On 2/9/15, the IRS released the final forms and instructions for reporting on individual and employer mandates. We have previously written about this matter, including familiarization with the draft forms HERE. These instructions and forms are to be used by applicable large employers, insurers and employers with self-insured plans. (Source: Cigna)
The Final Rules on Minimum Essential Coverage (MEC) and Large Employer reporting were released on 3/5/14. The first reporting is required in early 2016 for the 2015 calendar year. Employers had the option to voluntarily report 2014 information by 1/31/15 for the 2014 calendar year.
What the Instructions Cover
The instructions provide an overview of why the forms/reporting are required. They also cover basic information including:
- who must complete the forms
- how the transmittal forms need to accompany their respective 1095-B or 1095-C Forms
- where to mail paper forms; details for filing electronic forms are expected when the IRS posts Publication 5165
- specific line by line instructions
- general directions for contact person, signature on form and phone number
- definitions of various terms used in reporting data
- minimum guidance on multi-employer arrangements
- transitional relief for off-calendar year plans
Employer Mandate: What You Need to Know for 2015 and Beyond
See our previous blog, Employer Mandate 2015: 100+ Employees? Offer Health Care Coverage or Pay a Penalty, for in-depth details, links and downloads on this subject.
There are two forms required for each set of information being reported: 1) a transmittal form that serves as a cover letter; and 2) forms providing data on either the individual or employer mandate, or both for self-insured employer sponsors. The instructions and respective forms to be completed and filed are as follows:
Employer Forms and IRS Reporting
- Form 1094-C (a transmittal/cover sheet) to the IRS only, and
- Form 1095-C to both the IRS and named individuals*.
*Note: If its plan is insured, the employer will only complete Parts I and II of Form 1095-C.
Insurer Forms and IRS Reporting
- Form 1094-B (a transmittal/cover sheet) to the IRS only, and
- Form 1095-B to both the IRS and named INDIVIDUALS.
These instructions and forms can be found on the IRS website:
Additional/Previously Posted Information on Employer and Individual Mandate
Self-Funding Alternatives and Cost Containment Strategies
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