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ACA Filing Requirements

Filing Requirements for Forms 1095-C and 1095-B

Employers with 50 or more full-time employees (including FTEs – Full-time Equivalent Employees) and all self-insured employers regardless of size must report their health care coverage information to their employees and the IRS. Applicable Large Employers (ALE) (those that employ 50 or more full-time employees) are required to report under section 6056.

A full-time employee generally includes any employee who was employed on average for at least 30 hours of service per week for more than 120 days in a year. It is interesting to note that using these guidelines, you may have less than 50 full-time employees, but you may meet the requirements for ACA reporting. For example, if you had three employees – who each worked for 120 days one after the other for at least 30 hours per week, they will be counted as three FTEs instead of as one employee. We suggest that you use the Full-time Equivalent Calculator provided by Healthcare.gov to help determine your filing obligations.

Further information about ALE- Applicable Large Employer and Employer Shared Responsibility is provided by the IRS and can be found here.

If you are an insurance company or business that is required to report health care coverage, you will need to file one of the two form types with the IRS.

Form 1095-C and 1094-C

Under IRC Section 6056, starting in January 2015, large employers (those with 50 or more full-time employees, including FTEs) are required to provide Form 1095-C (employee statement) to each of their employees and send a 1094-C (transmittal) to the IRS. Form 1095-C and the transmittal 1094-C require specific information on the employees’ (and their dependents’, if applicable) insurance coverage. The forms include data such as Tax Id (TIN or EIN), address, full-time status, length of employees’ full-time status, proof of minimal essential coverage offered, coverage dates and employee’s share of coverage premium costs.

For further information about section 6056 reporting requirements see the Instructions for Forms 1095-C and 1094-C.

Form 1095-B, and 1094-B

Under IRC Section 6055, starting in January 2015, insurance companies (self-insured employers) are required to provide Form 1095-B to the individuals covered and to send Form 1094-B (transmittal) to the IRS. Form 1095-B and the transmittal 1094-B need specific information on the employee’s (and their dependents’, if applicable) insurance coverage. The forms include data such as Tax Id (TIN or EIN), address, and period of coverage.

For further information about section 6055 reporting requirements see the instructions for Forms 1095-B and 1094-B.

Forms 1095-C and 1095-B can be filed on paper or electronically with the IRS. However, businesses having more than 250 forms, must e-file with the IRS.

Currently, there are no state reporting requirements associated with the 195-C and 1095-B.

For employers and employees who do not comply with the ACA reporting requirements, penalties will be imposed.

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