The IRS has finalized the 2015 forms and instructions for reporting under the individual and employer mandates and issued additional guidance on these new reporting requirements.

Forms and Instructions. The following forms are now available:

The new forms and instructions closely adhere to drafts published earlier this year with a few clarifications. For example:

  • If an employer offers a health reimbursement account to employees who enroll in its insured health plan, the employer is no longer required to report on coverage under the HRA, as the rules previously suggested. A similar exception applies in certain other situations where the availability of one type of minimum essential coverage is contingent on enrollment in another.
  • An offer of COBRA coverage on termination of employment is no longer to be reported as an offer of coverage on Form 1095-C, even if the terminated employee actually enrolls under COBRA.
  • A new option for reporting the total number of employees on Form 1094-C is available; this option allows employers to take a snapshot on the 12th day of each month.
  • When Form 1094-B is provided to individuals (but not to the government), the employer identification number may be truncated.
  • A new box on Form 1095-C has been added to indicate when the plan year starts (completion of this box is optional for 2015).

Together with the final forms and instructions, the IRS has published guidance (some still in draft form) relating to the reporting requirements, including:

  • A new notice heralding regulations that are soon to be proposed under Section 6055-B, regarding the reporting of coverage under the individual mandate. Some of those proposals reflect matters included in the instructions for 2015 (described above), but they address other matters as well. For example, allowing statements to individuals participating in expatriate health plans to be provided electronically unless the individual affirmatively refuses to consent to electronic delivery or requests a paper statement. The Notice also provides temporary guidance on when a reporting entity may provide a current enrollee’s birthdate in lieu of a Social Security number by making certain solicitations for the Social Security number.
  • IRS Publications 5164 and 5165, which include information on electronic reporting under the Affordable Care Act Information Return System (the AIR System), including information on registration, application for a Transmitter Control Code, and testing. Registration and the TCC applications are available now. Testing for 2015 is scheduled to become available in early November.
  • IRS Publication 5223 on the requirements for substitute forms and statements that may be used to meet the reporting requirements.

The IRS has also announced the introduction of a new website, ACA Information Center for Applicable Large Employers, specifically designed to provide guidance for applicable large employers, which are subject to the employer mandate and related reporting requirements under the Internal Revenue Code.

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 this alert or other aspects of the ACA reporting requirements, contact Edward I. Leeds at 215.864.8419 or or another member of our Employee Benefits/Executive Compensation Practice Group.