The Internal Revenue Service has finalized the forms and instructions for reporting information necessary for enforcement of the individual and employer mandates under sections 6055 and 6056 of the Internal Revenue Code. The forms and instructions are very similar to the drafts previously issued by the IRS but clarify several specific points, such as:
- The treatment of newly hired employees who are expected to work full-time hours, but have not yet become eligible for coverage. They are not treated as full-time during the applicable grace period known as the “non-assessment period.”
- A large, self-funded employer’s option to report coverage for non-employees, including retirees, COBRA participants, and outside directors, using either Forms 1094-B and 1095-B or Forms 1094-C and 1095-C.
- The need for employers in the same controlled group to coordinate which one will report for an employee who works for both of them in the same month.
The forms apply to health plan providers and employers voluntarily reporting for the 2014 year. Mandatory reporting will not be required until early next year, when reports for 2015 are due. The IRS will need to publish forms for 2015; it is expected that they will include very few changes and hoped that publication will occur well before the end of this year.
The forms and instructions now include:
- Form 1095-A for health insurance exchanges to report on individual coverage (finalized earlier)
- Form 1094-B for health plan providers to transmit Form 1095-B
- Form 1095-B for health plan providers to report on coverage provided to individuals under section 6055 (for individual mandate)
- Form 1094-C for large employers to transmit Form 1095-C
- Form 1095-C for large employers to report coverage provided to individuals under section 6056 (for employer mandate)
- Instructions for Forms 1094-B and 1095-B
- Instructions for Forms 1095-C and 1095-C
As the federal health care reform effort gained steam, Ballard Spahr attorneys established the Health Care Reform Initiative to monitor and analyze legislative developments. With federal health care reform now a reality, our attorneys are assisting health care entities and employers in understanding the relevant changes and planning for the future. They also have launched the Health Care Reform Dashboard, an online resource center for news and analysis on developments under the Affordable Care Act.
If you have questions about reporting requirements under the Affordable Care Act, contact Edward I. Leeds at 215.864.8419 or leeds@ballardspahr.com or any other member of our Employee Benefits and Executive Compensation Group.