Affordable Care Act Compliance: IRS Reporting Requirements

 

One of the major Affordable Care Act requirements for compliance is reporting health care coverage enrollment and eligibility. To assist in your filing, Paytime has compiled the major components to the IRS reporting requirements. While we have collected the following information to support you, we also want you to know that we are here to answer your questions, guide you through the process, and we have advanced tools for simplifying some of the filing processes.

 

Section 4980H – “Pay or Play” Penalties

Employers with 50 or more full-time equivalent employees (FTE) are considered “large” employers under the ACA. Section 4980H of the ACA imposes penalties on large employers who fail to offer health care coverage or offer coverage that is deemed inadequate under the law. Health care coverage is not considered “affordable” if the insurance offered is more than 9.5% of an employee’s household income or if the cost of the coverage brings an employee below poverty level.

Sections 6055 & 6056 Reporting Requirements

IRS Code Section 6055 states that every provider of minimum essential coverage will report coverage information by filing an information return to the the IRS and furnishing a statement to individuals. The information is used by the IRS to administer and for individuals to show compliance with the individual shared responsibility provision in Section 5000A. Form 1095- B for insured coverage and Form 1095-C (Part III) for self insured coverage.

IRS Code Section 6056 requires applicable large employers to file information returns with the IRS and provide statements to their full time employees about the health insurance coverage the employer offers. This information is reported on Part II of Form 1095- C. The IRS will use this form to calculate penalties.

 
 
 

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