IRS Reporting on Individual and Employer Mandates under the ACA

The IRS has released the final forms and instructions under sections 6055 and 6056 for applicable large employers (‘ALEs’), insurers and employers with self-insured health plans for reporting on individual and employer mandates under the Affordable Care Act (ACA). The first reporting is required in early 2016 for the 2015 calendar year. (Employers had the option to voluntarily report their 2014 information in January 2015.)

The instructions provide an overview of why the forms/reporting are required. They also cover basic information such as who must complete the forms, how the transmittal forms need to accompany the 1095-B or 1095-C Forms, where to mail the forms (electronic info is forthcoming), definitions of various terms used in the reporting data and information on transitional relief for off-calendar year plans.

There are two forms required for each set of information being reported: 1) a transmittal form that serves as a cover letter; and 2) forms providing data on either the individual or employer mandate, or both for self-insured employer sponsors. The instructions and respective forms to be completed and filed can be found on the IRS website. This chart can help you determine your reporting type, how to report, and which IRS forms you will need.

The intent of the above is to provide general information regarding the provisions of current healthcare reform legislation and regulation. It does not necessarily fully address all issues. It should not be construed as, nor is it intended to provide, legal advice. Your organization’s general counsel or an attorney who specializes in this practice area should address questions regarding specific issues.