Employer Reporting Requirements of Health Coverage & Other Guidance on ACA

On March 10, 2014, the IRS published final regulations on various reporting requirements for employers and health insurance issuers.  These reporting requirements, originally set to become effective for 2014 but delayed along with the employer shared responsibility requirements mid-2013, are applicable for the 2015 calendar year.

The regulations under Code section 6056, which outline the reporting requirements by applicable large employers (generally employers with at least 50 full-time employees, including full-time equivalent employees) offering health coverage under employer sponsored plans, can be found by clicking HERE.

As set forth in the summary: “Section 6056 requires [applicable large] employers to report to the IRS information about the health care coverage, if any, they offered to full-time employees, in order to administer the employer shared responsibility provisions of section 4980H of the Code.  Section 6056 also requires those employers to furnish related statements to employees that employees may use to determine whether, for each month of the calendar year, they may claim on their individual tax returns a premium tax credit under section 36B (premium tax credit).

Information reporting of minimum essential coverage is also required by health insurance issuers and others, including certain employers, under Code section 6055.  These final regulations, also published on March 10th, are found at this LINK.

As set forth in its summary: “Health insurance issuers, certain employers, and others that provide minimum essential coverage to individuals must report to the IRS information about the type and period of coverage and furnish the information in statements to covered individuals.”

The fact sheet describing the above reporting requirements issued by the Treasury Department is accessible at by clicking HERE.

Significantly, for applicable large employers who self-insure and are subject to reporting under both Code section 6055 and 6056, the final regulations have streamlined the process and allow for a single, consolidated form for information reporting.  There is also a “simplified option” for reporting for employers that provide a “qualifying offer” of coverage to their full-time employees.

Last, CMS has issued an extension of the health insurance transition policy through October 1, 2016, which allows certain employers in the small group market, as well as individuals, to renew policies (if permitted by applicable State authorities and if allowed by the health insurer), without penalty through the transition period even if they are not compliant with the ACA.  The transition policy can be found by clicking HERE.

For more information on this issue, please contact Elizabeth H. Latchana at 517.377.0826 or elatchana@fraserlawfirm.com.