What is form 1095 C from a Large Employer?
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is provided by a large employer to employees so they can prove they had coverage for the year or so they can get coverage, if no coverage is provide.
Form 1095-C provides information about the health coverage offered by your employer in 2016 and, in some cases, about whether you enrolled in this coverage. Use Form 1095-C to help determine your eligibility for thepremium tax credit.
- If you enrolled in a health plan in the Marketplace, you may need the information in Part II of Form 1095-C to help determine your eligibility for the premium tax credit.
- If you did not enroll in a health plan in the Marketplace, the information in Part II of your Form 1095-C is not relevant to you.
Use Form 1095-C for information on whether you or any family members enrolled in certain kinds of coverage offered by your employer – sometimes referred to as “self-insured coverage”.
- If Form 1095-C shows coverage for you and everyone in your family for the entire year, check the full-year coverage box on your tax return.
- If there are months when you or your family members did not have coverage, determine if you qualify for anexemption or must make an individual shared responsibility payment.
You don’t need to wait for your Form 1095- C to file your tax return. Do not attach Form 1095-C to your tax return – keep it with your tax records. Contact the issuer if you have questions about your Form 1095-B.
Form 1095-C, Employer-Provided Health Insurance Offer and Coverage Insurance,
provides you with information about the health coverage offered by your employer. In some cases, it may also provide information about whether you enrolled in this coverage. Employers that are required to issue Form 1095-C should furnish it to you by March 31, 2016.
- For questions about your Form 1095-C, contact your employer. See line 10 of Form 1095-C for a contact number. The IRS does not issue and cannot provide you with your Form 1095-C.
- You might not receive a Form 1095-C by the time you are ready to file your 2015 tax return, and it is not necessary to wait for it to file.
- The information on these forms may assist in preparing a return. However you can prepare and file your return using other information about your health insurance.
Eight Things ALEs Should Know about Information Reporting and Health Coverage Offers
The Affordable Care Act requires applicable large employers to file information reporting returns with the IRS and employees. ALEs are generally those employers with 50 or more full-time employees, including full-time equivalent employees in the preceding calendar year. The vast majority of employers are not ALEs and are not subject to this health care tax provision. However, those who are must use Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, and Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, to report the information about offers of health coverage and enrollment in health coverage for their employees. Here are eight things ALEs should know about the information returns they must file at the beginning of 2016.
- Form 1095-C is used to report information about each employee who was a full-time employee of the ALE member for any month of the calendar year.
- Form 1094-C must be used to report to the IRS summary information for each employer, and to transmit Forms 1095-C to the IRS.
- ALEs file a separate Form 1095-C for each of its full-time employees, and a transmittal on Form 1094-C for all of the returns filed for a given calendar year.
- Employers that offer employer-sponsored self-insured coverage use Form 1095-C to report information to the IRS and to employees about individuals who have minimum essential coverage under the employer plan.
- The information reported on Form 1094-C and Form 1095-C is used in determining whether an employer owes a payment under the employer shared responsibility provisions.
- Form 1095-C is used by the IRS and the employee in determining the eligibility of the employee for the premium tax credit.
- An ALE may satisfy this requirement by filing a substitute form, but the substitute form must include all of the information required on Form 1094-C and Form 1095-C and satisfy all form and content requirements as specified by the IRS.
- Forms 1094-C and 1095-C, or a substitute form must be filed regardless of whether the ALE member offers coverage, or the employee enrolls in any coverage offered.
The Time is Here: Reporting Requirements for Applicable Large Employers
Under the health care law, applicable large employers – those with 50 or more full-time employees, including full-time equivalent employees, in the preceding year – are required to report some information regarding health coverage by filing information returns with the IRS and furnishing statements to full-time employees. If you’re an ALE, you report information about health coverage you offered to each full-time employee, or to show that you didn’t offer coverage to the full-time employee. This information will help the IRS determine whether an employer shared responsibility payment applies to your organization and is also used in determining the eligibility of employees for the premium tax credit. Here are some key points about the information reporting requirements under the health care law:
- If you are an ALE, you are required to report certain information to the IRS, as well as to all of your full-time employees, regardless of whether you offer health insurance coverage.
- These ALE reporting requirements are new. Your first information reporting returns are due in 2016 for the year 2015.
- There are new IRS forms that ALEs will use to complete this reporting – Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, and Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns. Form 1094-C is used to report to the IRS summary information and to transmit Forms 1095-C to the IRS. Form 1095-C is used to report information about each full-time employee, and is the form that is furnished to full-time employees.
- If you are an ALE, you are required to furnish each full-time employee with a statement, Form 1095-C, by Jan. 31 of the calendar year following the calendar year to which the information relates. Because Jan. 31, 2016 is a Sunday, the Jan. 31 due date will shift to Feb. 1, 2016. You will meet the requirement if the form is properly addressed and mailed on or before the due date.
- If you are an ALE, you must file the information returns Forms 1094-C and 1095-C with the IRS no later than Feb. 28 – or March 31 if filed electronically – of the year immediately following the calendar year to which the return relates. Because the 2016 deadline falls on a Sunday, the Feb. 28 due date will shift to Feb. 29, 2016.
- Even if you’re an ALE that is not liable for an employer shared responsibility payment because of transition relief, you still have to comply with the information reporting requirements for 2015. You use the reporting forms to communicate to the IRS that you are eligible for transition relief under the employer shared responsibility provisions.
- • If you’re an ALE that sponsors a self-insured group health plan for your employees, you also must report information about employees and their dependents who enroll in the coverage, whether or not the employee is a full-time employee.
How to Report If you file 250 or more information returns during the calendar year, you must file Form 1095-C and Form 1094-C with the IRS electronically. You will meet your requirement to furnish a statement to your full-time employees if you provide each full-time employee with a copy of the Form 1095-C that you file with the IRS. Statements must be furnished to employees on paper by mail or hand delivered, unless the recipient affirmatively consents to receive the statement in an electronic format. For information on using substitute forms and alternative furnishing methods that apply in limited circumstances, see our Questions and Answers about Information Reporting by Employers on Form 1094-C and Form 1095-C and employer reporting requirements. Also, see Publication 5196, Affordable Care Act: Reporting Requirements for Applicable Large Employers.
Understanding Form 1095-C, Employer-Provided Health Insurance Offer and Coverage
Employers with 50 or more full-time employees, including full-time equivalent employees, in the previous year use Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, to report the information required about offers of health coverage and enrollment in health coverage for their employees. Form 1095-C is used to report information about each employee. Employers that offer employer-sponsored self-insured coverage also use Form 1095-C to report information to the IRS and to employees about individuals who have minimum essential coverage under the employer plan and therefore are not liable for the individual shared responsibility payment for the months that they are covered under the plan. An employer must furnish a Form 1095-C to each of its full-time employees by January 31 of the year following the year to which the Form 1095-C relates. Employers will meet the requirement to furnish Form 1095-C to an employee if the form is properly addressed and mailed on or before the due date. If the regular due date falls on a Saturday, Sunday, or legal holiday, employers may file by the next business day. The Form 1095-C that employers send may include only the last four digits of the employee’s social security number, replacing the first five digits with asterisks or Xs. Forms 1095-C must be sent on paper by mail or hand delivered, unless the employee consents to receive the statement in an electronic format. The consent ensures that the employee can access the electronic statement. If mailed, the statement must be sent to the employee’s last known permanent address, or if no permanent address is known, to the employee’s temporary address. Individuals who worked for multiple employers that are required to file Form 1095-C may receive a Form 1095-C from each employer. More information:
- Form 1095-C, Employer-Provided Health Insurance Offer and Coverage
- 2015 Instructions for Forms 1094-C and 1095-C
Resources Available to Help Insurance Providers and Employers Understand ACA Filing Requirements
The IRS will receive and process information returns reporting on individual’s health insurance coverage from insurance companies, self-insured companies, and large businesses and businesses that provide health insurance to their employees. ACA information returns and transmittals are electronically filed through the ACA Information Returns system, also known as AIR. For information regarding the AIR system and filing Affordable Care Act Information Returns go to the Affordable Care Act Information Returns Program webpage. The following resources are available:
- ACA Assurance Testing System / AATS Information
- AIR Program – Did You Know?
- AIR Program Overview
- AIR Schemas and Business Rules
If you encounter an issue or limitation that prevents an information return from being submitted electronically through AIR, and the solution is not posted on IRS.gov for the AIR webpage, call the phone number listed in Publication 5165, Guide for Electronically Filing Affordable Care Act Information Returns for Software Developers and Transmitters. The AIR staff will then work on making the appropriate corrections or which are temporary changes to allow the return to be transmitted electronically.
The IRS will hold the next live ACA AIR webinar for transmitters, software developers, and issuers and payers on November 17, 2016 at 3:00 p.m. EST. See the following page for webinar details and information regarding webinar registration. IRS Health Care Tax Tip 2015-51 provides links to in depth recorded webinars on the information reporting requirements. The ACA Information Returns (AIR) Program webpage can be accessed by typing AIR in the IRS.gov search window. Information about these and other tax provision can be found at IRS.gov/aca. AIR uses Quick Alerts, an IRS e-mail service, to disseminate information quickly regarding AIR issues to subscribers. This service keeps tax professionals up to date on AIR issues throughout the year.
Lecture on filling out 1095 C