ACA EMPLOYER Reporting Requirements

Last week (March 5, 2014), the IRS and the Department of Treasury (DOT) released FINAL rules related to some very important Affordable Care Act (ACA) requirements addressing health insurance plan reporting.  These reporting requirements (originally set to take effect at the end of this year, but delayed one year along with the employer mandate) affect employers with 50 or more full-time employees (including full-time equivalents) starting in early 2016 for plans in force during the 2015 calendar year (regardless of anniversary or ERISA plan date).   Reporting is voluntary for 2014/2015, although it might not be a bad idea to consider a “dry run” in preparation for the 2016 requirement. This week’s blog provides a very general overview of the final rules and their impact on what the rules refer to as ALE’s or applicable large employers, which again, are those with 50 or more FT or FTE’s.

There are two levels of reporting: 1. health insurance coverage offerings; and 2. minimum essential coverage (sometimes referred to as MEC), both of which impact a number of ACA conditions such as employer shared responsibility, individual mandate, and employee eligibility for income tax credits.  In other words, a “paper trail” for ACA compliance on a number of levels/provisions relating to both the “IF” and “WHAT” of coverage.  These sections are identified by DOT as sections 6055 and 6066, both reportable on IRS form 1095-C, which we will all become familiar with in time.

DOT/IRS sought to “simplify” the reporting of duplicate information that must be provided to both the IRS and affected employees through the establishment of a “streamlined process”.  In other words, all employees listed on an employer’s IRS report must receive a duplicate copy of the statement provided to the IRS.  This would apply to both of the aforementioned levels of reporting (i.e., coverage offered and MEC), so two (2) sets of IRS and employee reports/statements.

The yet to be provided IRS forms will include information to be collected/reported by employers such as:

  • employer contact information
  • number of full-time employees
  • the premium cost of the lowest cost option for “employee only” coverage, that meets the minimum value criteria
  • detailed information relative to each full-time employee offered coverage; and information collected/reported by insurers/third party administrators such as:
  • contact and other information relative to the insurer or entity providing coverage
  • enrolled individuals – identifying information and the months in which they are/were enrolled

Included in the IRS/DOT release are “special rules” intended to further simplify the reporting process, and provide transitional relief, which I believe most employers will be able to utilize to their benefit.  Once the forms have been released by the IRS, I will provide a follow up blog post that includes more detail on these special rules, in addition to links to the forms.  Readers that don’t want to wait for this post can access a DOT Fact Sheet here –

In closing this week’s post, I want to address two more issues:
Electronic Statements – the regulations allow employee statements to be provided electronically, IF employees agree in writing to receive them electronically; and
Reporting/Statement Due Dates – the first reports to the IRS are required no later than March 1, 2016 for 2015 calendar year coverage (again, regardless of anniversary or ERISA plan date).  If employers opt to file electronically, the due date is no later than March 31, 2016.
The first employee statements are required no later than January 31, 2016 for the 2015 calendar year. Again, employers are “encouraged” to voluntarily report coverage information in 2015 (presumably with the same dates as above) for the 2014 calendar year.