Employer Mandate Reporting Requirements

February 25, 2016  

Employer Mandate reporting for the 2015 tax year has begun. In this article, we will briefly explain the responsibilities of employers of different sizes and in different situations. Reporting is mandatory for large employers with 50 or more full-time equivalent employees. It’s also mandatory for those small employers with less than 50 full-time equivalents that have a self-funded plan.

Business Size Impact

The specific tax forms you need to file depend on the size of your group and what type of health plan you offer.

For small groups with less than 50 full-time equivalent employees, there are no employer mandate reporting requirements under Section 6056 of the Internal Revenue Code.”

Large employers that have a fully-funded health plan, are self-insured, or have no health plan are responsible for filing the 1094-C. This is a tax form that tells the IRS whether the employer provided minimum essential health insurance coverage to its full-time employees.

Large employers with a fully-funded health plan or no health plan must also distribute the 1095-C Parts I-II to each employee working 130+ hours per month and file them with the IRS. Large employers that are self-insured must file and distribute the 1095-C Parts I-III to each employee. The 1095-C tells the IRS and each employee what employer-provide coverage they had or didn’t have throughout the year.

For small groups with less than 50 full-time equivalent employees, there are no employer mandate reporting requirements under Section 6056 of the Internal Revenue Code. However, small employers offering a self-insured health plan do have reporting requirements under Section 6055 of the Internal Revenue Code. In that case, the employer should file a 1094-B with the IRS and the 1095-Bs should be filed and distributed to employees.

The insurance carrier is responsible for filing and distributing the 1094-B and 1095-Bs for small groups that are fully-funded. For small groups that are self-insured, the employer must complete the Form 1094-B and file and distribute a Form 1095-B for each enrolled employee. The insurance carrier maintains responsibility for filing the 1094-B for large groups that are fully-funded and the carrier will also provide a 1095-B to each enrolled employee.  For large groups that are self-insured, the employer should complete the 1094-C and the 1095-Cs Parts I, II, and III.

After considering feedback from private sector businesses and insurers, the IRS has extended the deadlines for reporting 2015 information under the Affordable Care Act.

Employers now have until March 31 (previously before February 1) to provide employees with their Form 1095-C or Form 1095-B.

Additionally, the deadlines for employers to report offers of health coverage to the IRS (Forms 1094-B, 1094-C, 1095-B, and 1095-C) have been extended by three months: The deadline for paper filing (available only to employers submitting fewer than 250 1095-Cs) is now May 31. The deadline for electronic filing (available to all employers) is now June 30.

Again, the deadline extensions apply only to this year. The IRS will still begin accepting reporting in January.

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