For an employer that is an ALE Member, this information must be reported on Form 1095-C, Part III, for any employee who is enrolled in coverage (and any spouse or dependent of that employee). Reporting by Employers That Sponsor Self-Insured Health PlansĪn employer that offers health coverage through a self-insured health plan must report information about each individual enrolled in such coverage. For more information on determining full-time employees, see Full-Time Employee in the Definitions section of these instructions, which includes information on the treatment of new hires and employees in Limited Non-Assessment Periods.įor purposes of reporting on Forms 1094-C and 1095-C, an employee in a Limited Non-Assessment Period is not considered a full-time employee during that period. Each ALE Member is required to file Forms 1094-C and 1095-C reporting offers of coverage to its full-time employees (even if the ALE Member has fewer than 50 full-time employees of its own).įor more information on which employers are subject to the employer shared responsibility provisions of section 4980H, see Employer in the Definitions section of these instructions. If the Aggregated ALE Group, taking into account the employees of all ALE Members in the group, employed on average 50 or more full-time employees (including full-time equivalent employees) on business days during the preceding calendar year, then the Aggregated ALE Group is an Applicable Large Employer and each separate employer within the group is an ALE Member. For purposes of determining if an employer or group of employers is an Applicable Large Employer, all ALE Members under common control (an Aggregated ALE Group) are aggregated together. An Applicable Large Employer, generally, is an employer with 50 or more full-time employees (including full-time equivalent employees) in the previous year. Generally, the ALE Member is required to furnish a copy of the Form 1095-C (or a substitute form) to the employee.Īn ALE Member is, generally, a single person or entity that is an Applicable Large Employer, or if applicable, each person or entity that is a member of an Aggregated ALE Group. Form 1095-C is also used in determining the eligibility of employees for the premium tax credit.ĪLE Members that offer employer-sponsored, self-insured coverage also use Form 1095-C to report information to the IRS and to employees about individuals who have minimum essential coverage under the employer plan.Īn ALE Member must file one or more Forms 1094-C (including a Form 1094-C designated as the Authoritative Transmittal, whether or not filing multiple Forms 1094-C), and must file a Form 1095-C for each employee who was a full-time employee of the ALE Member for any month of the calendar year. Forms 1094-C and 1095-C are used in determining whether an ALE Member owes a payment under the employer shared responsibility provisions under section 4980H. Form 1095-C is used to report information about each employee to the IRS and to the employee. Form 1094-C must be used to report to the IRS summary information for each Applicable Large Employer (ALE Member) (defined below) and to transmit Forms 1095-C to the IRS. For FAQs specifically related to completing Forms 1094-C and 1095-C, go to IRS.gov/Affordable-Care-Act/Employers/Questions-and-Answers-about-Information-Reporting-by-Employers-on-Form-1094-C-and-Form-1095-C.įor additional guidance and proposed regulatory changes relating to section 6055, including the requirement to solicit the TIN of each covered individual for purposes of the reporting of health coverage information, see Proposed Regulations section 1.6055-1(h) and Regulations section 301.6724-1.Įmployers with 50 or more full-time employees (including full-time equivalent employees) in the previous year use Forms 1094-C and 1095-C to report the information required under sections 60 about offers of health coverage and enrollment in health coverage for their employees. For answers to frequently asked questions regarding the employer shared responsibility provisions and related information reporting requirements, visit IRS.gov.įor information related to filing Forms 1094-C and 1095-C electronically, visit IRS.gov/AIR. For the final regulations under section 4980H, Shared Responsibility for Employers Regarding Health Coverage, see T.D. For the final regulations under section 6055, Information Reporting of Minimum Essential Coverage, see T.D. For the final regulations under section 6056, Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under Employer-Sponsored Plans, see T.D. For information related to the Affordable Care Act, visit IRS.gov/ACA.
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