Blog

Wednesday, February 28, 2018

What You Need to Know About The ACA Reporting Requirements 2018

Mailing paper ACA forms for the deadlineToday is the last day to paper file your ACA Forms! 

That’s right, your Affordable Care Act Form 1094 and 1095 reporting information for the tax year 2017 are due (today) February 28, if you plan to paper file.

If you have waited until the last moment here is what you need to know about the ACA reporting requirements 2018.




What You Need to Know About The ACA Reporting Requirements 2018


Infographic PDF ACA reporting requirements 2018

Infographic PDF ACA reporting requirements 2018


ACAwise: ACA Reporting Requirements 2018

You can download this employer guide to ACA reporting requirements 2018 to reference while preparing your ACA annual reporting.

    




Handsome bearded businessman in classic suit is using a laptop and taking notes on ACA reporting requirements 2018Your Ultimate Last-minute Guide to The 1095-C Codes 2017

Have questions about your 1095-C Codes? Well, you are in luck understanding your codes do not need to be with our last-minute guide “Understanding 1095-C Codes” 2017 edition.

This guide can make your Employers Mandate reporting a little smoother and ensure you are submitting ACA forms error-free.

Click here for 1095-C Codes 2017



ACA 1095 & 1094 Electronic Filing

Employers filing more than 250 of any form must e-file with the IRS (although the IRS highly encourages all employers to e-file all forms submitted). Also, it should be noted that the deadline for e-filing deadline gives filers an additional 30-days.


Paper Filing Deadline: TODAY!!!
Electronic Filing Deadline: Monday, April 2, 2018
Recipient Deadline: Friday, March 2, 2018

 



ACA Reporting Software for 1095 and 1094 Filing

If you are looking for an affordable alternative to paper filing you are in luck! Not only does ACAwise offer a full-service filing solution, but you will have a personal ACA expert on your side.

Our product manager and team lead, Jarissel Morillo, works directly with both Applicable Large Employer to provide ACA reporting & compliance assistance every step of the way. Jarissel is happy to answer any questions you have about ACA reporting requirement 2018 or volume-based pricing proposal opportunities.


Contact Our ACA Expert, Jarissel, For a Free Proposal




Read More »

University Healthcare Professor Weighs In On The ACA

Expert Opinion on ACA MandateThe longevity of the Affordable Care Act (ACA) has likely created a certain level of uncertainty in your organization over past year.

There have been several significant changes since its enactment and this year is no exception with tax reforms, continuing negotiations, and of course, the states suing over Obamacare.








Today Dr. Michael Matthews, Professor of Healthcare Management at Winthrop University, weighs in on the Affordable Care with our ACA expert Jarissel on the BanditRoom.



ACA Reporting Software for 1095 and 1094 Filing

Despite the uncertainty of the Affordable Care Act, all applicable employers must comply with ACA reporting requirement 2018. If your business is still seeking a reporting service, ACAwise provides a full-service solution with flexible volume-based pricing. Avoid impending ACA penalties 2018 by filing and providing Form 1095 by the March 2nd deadline.




Read More »

Tuesday, February 27, 2018

Spotlight: The Unparalleled Truth 20 States Sue Obamacare

Facade of US Supreme court in Washington DC as 20 states sue Obamacare and Federal Government


There has been slight movement in the Texas v. United States case launched over the constitutionality of the Affordable Care Act since the repeal of the Individual Mandate.

August case update: At the National Association of Insurance Commissioners summer Boston meeting, D.C.-based benefits lawyer Anthony Shelley said he anticipates that the Texas federal district court will likely rule on the Texas v. United States suit by Jan. 1, 2019, after which there is a good chance the case is bound for the U.S. Supreme Court.

It likely won’t be alone. ThinkAdvisor reports that Shelley believes the U.S. Department of Labor’s new regulations for association health plans, which are aimed at providing small employers access to the type of coverage that currently only large employers with self-insured plans offer, could be basis for another court case. The current administration’s regulations regarding the short-term medical insurance benefit period could also spark its own case.

Previously: The latest news coming from Washington D.C. this morning is the news that a coalition of twenty U.S. states sued the federal government on Monday over Obamacare. They claim the law is no longer constitutional following the repeal of the Individual Mandate. So let's shine a light to discover the unparalleled truth as twenty states sue Obamacare.

Spotlight: The Unparalleled Truth 20 States Sue Obamacare


Before we dive into the heart of the case, let’s set the scene for those of you who are just now tuning in.


What states are Involved in Lawsuit?

  • Texas
  • Wisconsin
  • Alabama
  • Arkansas
  • Arizona
  • Florida
  • Georgia
  • Indiana
  • Kansas
  • Louisiana
  • Maine
  • Mississippi
  • Missouri
  • Nebraska
  • North Dakota
  • South Carolina
  • South Dakota
  • Tennessee
  • Utah
  • West Virginia

Leading the lawsuit is Texas Attorney General Ken Paxton in partnership with the Wisconsin Attorney General Brad Schimel. The case was filed Monday, February 26th, 2018 in the United States District Court Northern District of Texas Fort Worth Division. The complaint for declaratory and injunctive relief filed as case number 4:18-cv-00167-O is a 33-page document stating the beliefs and understanding of the combined twenty states.


The Defendants of the Case

  • The United States of America
  • United States Department of Health and Human Services
  • Alex Azar ( Secretary of Health and Human Services
  • The United States Internal Revenue Service
  • David J. Kautter (Commissioner of Internal Revenue)



Lady Justice isolated on Front Columns of the Supreme Court of U.S. background what will happen as 20 states due ObamacareThe State (Plaintiff's) Claim: ObamaCare is Unlawful.

The lawsuit claims that without the Individual Mandate, which was eliminated by President Donald Trump in December as part of the GOP’s Tax Cuts and Jobs Act, the Affordable Care Act (ObamaCare) is unlawful.

Texas Attorney General Ken Paxton stated that “The U.S. Supreme Court already admitted that an Individual Mandate without a tax penalty is unconstitutional. With no remaining legitimate basis for the law, it is time that Americans are finally free from the stranglehold of Obamacare, once and for all.”

Paxton is referring to the previous state suit that was brought before the Supreme Court which ruled five to four that the Affordable Care Act (ObamaCare’s) Individual Mandate was constitutional because Congress had the power to levy taxes. The new lawsuit brought before the court cities this ruling to claim the law is no longer constitutional.


The Administration's Reaction to Lawsuit

The Justice Department has not made an immediate response, and it is currently unclear how the Trump administration will respond to the case.

The Individual Mandate in the Affordable Care Act is used to ensure the health insurance market stays viable by mandating young and healthy Americans buy coverage. This brings down the price for all Americans and benefits the greater good for those needing healthcare.


What Does This Mean For Your Business?

No matter the result of this case your business is still required to file all ACA reporting requirements including ACA Form 1095. If you fail to file by the deadline you will be penalized heavily by the IRS. If you are still seeking an ACA reporting service, ACAwise is here to help.

Simply send in your employees information, and we will take care of the rest. Once we have compiled your forms, you can review for quality assurance. Then we will transmit them directly to the IRS. However, time is running out, and the deadline for providing recent copies is Friday, March 2nd, 2018.



Contact Us Today Before It’s Too Late!


Read More »

Your Ultimate Last-minute Guide to The 1095-C Codes 2017

successful manager working in cafe during break and searching for 1095-C Codes 2017 on internet on his portable computer
As a business owner or HR professional, Affordable Care Act (ACA) reporting is complicated enough. But, understanding the codes does not have to be with our last-minute guide “Understanding 1095-C Codes” 2017 edition. This guide can make your reporting and Employers Mandate compliance a little smoother and ensure you are submitting ACA forms error-free.

Your Ultimate Last-minute Guide to The 1095-C Codes 2017

The IRS created two sets of codes to provide employers with a consistent way to report employees healthcare coverage. Each code is used to indicate unique scenarios regarding coverage or to give an explanation as to why an employee was not offered coverage.

1095-C Codes Explained

ACA Form 1095 C is used to provide your employees information about their healthcare coverage and benefits for tax filing purposes. Here is what is included in 1095 Form 2017 edition:
  • Line 14- What coverage was offered to employees?
  • Line 15- Was the healthcare coverage affordable?
  • Line 16- Did the employee accept the employer-provided healthcare coverage?









ACAWise: Guide to 1095-C Codes 2017 Edition

You can download this last-minute guide to reference while preparing your ACA annual reporting.

    
                    
    



professional businessman in black suit working on 1095-C Codes 2017 with notebook computer while sitting at his office,


ACA Reporting Software for 1095 and 1094 Filing

Is your business still looking for an ACA filing service? Well, you are in luck! Not only do we offer a full-service filing solution, but you will have a personal ACA expert on your side.

Our team lead and product manager here at ACAwise is Jarissel Morillo. She works directly with both ALE’s and TPA’s to provide Affordable Care Act reporting & compliance assistance every step of the way. Jarissel is happy to answer any questions you have about ACA reporting requirement 2018 or volume-based pricing proposal opportunities.










Read More »

Monday, February 26, 2018

What You Need to Know About Upcoming ACA Reporting Deadline 2019

Young handsome businessman Confident and successful man after the ACA reporting deadline 2018
The year-end filing deadline for employers is here, the Affordable Care Act still stands, and the IRS is standing by to fully enforce the Employer Mandate. This means Applicable Large Employers (ALEs) and Third Party Administrators (TPAs) must file 1095 Form 2017 and provide recipient copies to employees by the IRS deadline. Here is what you need to know about the upcoming ACA reporting deadline 2019.

What You Need to Know About Upcoming ACA Reporting Deadline 2019


To stay on schedule employers must meet the following ACA reporting deadline 2019:


Recipient Copy Deadline: Friday, March 4, 2019
Paper Filing Deadline: Wednesday, February 28, 2019
Electronic Filing Deadline: Monday, April 1, 2019


ACA Form 1095-C Deadline 2019

Applicable Large Employers (ALEs) and Third Party Administrators (TPAs) are responsible under the Employer Mandate to provide employees with ACA forms including correct 1095-C codes 2017. These forms must be provided to eligible employees no later than March 4, 2019.

Applicable ACA employers must also file Form 1095-C with the IRS. Paper filers must have forms submitted by February 28, 2019, and e-filers must transmit by April 1, 2019. If a business fails to meet the 1095-C deadline, that business will face hefty IRS penalties.

Click here for 1095-C Codes 2019


What is a 1095-C Form For Tax Purposes?

Your employees need the Affordable Care Act Form 1095-C, the Employer-Provided Health Insurance Offer and Coverage Information Returns, to help them complete their tax returns.

Young handsome businessman Confident and successful man after the ACA reporting deadline 2018


ACA Form 1094-C Deadline 2019

Transmittal Form 1094-C is filed on the Form 1095-C and serves as proof that Applicable Large Employers (ALEs) and Third Party Administrators (TPAs) were compliant. A businesses compliance is determined by the IRS regulation and the Employer Mandate. All applicable employers must report whether they offered the affordable minimum health coverage and enrollment to all eligible employees.

Under Section 6055 and 6056, Applicable Large Employers and Third Party Administrators must use 1095-C Codes 2019 to report coverage and enrollment in regards to Employer Mandate.

ACA 1095 Electronic Filing

Employers filing more than 250 forms must e-file with the IRS. Also, it should be noted that the deadline for paper filing falls one month prior to the electronic reporting deadline.

Your Filing Solution for ACA Reporting Deadline 2019

Are you still looking for a full-service ACA e-filing service? Talk to one of our outstanding team members for more information!




Contact an ACA Expert, Today!




Read More »

Friday, February 23, 2018

What Businesses Can Expect From the 2018 Obamacare Penalty


Handsome businessman in suit and eyeglasses writing in office reviewing 2018 Obamacare penaltyFollowing the repeal of the Individual Mandate President Donald Trump announced: “Obamacare is being repealed.” However, this is not exactly correct, although some are worried about the repercussions of eliminating the Mandate the majority of regulations are still in full effect. So what can businesses expect from the 2018 Obamacare penalty?


What Businesses Can Expect From the 2018 Obamacare Penalty


Don’t cancel your employee health insurance plans just yet. The tax bill eliminating the Individual Mandate and its coinciding penalty will not go into effect until 2019. Meaning those who forgo a healthcare plan for 2018 can face a penalty.


ACA Reporting Deadlines 2018:


March 2nd: Provide Forms 1095-B or 1095-C to Full-Time Employees
February 28th: IRS Paper FIling Deadline for Form 1095-B or 1095-C
March 31st: IRS E-filing Deadline for Form 1095-B or 1095-C


ACA Penalties 2018

While the American Health Care Act (AHCA) or Trumpcare is yet to pass through the legislature the 2018 Obamacare penalty is still fully enforced. All Applicable Large Employer and Third Party Administrators are still required to file ACA Form 1095 by the ACA filing deadline.


Failure to File/ Inaccurate Filing

Your business could potentially be penalized $260 - $520 per form if you fail to file a correct information return (1094 or 1095 Form), but this amount can not exceed $6 million in total.

Failure to E-file

Handsome businessman in suit and eyeglasses writing in office reviewing 2018 Obamacare penaltyIf your business paper files 250 or more forms, you are required to e-file. If you fail to do so, then you will incur a $260 per form penalty.

Failure to Meet 95%

If you do not offer coverage to a minimum of 95% of full-time employees, your business will face a fine of $2,260 ($188.33 per month) per full-time employees.

Failure to Offer Coverage

If your business fails to offer affordable health coverage, you will be fined $3,390 ($282.50 per month) per full-time employee.

Complete ACA Service

Choose the best ACA service available for Applicable Large Employers (ALEs) and Third Party Administrators (TPAs). ACAwise offer volume-based pricing and US-based support to provide employers with the best ACA reporting service available. Our flexible pricing guarantees you are getting the best deal on the market today!




Get a Free Volume-Based Pricing Proposal Today!




Read More »

Thursday, February 22, 2018

Is the Affordable Care Act Still in Effect?

The US Senate and the President Trump continue efforts to repeal and replace the affordable care act

Is Obamacare Gone?


Because of the widespread interest concerning the Affordable Care Act (ACA), one would think that most Americans would be well informed about its current state. So is the Affordable Care still in effect? Or did Trump repeal Obamacare? According to research findings by the Henry J. Kaiser Family Foundation, only 36% of voters are aware of the Individual Mandate repeal. Moreover, even more, shocking is that 14% of voters are under the empress that the Affordable Care Act has been repealed altogether, not just the Individual Mandate.


Is the Affordable Care Act Still in Effect?

After four attempts to overhaul the current health care law, Republicans in Washington are tabling repeal efforts for now….


Attempt #1: Repeal and Replace

On Tuesday, July 25th, 2017 Senate Majority Leader Mitch McConnell, and Republicans made their first efforts under the current administration to repeal and replace Obamacare. This effort raised the 51 votes needed to start the debate but fell short in the final Senate vote.

Nine Republican senators including conservative and moderators voted against the replacement plan. The proposed Senate bill allowed for a rollback on Medicaid expansion and capped spending budget, less comprehensive plans, and the elimination of the individual/employer mandate.


Attempt #2: Straight Repeal of Obamacare

Republican Senators came together to revise the 2015 GOP bill that was previously vetoed by former President Barack Obama. This would have introduced an amendment to bar federal dollars for abortion fundings. A simple majority was needed to pass the bill, but seven Republican Senators voted the measure down.

The bill would have repealed many of the regulations set down by the Affordable Care Act without implementing an immediate replacement. The plan was to have the health care bill repealed in two years giving lawmakers additional time to pass a replacement act.


Attempt #3: Skinny Repeal

Three Republican Senators effectively squashed the last-ditch effort to repeal Obamacare as part of the budget process. With the party unable to push more sweeping legislation leadership crafted a “skinny” repeal plan that left much of the current Affordable Care Act in place. Medicaid and subsidies were to be left untouched, but this would have eliminated the individual/ employer mandate, and medical device tax.


Attempt #4: Graham-Cassidy

The US Senate and the President Trump continue efforts to repeal and replace the affordable care actOn September 30th, 2017 the budget reconciliation expired blocking the GOP’s opportunity to overhaul the Affordable Care Act with just 50 voters. Senator Lindsey Graham of South Carolina and Bill Cassidy of Louisiana revised their former draft of the Republican plan to repeal and efficiently replace Obamacare. This would install additional funding provisions and regulatory change aimed at securing senators support.

This plan would have eliminated the following: Medicaid expansion, cost-sharing subsidies, tax credits, and the Individual/Employer Mandate.


GOP’s New Bill: The Tax Cuts and Jobs Act

On December 22nd President Trump signed the Tax Cuts and Jobs Act after the House passed the tax bill with a historical party-line vote. This tax reform bill reduces the federal budget deficit by approximately $318 billion by eliminating costs associated with the individual mandate.

Although the individual mandate has been repealed, individuals must comply with the previous obligation for the 2018 tax season. Applicable Large Employers and Third Party Administrators are still required to track ACA compliance and provide ACA reporting for the 2017 fiscal tax year. Those who fail to file will face ACA filing penalties.

For more information on your ACA reporting and filing, obligations click here.

The current administration claims that this will make the end of the ACA, but applicable businesses must prepare and file all required healthcare information forms.


ACA Reporting Deadlines 2018

Despite the continued efforts to “repeal and replace” the Affordable Care Act, your business will still be required by law to report and file required information returns. Those who ignore this responsibility will face severe penalties.

While the road ahead might be rocky, ACAwise will continue to provide full-service ACA reporting and compliance. Getting started is easy, and, with volume-based pricing, you will get the best deal available! Get to know one of our knowledgeable product managers and learn how we can help you smoothly file your IRS Form 1094-c and 1095-c.



Read More »

Wednesday, February 21, 2018

The Complete ACA Reporting Codes Cheat Sheet


One of the most important aspects of Form 1095-C is knowing how to indicate data about the coverage offered to employees. To do this your business will need to use Code Series 1 and Code Series 2 in lines 14 and 16 of Form 1095-C. The IRS will review the codes used and make sure you are compliant with your ACA employer requirements. Here is the complete ACA reporting codes cheat sheet.


The Complete ACA Reporting Codes Cheat Sheet


Code Series 1
(Line 14 of Form 1095-C)
Code Series 2
(Line 16 of Form 1095-C)
  • Whether Employees Were Offered Coverage
  • Type Of Coverage Offered
  • Months Coverage Offered
  • Full-time or Part-Time Employment 
  • Coverage Enrollment
  • Transition Relief Eligibility 
  • IRS Safe harbor: Whether Coverage was Affordable





ACA Form 1095-C: Line 14

Code
What does the Code Mean?
When Should You Use the Code?
1A
Qualifying offer made to the employees, their spouse, and dependent(s)
Qualifying offers must not exceed 9.5 % of the mainland single federal poverty line


1B
Coverage is only offered to employees
Coverage meets minimum essential coverage and the minimum value.

You exclude spouses and dependent from plan.

1C
Coverage offered to employees and their dependent(s)
Spouses are excluded from plan


1D
Coverage offered to employees and their spouse
Dependents are excluded from plan


1E
Coverage is offered to employees, their spouse, and dependent(s).
Plan meets MEC MV, but coverage may not be affordable


1F
Coverage offer to employee or employee, spouse, and dependents
Coverage does not provide minimum value

1G
Self-insured coverage offered to employees who worked part-time at any point in the year
Employer offers a self-insured plan

Non-full time employee eligible for plan

Employee enrolled in coverage plan


1H
Coverage was not offered to the employee
Employee was not hired yet

Limited non-assessment period
Ineligible for coverage

Coverage did not meet minimum essential coverage

Employee terminated and offered COBRA






ACA Form 1095-C: Line 16

Code
What does the Code Mean?
When Should You Use the Code?
2A
Employee was not employed during the month
Employee was not yet hired

The employee is no longer employed


2B
Employee was not working full-time during the month
Employee is part-time

Seasonal employee

2C
The employee enrolled in the coverage offered
Employee accepts coverage offer

If you have an option between code 2C and another code, always use code 2C

2D
Employee enrolled in Limited Non-assessment Period (LNAP) for the month
Waiting period monthly or Look-Back measurement method

The employee’s initial measurement period used the Look-Back method

2E
Employer eligible for multiemployer interim relief rule
Portion of workforce eligible for multiemployer (Union) plan

Ongoing contribution on behalf of Union employees toward plan

2F
Coverage offered affordable based on Form W-2 Safe Harbor
W-2 Safe Harbor used every month employee was offered coverage

2G
Coverage offered affordable based on Federal Poverty Line Safe Harbor
Affordability is based on Federal Poverty Line Safe Harbor


2H
Coverage offered affordable based on Rate of Pay Safe Harbor
Affordable based on Rate of Pay Safe Harbor



Line 16 does not require codes to be entered, however, if a code applies you must enter it to provide an explanation to the IRS. This will help employers to avoid any unfair penalties for an employee during a given month.



ACAwise is a Full-Service ACA Filing Service


Choose the best full-service ACA reporting solution for Third Party Administrators (TPAs) and Applicable Large Employers (ALEs). ACAwise offers volume-based pricing and US-based support to provide employers with the best ACA reporting service available. Our flexible pricing guarantees you are getting the best deal on the market today!


Get a Free Volume-Based Pricing Proposal Today!

 

 

ACA Reporting Deadlines 2018:


Recipient Deadline: Friday, March 2, 2018
Paper Filing Deadline: Wednesday, February 28, 2018
Electronic Filing Deadline: Monday, April 2, 2018




Read More »

Tuesday, February 20, 2018

What's Going on in Idaho? Controversial Health Plans


Blue Cross of Idaho in trouble with government over non-compliance with ACA
Idaho Obamacare

On February 13th, 2018, Blue Cross of Idaho officially filed five individual market plans that do not comply with laws set by the Affordable Care Act (ACA). This is following an executive order and press release by Governor C.L. “Butch” Otter of Idaho directing the Department of Insurance of Idaho to restore health insurance choice.


Executive Order 2018-02 the Section 1332 waiver directs the Idaho Department of Insurance to “seek creative options” that provide lower cost benefits and plans compared to current coverage. This order also directs the department to “approve options that follow all state-based requirements, even if not all PPACA requirements are met.” The Idaho Department of Insurance has been directed to approve plans that meet the state requirements, but not the ACA requirements. 


The new “Freedom Blue” plans offered by Blue Cross of Idaho do not comply with the ACA and insurers that offer these plans are at legal risk and are generating uncertainty. The Department of Health and Human Services (HHS) is expected to step in to enforce ACA consumer protection. They are required to do so under the Public Health Service Act, and federal regulations set down by the past administration.



Medical examination and healthcare plans in Idaho Charlene Maher, CEO of Blue Cross stated that, “ The current marketplace is not affordable for middle-class families. Our new state-based plans are a response to Governor Otter’s executive order, which begins to solve the issues that have kept middle-class Idahoans from buying health insurance. Our Freedom Blue plans bring more choices and lower prices to consumers.”


However, the Section 1332 waiver used can only waive specific provisions of the Affordable Care Act, not the whole act itself. States under federal law cannot use Section 1332 to waive all protections regarding community rating or the ban on limits. States must also demonstrate that coverage is comprehensive and affordable. This would be more than challenging under Idaho’s proposed plan. This means that Section 1332 is not a likely option for making this plan a reality.


2017 ACA Reporting Services

This latest development brings a whole new level of uncertainty to the Affordable Care Act, but your business must still prepare its ACA reporting for 2017.


ACAwise is an all-in-one ACA reporting service designed specifically for Applicable Large Employers and Third Party Administrators. When you file with ACAwise, you are trusting the most experienced and knowledgeable IRS-authorized software in the industry. Volume-based pricing combined with our US-based ACA experts provide you the best ACA reporting service available.


Flexible pricing is essential for any business, and we guarantee you are getting the best deal on the market today.


Get a Free Volume-Based Pricing Proposal Today!




Read More »

Monday, February 19, 2018

The Ultimate ACA Compliance 2017 Checklist

Applicable Large Employer Use a ACA compliance 2017 checklist to complete his Affordable Care Act Reporting

The Affordable Care Act (ACA) has undergone several significant changes since the law was enacted in 2010. Many of these key updates include design changes, wellness program incentive, and of course the Employer Shared Responsibility Mandate. This ACA compliance 2017 checklist covers changes taking effect during the 2017 year-end tax season.

To prepare for 2018, all Applicable Large Employers (ALEs) should review new requirements and develop an ACA reporting and compliance strategy.



Highlights
ACA Changes for 2018
  • Cost-Sharing Limits
  • Coverage Affordability Percentages
  • Maximum Penalties for ACA Reporting Violations
  • Salary Contribution Limit
  • 1095-C Recipient Extension
Other Expected Changes:
  • Amount for Calculating Employer Shared Responsibility


ACA Compliance 2017 Checklist


The Affordable Care Act requires Applicable Large Employers (ALEs) to report information to the IRS and to their full-time employees regarding employer-sponsored health cover offered. The IRS uses the information ALEs report to verify employer-sponsored coverage and administer the Employer Shared Responsibility Mandate. (Code Section 6056)

Section 6055 is used to determine whether individuals are covered by minimum essential coverage. This section calls for the health plan issuer or insurance company to provide Form 1095-B and Form 1094-B to show the individual's coverage levels. This will also prove the if an individual is fully insured through their employer or if they receive coverage through a spouse or parent.

These ACA reporting requirements took effect in 2015, and all returns reporting coverage offered or provided in 2017 are due early 2018. ACA Form 1095-C and Form 1094-C must be filed with the IRS by February 28th ( or April 2nd, if filed electronically) of the year following the calendar year to which the returns relate. ACA Form 1095-C generally must be provided to employees no later than January 31st of the following yes coverage was provided. For the 2017 calendar year, all individual statement must be furnished no later than March 2nd, 2018.

Applicable Large Employers (ALEs) with self-funded health care plans are required to comply with all reporting obligations, while ALEs with insured plan need to only file section 6056. The IRS simplify this process by allowing ALEs with self-insured plans to combined single for to reporting all information under Section 6055 and 6056.



ALEs:
Self-Insured Plans

ALEs:
Insured Plans

Non-ALEs:
Self-Insured Plans

Non-ALEs:
Insured Plans

Required to report MEC information under Section 6055.

Required to report health coverage under Section 6056.

Required to report Section 6056 information.

Not required to report information under 6055


Required to report MEC information under Section 6055.

Not required to report under Section 6056.

Not required to report under Section 6055 or 6056.


ACA Reporting Forms

Entities typically filing Forms 1094-B and 1095-B will report under Section 6055. Business filing Forms 1094-C and 1095-C for each full-time employee for any month will report under Section 6056. Those who are required to report under both Sections 6056 and 6055 will file a combined report on Form 1095-C and Form 1094-C.

Section 6055:

Form 1095-B
IRS information return that must be sent to the covered individual and filed with the IRS.
Form 1094-B
IRS transmittal Form to be filed with the IRS along with Form 1095-B

Section 6056:

Form 1095-C
IRS information return that must be sent to the covered individual and filed with the IRS.
For 1094-C
IRS transmittal Form to be filed with the IRS along with Form 1095-B.



ACA Reporting    Requirements

Submit to the IRS:

Recipient Copies:

Section 6055
Form 1094-B

Individual Copies of Form 1095-B for each person covered


Form 1095-B

Section 6056

Form 1094-C

Individual Copies of Form 1095-C for each employee


Form 1095-C

Section 6056 &
Section 6055

Form 1094-C

Individual Copies of Form 1095-C for each employee and individual


Form 1095-C


ACA Electronic Filing

By law, any Applicable Large Employers or Third Party Administrators fling more than 250 forms must file Affordable Care Act information returns electronically. If your business files less 250 forms, you can paper file, although the IRS highly encourages e-filing. Keep in mind that the Affordable Care Act reporting deadline for furnishing Form 1095-C to recipients is March 2nd, less than two weeks away.


ACAwise is a Full-Service ACA Filing Service


Choose the best full-service ACA reporting solution for Applicable Large Employers (ALEs) and Third Party Administrators (TPAs). When you file with ACAwise, you are trusting the most experienced and knowledgeable IRS-authorized software in the industry. Volume-based pricing combined with our US-based ACA experts provide you the best ACA reporting service available.

Flexible pricing is essential for any business, and we guarantee you are getting the best deal on the market today.


Get a Free Volume-Based Pricing Proposal Today!




Read More »