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November 5, 2015

Affordable Care Act – November 2015 Update - New Filing Requirements

In past e-mail updates we have alerted you to general requirements of the Affordable Care Act that went into effect in 2015 and what the repercussions could be for non-compliance.  Now we would like to keep you up to date and prepared for the new reporting requirements that you may have to fulfill at the end of this year.

The IRS has created two new forms, 1095-B and 1095-C (along with their transmittal forms the 1094-B and 1094-C) which are due on February 28 of the year following the year being reported (Forms for calendar year 2015 are due on February 28, 2016).  Electronically filed forms are given an extra month for compliance and are not due until March 31.  As with Forms W-2 and 1099-MISC, which you are all familiar with, individual recipients must receive their copy of the form no later than January 31.  A penalty of up to $200 per form will be charged for failing to provide these forms to the recipients. 

Forms 1095-B and 1094-B: 

If you are providing your employees with group health insurance, either because you are required to, or just because you have always provided benefits to your employees, the Form 1095-B and 1094-B should be prepared for you by your health insurance provider.  The forms will report the covered employee’s name, address, social security number and date of birth as well as the same information for any family members covered by the plan.  Employees who opt out of coverage are not reported on this form. 

Form 1095-C and 1094-C: 

Applicable Large Employers are required to file these forms for all employees whether they participate in the plan or not.  Additionally, part-time employees who participate in the plan must be reported as well.  Please keep in mind that while Applicable Large Employer has been redefined, for the year 2015, as an employer with 100 or more full-time employees for purposes of the Employer Shared Responsibility Penalty, it is still defined as an employer with 50 or more full-time employees for purposes of being required to file this form. 

Important Things to Consider: 

As with so many other aspects of the Affordable Care Act there are serious penalties imposed by the law for failure to comply.  Most of the information needed should already be on file with both your payroll service provider and insurance carrier but even if it is they need to be aware that you expect them to prepare and file these forms on your behalf.  Many of these providers are not doing so automatically and many have very strict and fast approaching deadlines to enroll in their services for preparing these forms.  Now is the time for you to take an active role in determining what compliance reports need to be filed and who will be filing them.  We suggest that you contact your payroll service provider and insurance carrier immediately to see what steps they are taking to insure your compliance with these filing requirements. 

If you have general questions about the Affordable Care Act, any information provided in this message or suggestions for a future update on this subject please contact Arthur Schwartzman (aschwartzman@wiss.com), Mike Bodrato (mbodrato@wiss.com), or Andrew Goldstein (agoldstein@wiss.com) at (212) 594-8155 or (973) 994-9400.