Affordable Care Act (ACA) of 2010 created new health insurance marketplaces to provide premium and cost sharing subsidies for low income Americans. E-Filing IRS ACA Forms 1094-B, 1094-C, 1095-B and 1095-C with ExpressIRSForms.com

1. Affordable Care
Act (Oba)
Affordable Care Act

2. ACA - An Introduction
Affordable Care Act (ACA) of 2010 created new health insurance marketplaces /
exchanges to provide premium and cost sharing subsidies for low income Americans
ACA tends to
•Improving quality and lowering healthcare costs
•Providing new consumer protections and access to healthcare
•Providing Insurance options covering preventive
services
•Holding insurance companies accountable

3. Affordable Care Act(ACA) Reporting - Responsible
Individual Health Coverage
Individual & Family
Insurance Marketplaces
Online exchanges operated by
individual states or by the federal
government, where individuals
and families can buy health
insurance directly from insurers.
People with incomes between
100 and 400 percent of the
federal poverty level are eligible
Small Business Insurance
Marketplaces (SHOP) /
Applicable Large Employers
(ALE)
Online exchanges
(known as Small
Business Health
Options or SHOP and
ALE) to help firms <50
or >50 employees cover
their workers
Medicaid
Expansion
Broader Medicaid
eligibility to
include those
earning up to 138
percent of the
federal poverty
level

4. ACA Tax Forms – An Overview
● Section 6056 Reporting is the required
reporting of information to the IRS relating
to offers of health insurance coverage by
Applicable Large Employers (ALE). The
1095-C form is a statement disclosing
information about the offer of coverage.
The 1094-C form is the IRS’ cover sheet for
their copies of the 1095-C forms
● Section 6055 Reporting is the required reporting by Medical Carriers
(labeled as Insurers in the chart below). The employer does not have a
responsibility for this reporting unless it is a self-funded plan. 1095-A form is
used by the Marketplace to send coverage information. 1095-B form is used
by a few different scenarios like SHOP marketplace and off-marketplace
plans.

5. Section 6055 & 6056 Reporting
Self Insured Fully Insured Applicable Large
Employers
self-insured employers
that are not applicable
large employers, those
with fewer than 50 full-
time or full-time
equivalent employees
fully insured plans where
the employer contracts an
insurance company to
cover the employees and
dependents.
An applicable large
employer is generally
defined as an employer
that employed an
average of at least 50
full-time employees -
including full-time
equivalent employees.

6. Section 6055 & 6056 Reporting

7. Organizations/Employers - IRS
Reporting criteria for ACA Tax forms
Minimum Essential coverage (MEC)
under self-insured plan ?
Applicable Large Employer (ALE) ?
Yes
NO
Section
6055
Section
6055
Yes NO
Applicable Large Employer (ALE) ?
Yes NO
Section
6056
Section
6056
To satisfy 6055
requirements,
Employers must
submit:
1. Form 1095-B to
employees
2. Form 1094-B and
1095-B copies to IRS
To satisfy 6055 & 6056
requirements,
Employers must submit:
1. Form 1095-C to
employees
2. Form 1094-C and
1095-C copies to IRS
To satisfy 6056
requirements,
Employers must submit:
1. Form 1095-C to
employees
2. Form 1094-C and
1095-C copies to IRS
No reporting is
due

8. DeadLine for ACA Forms
August 31January 31 March 31February 29
deadline for paper filers
Last Day to file
corrections before penalty
increase
Form 1095-B and Form
1095-C statements must
be furnished by ALEs to
Full Time Employees or
responsible individuals
deadline for E-filers

9. ACA Tax Forms - Penalties
Information Returns: Failure to timely file or include
all required information, including incorrect information
Individual Statements: Failure to timely furnish or
include all required information, including incorrect
information on statement
Penalty Amounts
● $100 per form for not furnishing 1095-B/C to the recipients by 31
January
● $100 per form for not furnishing 1095-B/C to the IRS by 31 March
● Employer with 100 employees can be fined upto $10k - $20k if forms
are not submitted to IRS or employees!

10. Penalties For Form Corrections

11. Thank you!