
2. Obtain an AIR Transmitter Control Code (TCC), a unique identifier
authorizing each Submitting Entity to submit the reporting forms
3. Pass a series of technical/system tests to ensure that Reporting Forms will
be properly submitted when due.
The first two steps can be completed now while the third step will be available
for completion later in 2015.
37. Employer Reporting – Next Steps
1. Determine your company’s filing requirements for 2015 now
2. Identify required data collection needed to complete required forms
3. Address any shortfall in current data collection immediately
4. Implement necessary data retention process
5. Identify possible Form preparation providers or resources: payroll
company, CPA, software product.
6. Complete the first two steps of the IRS’s AIR system registration process
and schedule completion of the third step for Fall 2015.
7. Schedule preparation, employee distribution and filing of returns with the
IRS for early 2016 as appropriate.