As we enter tax season and you prepare your ACA filings with the IRS and state governments we wanted to provide some helpful resources to ensure your business is compliant and will avoid fines.
What Type of organization must comply with the ACA’s Employer Mandate?
Under the ACA’sEmployer mandate, all Applicable Large Employers (ALEs) with at least 50 full time equivalent (FTE) employees must comply with the following:
- Offer Minimum Essential Coverage to at least 95% of their full-time employees and their dependents whereby such coverage meets Minimum Value.
- Ensure that the coverage for the full-time employee is affordable based on one of the IRS-approved methods for calculating affordability
Employer ACA Filing Requirements:
1095-C Forms: Form 1095-C is filed and furnished to any employee of an Applicable Large Employers (ALE) member who is a full-time employee for one or more months of the calendar. ALE members must report that information for all twelve months of the calendar year for each employee.
- All ALEs are required to furnish to their ACA full-time employees a 1095-C Form. The same goes for filing to the IRS and most state governments.
- If an employer provides a self-insured health plan, the ALE must also report on any individuals who is enrolled in the self-insured health plan, including any non-full-time employees and non-employee individuals (ie. spouses & dependents).
1094-C Forms: Form 1094-C summarizes the ALE’s 1095-C information returns as well as details pertaining to the organization, such as EIN, address, point of contact, and certifications of eligibility regarding the health insurance offered for a particular year. Specifically, Form 1094-C includes the following:
- ALE’s address, phone number, employer identification number
- Numbers of full-time and total employees
- Contact person
- How many 1095-C forms are being submitted
- Certifications of Eligibility
- Aggregated ALE Group Members
Substantiating ACA reporting:
Supporting information you’ll likely be required to provide in order to substantiate your filings to the IRS include specific information surrounding your benefits, this information includes:
- Summaries of Benefits of Coverage and Enrollment Guides
- Employee Handbook
- Summary Plan Documents
- Employee Premium Rate Sheets, and/or Acknowledgement of Offer of Coverage
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