IRS 6055 and 6056 Employer Reporting Requirements
for ACA Obamacare
The Affordable Care Act (ACA) added Section 6056 to the Internal Revenue Code (IRC) requiring annual information reporting to the Internal Revenue Service (IRS) by applicable large employers with fully insured plans relating to the health insurance that the employer offers (or does not offer) to full-time employees and their dependents.
Section 6055 requires annual information reporting to the IRS by health insurance issuers, employers with self-insured plans, government agencies, and other providers of health coverage.
Health Net Bulletin on 6055 MEC Minimum Essential Coverage
Our Webpage on 1095 C form to be give to employees
Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage
Visit our webpage on Minimum Essential Coverage
What forms must employers complete to comply with ObamaCare?
W-2 Federal Wage and Tax Statement to employees, must include value of Health Insurance Benefits if over 250 employees
Summary of Benefits – Generally 12 pages of standardized coverage language to make benefits more understandable.
Guidance for Notice to Employees of Coverage Options
(DOL #2013-02 6 Pages)
Don’t offer – 2 Pages
Slides from NAIFA Seminar on Reporting
- Plain Meaning Rule – Read the statute or policy 3 times
- COBRA – Right to Keep your Employer Group Health Coverage
- Employer Credible Coverage Part D
- Mental Health – An Essential Benefit
- Dual Coverage – Who pays 1st? Collect Twice?
- ERISA Employee Retirement Income Security Act — 1974
- Covered CA Appeals
- Last Minute Application? When does coverage start?
- Medical Necessity – reasonable and necessary
Blue Cross Administrative, Renewal & Wellness Tools
Health Net Administrative, Wellness & Renewal Tools
W -2 Must show dollar benefit of Health Insurance
The premiums are still NOT taxable as income to the employee and a deduction for the employer (IRC 106), the purpose is to provide useful and comparable information to employees on the cost of their health care coverage. (Notice 2012-9, Q&A2).
Consumer Resources & Links
How to file W-2 online #10033 (Small Biz?)
IRS Questions and Answers that helps employers
The health care law requires applicable large employers to file information returns with the IRS and provide statements to their full-time employees about the health insurance coverage the employer offered. An applicable large employer is an employer that employed an average of at least 50 full-time employees on business days during the preceding calendar year.
Here are three questions and answers that address specific situations that might apply to your organization.
Is an ALE member that sponsors a self-insured health plan required to file Form 1094-C and Form 1095-C
if the ALE member has no full-time employees?
Generally, yes. An ALE member that sponsors a self-insured health plan in which any employee or employee’s spouse or dependent has enrolled is required to file Form 1094-C and Form 1095-C, whether or not that employer has any full-time employees and whether or not that individual is a current employee or a full-time employee. For an individual who enrolled in coverage who was not an employee in any month of the year, the employer may file Forms 1094-B and 1095-B for that individual.
Is an employer that is not an ALE member required to file under the Affordable Care Act
if the employer sponsors a self-insured health plan that provides minimum essential coverage?
No; however, such an employer is subject to the reporting obligations under the Affordable Care Act. An employer that is not an ALE member that sponsors a self-insured health plan in which any individual has enrolled is not subject to the reporting requirements of ACA. Such an employer will generally satisfy its reporting obligations by filing Form 1094-B and Form 1095-B.
Is an ALE member required to report under the Affordable Care Act
with respect to a full-time employee who is not offered coverage during the year?
Yes. An ALE member is required to report information about the health coverage, if any, offered to each of its full-time employees, including whether an offer of health coverage was – or was not – made. This requirement applies to all ALE members, regardless of whether they offered health coverage to all, none, or some of their full-time employees. For each of its full-time employees, the ALE member is required to file Form 1095-C with the IRS and furnish a copy of Form 1095-C to the employee, regardless of whether or not health coverage was or was not offered to the employee. Therefore, even if an ALE member does not offer coverage to any of its full-time employees, it must file returns with the IRS and furnish statements to each of its full-time employees to report information specifying that coverage was not offered.
For the full list of questions and answers about reporting requirements for employers, see our Reporting Offers of Health Insurance Coverage by Employers page on IRS.gov/aca. The IRS website is also the place to find questions and answers for a wide range of ACA topics for individuals, employers and other organizations.
Affordable Care Act Information Reporting (AIR) Program page on IRS.gov and in Publications 5164 and 5165.
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