Full Service ACA Support
ACA Filing Requirements
Applicable Large Employers (ALE) 50+ Full time Employees
Self-Insured Employers regardless of size
Forms to be Filed
– 1095-C Large Employer Group (50+) Employee Coverage Statement
– 1094-C Large Employer Reporting Transmittal to IRS
– 1095-B Self Insured Employee Statement to individuals covered
– 1094-B Self Insured Employer Reporting Transmittal to IRS
Filing Requirements for Forms 1095-C and 1095-B
Employers with 50 or more full-time employees (including FTEs – Full-time Equivalent Employees) and all self-insured employers regardless of size must report their health care coverage information to their employees and the IRS. Applicable Large Employers (ALE) (those that employ 50 or more full-time employees) are required to report under section 6056.
A full-time employee generally includes any employee who was employed on average for at least 30 hours of service per week for more than 120 days in a year. It is interesting to note that using these guidelines, you may have less than 50 full-time employees, but you may meet the requirements for ACA reporting. For example, if you had three employees – who each worked for 120 days one after the other for at least 30 hours per week, they will be counted as three FTEs instead of as one employee.
Further information about ALE- Applicable Large Employer and Employer Shared Responsibility is provided by the IRS and can be found here.
If you are an insurance company or business that is required to report health care coverage, you will need to file one of the two form types with the IRS.
Form 1095-C and 1094-C
Under IRC Section 6056, starting in January 2015, large employers (those with 50 or more full-time employees, including FTEs) are required to provide Form 1095-C (employee statement) to each of their employees and send a 1094-C (transmittal) to the IRS. Form 1095-C and the transmittal 1094-C require specific information on the employees’ (and their dependents’, if applicable) insurance coverage. The forms include data such as Tax Id (TIN or EIN), address, full-time status, length of employees’ full-time status, proof of minimum essential coverage offered, coverage dates, and employee’s share of coverage premium costs.
For further information about section 6056 reporting requirements see the Instructions for Forms 1095-C and 1094-C.
Form 1095-B, and 1094-B
Under IRC Section 6055, starting in January 2015, insurance companies (self-insured employers) are required to provide Form 1095-B to the individuals covered and to send Form 1094-B (transmittal) to the IRS. Form 1095-B and the transmittal 1094-B need specific information on the employees (and their dependents’, if applicable) insurance coverage. The forms include data such as Tax Id (TIN or EIN), address, and period of coverage.
For further information about section 6055 reporting requirements see the instructions for Forms 1095-B and 1094-B.
Forms 1095-C and 1095-B can be filed on paper or electronically with the IRS. However, businesses having more than 250 forms, must e-file with the IRS.
Currently, there are no state reporting requirements associated with the 1095-C and 1095-B.
For employers and employees who do not comply with the ACA reporting requirements, penalties will be imposed.
ACA Penalties and State Mandates
The ACA’s individual coverage mandate, which required adults in the U.S. to show they had ACA-compliant coverage, was effectively repealed as of January 2019, when tax legislation reduced the penalty for not having health insurance to zero.
The requirement to furnish employees with 1095 forms annually was not eliminated, and employers that fail to do so could be subject to the $280 per form IRS penalties.
Filing Deadline : The Clock is Ticking
ACA Requirements & Deadlines
Jan 31 (extended to March 2) : 1095 Forms delivered to Employees
Feb 28 : Paper Filing with IRS*
March 31 : Electronic Filing with IRS
Leveraging Our Partnership with Employee Navigator and NELCO to bring you Streamlined ACA Support Since 2015
Full Service : Support & Filing of 1095-C Forms
- Discovery Call Scheduled to obtain general information and to review templates needed for collection Data
- BBS uploads all data required for form filing and generates the form data
- BBS will assist the employer with troubleshooting and resolving any un-affordable /non qualifying offers prior to filing
- Employer audits all data
- BBS completes the filing on behalf of the client
- BBS makes PDF copies of the forms and data available to the client
- BBS will monitor Nelco for rejections and work with the client to assist in resolving rejections and issues
- BBS pays the Nelco cost when filing and re-filing. BBS will bill the client for any forms that need to be re-filed
Annual Setup Fee : $750
Per Form Filing Costs starting as low as $3.54 per form (fees are based on group size)