Time to Prepare for ACA Reporting in 2019
The IRS has published final forms and instructions to help employers prepare for next year's reporting on the health coverage they offered employees in 2018.
Employers subject to the Affordable Care Act (ACA) must distribute reporting forms to employees and file with the IRS early in 2019.
"The release of these documents is another clear message from the IRS that it's continuing to enforce the reporting requirements," said benefits attorney Arthur Tacchino, a principal with compliance firm SyncStream Solutions.
Below are links to the final forms and instructions on the IRS website:
- Form 1095-B, Health Coveage.
- Transmittal Form 1094-B to accompany Form 1095-B.
- Instructions for Forms 1094-B and 1095-B.
- Form 1095-C, Employer-Provided Health Insurance Offer and Coverage.
- Transmittal Form 1094-C to accompany Form 1095-C.
- Instructions for Forms 1094-C and 1095-C.
"The good news for employers is that there are no substantive changes to the forms from the prior year," Tacchino said. But given the complexity of Form 1095-C reporting, "employers should be ensuring they are on top of their data as the 2018 calendar year comes to a close."
"The focus for most employers should continue to be on accurate, timely gathering of the required data for reporting," said Kim Buckey, vice president of client services at DirectPath, a benefits education, enrollment and health care transparency firm.
The critical 2019 filing deadlines regarding 2018 coverage are as follows:
|1095 forms delivered to employees||Jan 31|
|Paper filing with IRS||Feb 28|
|Electronic filing with IRS||Apr 1|
Employers that file 250 or more information returns with the IRS must file the returns electronically.
It's unlikely that the IRS will provide an extension to the Jan. 31 deadline, as an extension was not given in 2018, Buckey said. "Employers can save themselves time, money and effort by carefully reviewing the data before year-end to ensure that full-time employees are correctly identified, and that the company is designing its programs to offer affordable coverage to all full-time employees."
Such preparation will reduce the risk of receiving penalty letters and paying assessments.
Not Just ALEs
With Form 1094-C, applicable large employers (ALEs)—those with, on average, 50 or more full-time employees or part-time equivalents during the preceding calendar year—show proof of compliance with the ACA's employer shared-responsibility mandate. ALEs use Form 1094-C to report whether they offered affordable health coverage and enrollment in minimum essential coverage for eligible employees.
"Come tax day 2019, employees must show whether they or their family members had minimum essential coverage on Line 61 of their individual tax returns," said John Duval, president and CEO of Fuse Workforce Management, a compliance software firm. "Form 1095-C helps employees complete their individual tax returns by providing important information regarding their health coverage for the previous calendar year."
Small employers with fewer than 50 full-time employees are exempt from most ACA reporting requirements but not all, the IRS points out. For example, self-insured small employers must complete and file Forms 1095-B and 1094-B (the transmittal form) with the IRS, as well as provide full-time employees with a copy of Form 1095-B.
Small employers also are required to file Forms 1095-C and 1094-C if they are members of acontrolled or affiliated service group that collectively has at least 50 full-time employees.
Employer Shared Responsibility
Employers not in compliance with the coverage provisions are subject to the ACA's employer penalty provisions, which apply if an ALE fails to offer minimum essential coverage.
To prepare for ACA reporting, the IRS advises ALEs to:
- Identify full-time employees based on the ACA definition of full time (those who average 30 hours of work per week in one month), considering special classifications such as staffing employees, independent contractors, temporary or short-term employees, and even interns.
- Assess whether the monthly measurement method or look-back measurement method to determine full-time status is best, based on the nature of the company's workforce.
- Update plan documents and summary plan descriptions if necessary for the measurement method selected.
- Determine the appropriate safe harbor the company will use for the affordability calculation: W-2, rate of pay or federal poverty line.
An IRS Q&A provides more information on 1095 filing requirements.
Penalty Letters Arrive
Earlier this year, the IRS sent out penalty assessment letters, called Letters 226J, for alleged violations of the ACA's employer mandate in 2015. A new round of letters is expected to be sent out later this year and through 2019.
Written by Stephen Miller, CEBS and published by SHRM on November 21, 2018