Confirmation of Employer & Non Covered CA Minimum Essential Coverage Coverage #1095 B

1095 B IRS Website FAQ’s to get most recent forms, regulations  & Instructions – So much of the ACA – Affordable Care Act is quite complex with rules changing all the time.  Please be sure you follow the links to the citation for the original source to make sure you have the latest information.  We are not attorney’s nor tax counsel.

What to Know About Health Coverage Information Statements You May Receive in 2017

Many individuals will receive ACA information statements from their employer or coverage provider by early March in 2017 about their 2016 health insurance coverage:

• Form 1095-B, Health Coverage
• Form 1095-C, Employer-Provided Health Insurance Offer and Coverage
• Here is information about these forms:

1095-B
Sent to	Individuals who had health coverage for themselves or their family members that is not reported on Form 1095-A or Form1095-C.
Sent by	Health Coverage Providers – Insurance companies outside the Marketplace Government agencies such as Medicare or CHIP Employers who provide certain kinds of health coverage, which is sometimes referred to as “self-insured coverage,” but are not required to send Form1095-C. Other coverage providers
What to do with This Form	This form provides information about your 2016 health coverage.   Use Form 1095-B for information on whether you and your family members had health coverage that satisfies theindividual shared responsibility provision.   If Form 1095-B 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- B to file your tax return. Do not attach Form 1095-B to your tax return – keep it with your tax records. Contact the issuer if you have questions about your Form 1095-B.  Source   HCTT-2016-81   IRS bulletin dated 12.21.2016

1095 B forms

May request Social Security #‘s

FAQ’s

Talking Points Minimum Essential Reporting

Minimum Essential Coverage

Draft IRS form as of 8.6.2015

Health Net Explanation

Kaiser Permanente 6 page pdf on Minimum Essential Reporting 8.2015

Deadline Extended for employers to send B & C,  IRS says you can file your 1040 without it  – Insure Me Kevin.com

 

 

Questions and Answers to Help Your Organization Understand ACA Reporting Requirements

The IRS has a series of Questions and Answers that helps employers understand the Affordable Care Act reporting requirements that apply to them.

The health care law requires applicable large employers to file information returns with the IRS and provide statements to their full-time employees about the health insurance coverage the employer offered.  An applicable large employer is an employer that employed an average of at least 50 full-time employees on business days during the preceding calendar year.

Here are three questions and answers that address specific situations that might apply to your organization.

Is an ALE member that sponsors a self-insured health plan required to file Form 1094-C and Form 1095-C if the ALE member has no full-time employees?

Generally, yes.  An ALE member that sponsors a self-insured health plan in which any employee or employee’s spouse or dependent has enrolled is required to file Form 1094-C and Form 1095-C, whether or not that employer has any full-time employees and whether or not that individual is a current employee or a full-time employee. For an individual who enrolled in coverage who was not an employee in any month of the year, the employer may file Forms 1094-B and 1095-B for that individual.

Is an employer that is not an ALE member required to file under the Affordable Care Act if the employer sponsors a self-insured health plan that provides minimum essential coverage?

No; however, such an employer is subject to the reporting obligations under the Affordable Care Act. An employer that is not an ALE member that sponsors a self-insured health plan in which any individual has enrolled is not subject to the reporting requirements of ACA. Such an employer will generally satisfy its reporting obligations by filing Form 1094-B and Form 1095-B.

Is an ALE member required to report under the Affordable Care Act with respect to a full-time employee who is not offered coverage during the year? 

Yes.  An ALE member is required to report information about the health coverage, if any, offered to each of its full-time employees, including whether an offer of health coverage was – or was not – made. This requirement applies to all ALE members, regardless of whether they offered health coverage to all, none, or some of their full-time employees.  For each of its full-time employees, the ALE member is required to file Form 1095-C with the IRS and furnish a copy of Form 1095-C to the employee, regardless of whether or not health coverage was or was not offered to the employee. Therefore, even if an ALE member does not offer coverage to any of its full-time employees, it must file returns with the IRS and furnish statements to each of its full-time employees to report information specifying that coverage was not offered.

For the full list of questions and answers about reporting requirements for employers, see our Reporting Offers of Health Insurance Coverage by Employers page on IRS.gov/aca. The IRS website is also the place to find questions and answers for a wide range of ACA topics for individuals, employers and other organizations.

Understanding Your Form 1095-B, Health Coverage

Form 1095-B, Health Coverage, is used to report certain information to the IRS and to taxpayers about individuals who are covered by minimum essential coverage and therefore aren’t liable for the individual shared responsibility payment.

Minimum essential coverage includes government-sponsored programs, eligible employer-sponsored plans, individual market plans, and other coverage the Department of Health and Human Services designates as minimum essential coverage.

By January 31, 2016, health coverage providers should furnish a copy of Form 1095-B, to you if you are identified as the “responsible individual” on the form.

The “responsible individual” is the person who, based on a relationship to the covered individuals, the primary name on the coverage, or some other circumstances, should receive the statement. Generally, the recipient should be the taxpayer who would be liable for the individual shared responsibility payment for the covered individuals. A recipient may be a parent if only minor children are covered individuals, a primary subscriber for insured coverage, an employee or former employee in the case of employer-sponsored coverage, a uniformed services sponsor for TRICARE, or another individual who should receive the statement. Health coverage providers may, but aren’t required to, furnish a statement to more than one recipient.

The Form 1095-B sent to you may include  only the last four digits of your social security number or taxpayer identification number, replacing the first five digits with asterisks or Xs. In general, statements must be sent on paper by mail or hand delivered, unless you consent to receive the statement in an electronic format.  The consent ensures that you will be able to access the electronic statement. If mailed, the statement must be sent to your last known permanent address, or, if no permanent address is known, to your temporary address.

Additional information about minimum essential coverage and the individual shared responsibility provision is at IRS.gov/aca.

More information:

• Form 1095-B, Health Coverage
• 2015 Instructions for Form 1094-B and 1095-B

 

Eight Facts for ALEs about New Information Statements to be Filed in 2016

The Affordable Care Act requires applicable large employers to file:

• Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns
• Form 1095-C, Employer-Provided Health Insurance Offer and Coverage

Here are eight basic facts for employers:

• The due date for furnishing these forms is extended.
  • The due date for furnishing the 2015 Form 1095-B and the 2015 Form 1095-C to the insured and employees is extended from February 1, 2016, to March 31, 2016.
  • The due date for health coverage providers and employers furnishing the 2015 Form 1094-B and the 2015 Form 1094-C to the IRS is extended from February 29, 2016, to May 31, 2016 if not filing electronically.
  • The due date for health coverage providers and employers electronically filing the 2015 Form 1094-B and the 2015 Form 1094-C with the IRS is extended from March 31, 2016, to June 30, 2016.

While the IRS is prepared to accept information reporting returns beginning in January 2016 and employers and other coverage providers are encouraged to furnish statements and file the information returns as soon as they are ready.

• An ALE is required to file Form 1094-C with the IRS; however, an ALE is not required to furnish a copy of Form 1094-C to its full-time employees.
• Generally, an ALE must file Form 1095-C or a substitute form for each employee who was a full-time employee for any month of the calendar year.
• In addition, an ALE that sponsors a self-insured plan must file Form 1095-C for each employee who enrolls in the self-insured health coverage or enrolls a family member in the coverage, regardless of whether the employee is a full-time employee for any month of the calendar year.
• Form 1095-C is not required for the following employees, unless the employee or the employee’s family member was enrolled in a self-insured plan sponsored by an ALE member:
  • An employee who was not a full-time employee in any month of the year
  • An employee who was in a limited non-assessment period for all 12 months of the year.
• If an ALE member sponsors a health plan that includes self-insured options and insured options, the ALE member should complete Part III of Form 1095-C only for employees and family members who enroll a self-insured option.
• An ALE member that offers coverage through an employer-sponsored insured health plan and does not sponsor a self-insured health plan should NOT complete Part III.
• An ALE may provide a substitute Form 1095-C; however, the substitute form must include the information on Form 1095-C and must comply with generally applicable requirements for substitute forms.

For more information, see the Instructions for Forms 1094-C and 1095-C and these additional Questions and Answers.

 

Recently, the IRS extended the information reporting due dates for insurers, self-insuring employers, other health coverage providers and applicable large employers. This chart can help you understand the filing requirements and the extended 2016 deadlines.

Action	Reporting Due Dates in 2016 for…
	Applicable Large Employers – Including Those That Are Self-Insured	Self-insured Employers That Are Not Applicable Large Employers	Coverage Providers – Other Than Self-Insured Applicable Large Employers*
Provide 1095-B to responsible individuals	Not Applicable**	Mar. 31	Mar. 31
File 1094-B and 1095-B with the IRS	Not Applicable **	Paper: May 31 E-file: June 30*	Paper: May 31 E-file: June 30*
Provide 1095-C to full-time employees	Mar. 31	Not Applicable	Not Applicable
File 1095-C and 1094-C with the IRS	Paper: May 31 E-file: June 30*	Not Applicable	Not Applicable

*If you file 250 or more Forms 1095-B or Forms 1095-C, you must electronically file them with the IRS. Electronically filing ACA information returns requires an application process separate from other electronic filing systems. Additional information about electronic filing of ACA Information Returns is on the Affordable Care Act Information Reporting (AIR) Program page on IRS.gov and in Publications 5164 and 5165.

**Applicable large employers that provide employer-sponsored self-insured health coverage to non-employees may use either Forms 1095-B or Form 1095-C to report coverage for those individuals and other family members.

This chart applies only for reporting in 2016 for coverage in 2015. In future years, the due dates will be different; see IRS Notice 2016-04 for information about these dates.

 

Other Pages in this section

Forms that Employers must provide to employees

Questions and Answers on Information Reporting by Health Coverage Providers (Section 6055) IRS Website

Our Webpage on 6055 & 6056 Reporting Requirements

• 1095 C Large Employer Coverage
• Confirmation of Employer & Non Covered CA Coverage #1095 B