ACA Form Primer

As an HR professional, it’s crucial to understand the IRS Forms 1095-B/C and 1094-B/C for Affordable Care Act (ACA) reporting. These forms are essential for reporting information to employees and the IRS. This article provides valuable insights into the purpose of each form, reporting deadlines, and who is responsible for their distribution and transmission.

Forms 1095-B and 1095-C

1. Purpose of Form 1095-B: Form 1095-B is used for ACA reporting and provides employees with information about their health coverage. It is furnished by health insurance companies or issuers/coverage providers to covered individuals. Additionally, small employers with self-funded health plans use Form 1095-B to report coverage information.
2. Purpose of Form 1095-C: Form 1095-C is also used for ACA reporting and provides employees with information about their health coverage and their employer’s offer of health coverage. Applicable Large Employers (those with 50 or more full-time employees in the prior year) must furnish Form 1095-C to their full-time employees to confirm the offer of health coverage to employees and their dependents.

Reporting Deadlines and Responsibilities

1. Furnishing Deadlines: The 1095 series of forms must be furnished to individuals by 30 days after January 31 of the year following the calendar year to which the form relates.
2. Transmittal Deadlines: The 1094 series of forms must be transmitted to the IRS by March 31 of the year following the calendar year to which the form relates.
3. Applicable Large Employer with Fully Insured Coverage: The employer sends Form 1095-C to full-time employees and transmits information to the IRS using Form 1094-C. The insurance company sends Form 1095-B to covered individuals.
4. Applicable Large Employer with Self-Insured Coverage: The employer sends Form 1095-C to full-time employees and covered individuals. The employer transmits information to the IRS using Form 1094-C.
5. Small Employer with Fully Insured Coverage: The insurance company handles all reporting using Forms 1094-B and 1095-B.
6. Small Employer with Self-Funded Coverage: The employer sends Form 1095-B to covered individuals and transmits information to the IRS using Form 1094-B.

Understanding Forms 1094-B and 1094-C

1. Purpose of Form 1094-B: Form 1094-B is used to transmit health plan information to the IRS. It provides summary information about coverage and offers of health coverage and includes copies of all 1095 forms furnished to employees. Small employers with self-funded health plans use Form 1094-B for transmission.
2. Purpose of Form 1094-C: Form 1094-C is also used for transmitting health plan information to the IRS. It identifies each Applicable Large Employer (location) with an EIN or entity tax ID number recognized by the IRS on a transmission to the IRS.

Conclusion

Understanding the IRS Forms 1095-B/C and 1094-B/C is essential for HR professionals involved in ACA reporting. By adhering to the designated deadlines and responsibilities, you can ensure accurate and timely reporting of health coverage information to both employees and the IRS.

For information about BAS’ health care reform data collection and reporting services, contact your account manager or solutions@basusa.com