Draft Instructions for IRS Reporting on Individual and Employer Mandates

On Thu, Jul 24, 2014, the IRS posted draft versions of the forms that large employers will use to report employer mandate compliance and the forms that self-funded employers will use report information about the coverage they offer. They published instructions for the forms on Thu, Aug 28 as well as revised draft forms for the employee health statements. Final versions of the forms and instructions should be published later this year.

Employers offering self-funded health plans and applicable large employers are required to report in early 2016 for the 2015 calendar year.

Reporting about Minimum Essential Coverage (IRC Section 6055)

All employers who offer self-funded health plans—this includes small employers who offer alternative funding plans—are required to report information about the type and period of coverage provided to each individual enrolled in their health plan. This includes information about employees and their covered dependents and must be provided to both the IRS and to each covered individual. For fully insured health plans, the insurer is responsible for the reporting. If the employer is also a “large employer,” this information can be combined with the employer mandate reporting explained below.

  • Form 1094-B – A transmittal cover sheet sent to the IRS only. Due Mar 31 if filed electronically or Feb 28 if filed in paper.
  • Form 1095-B – Individual statements sent to each covered individual and to the IRS. Due by Jan 31.
  • Instructions for Forms – IRS resource about completing and filing statements.

Reporting about Employer Mandate Compliance (IRC Section 6056)

Beginning in 2015, applicable large employers—generally employers who employ 50 or more full-time equivalent employees—are required to offer adequate and affordable coverage to all full-time employees and their dependents or face penalties for non-compliance. The government is providing various temporary exemptions to some employers from the penalties; however, all large employers will still be required to report to the IRS and individuals even if they are temporarily exempt from the penalties.

Employers will be required to report information about all employees who were full-time at any point during the applicable calendar year. The employer will provide individual statements to each employee and to the IRS along with a transmittal.

  • Form 1094-C – A transmittal sent to the IRS only. Due Mar 31 if filed electronically or Feb 28 if filed in paper.
  • Form 1095-C – Individual statements sent to each person who was a full-time employee at any point during the applicable calendar year and to the IRS. Employers who did not offer a self-funded plan will ignore Part III. Due by Jan 31.
  • Instructions for Forms