IRS Issues Draft Forms for Coverage Reporting Requirements under the Affordable Care Act


The Internal Revenue Service (IRS) has released draft versions of forms that will be used by employers to report health coverage information required under the ACA’s employer shared responsibility rules. As we have written in a previous alert, the ACA requires plan sponsors to begin reporting certain health coverage information to help the IRS enforce the employer shared responsibility and individual mandate components of the law. The reporting requirements are set forth under Internal Revenue Code Sections 6055 and 6056.

Under Code Section 6055, health insurers and employers (regardless of size) that sponsor self-insured health plans are required to report information regarding individuals covered under their health plans. This information must be reported using Form 1095-B, indicating the months for which each family member had coverage during the previous calendar year. Each primary insured person under the plan must be provided a copy of Form 1095-B with his or her pertinent information. All Forms 1095-B must be transmitted to the IRS in a single package using Form 1094-B as an accompanying transmittal form.

Code Section 6056 requires employers with 50 or more full-time employees to report whether they offered “minimum essential coverage” to their full-time employees and dependents, and if coverage was offered, what the employee’s share of the lowest cost monthly premium for self-only coverage was. Form 1095-C must be used to report this information, indicating offers of coverage and employee’s premium share information for each month of the previous calendar year. Each primary insured person must be provided a copy of Form 1095-C with his or her pertinent information; all Forms 1095-C must be transmitted to the IRS in a single package using Form 1094-C as an accompanying transmittal form. Form 1094-C also requests additional information regarding other members of the reporting employer’s controlled group.

The IRS has delayed the effective date of the reporting rules under both Code Sections 6055 and 6056. Reporting for the 2014 calendar year is optional; the first required filings must be submitted for the 2015 calendar year in early 2016.

Because these forms are still in draft form, they should be used for preparation purposes only, and not for an actual filing or reporting. The forms may undergo some changes before they are released in final form. Instructions for these forms are expected to be published soon. The IRS is also seeking comments on the draft forms, which may be submitted here.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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