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ACA 1094 and 1095 Reporting and Compliance Software |
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The Affordable Care Act (ACA) added §6055 to the Internal Revenue Code, which provides that every
provider of minimum essential coverage (MEC) will report coverage information by filing an information
return with the IRS and furnishing a statement to individuals. The information is used by the IRS to
administer, and individuals to show compliance with, the individual shared responsibility provision in
IRC §5000A.
Health insurance issuers, self-insured employers, government agencies, and others that provide MEC to an
individual during a calendar year must file an annual information return with the IRS. In general,
providers of MEC report on Form 1095-B, which is accompanied by a single transmittal form, Form 1094-B,
for all returns filed for a given calendar year. Providers file one Form 1095-B for all individuals
covered together under a policy or program.
Employer Shared Responsibility Provisions
ACA added the employer shared responsibility provisions under section 4980H of the Internal Revenue Code.
Under these provisions, certain employers (called applicable large employers or ALEs) must either offer
health coverage that is affordable and that provides minimum value to their full-time employees (and
offer coverage to the full-time employees' dependents), or potentially make an employer shared
responsibility payment to the IRS, if at least one of their full-time employees receives a premium tax credit for purchasing individual coverage on a Health Insurance Marketplace, also called the Exchange.
ALEs must report to the IRS information about the health care coverage, if any, they offered to full-time
employees. The IRS uses this information to administer the employer shared responsibility provisions and
the premium tax credit. §6056 requires employers to send Form 1095-C at year's end to each employee
who is eligible for employer-sponsored insurance, regardless of whether they actually participate in the
employer's health plan. Form 1095-C informs the employee of which months out of the year he/she was
eligible for coverage and how much the cheapest premiums available to him/her would have cost. ALEs must
give the IRS transmittal Form 1094-C with copies of all 1095-C forms.
Account Ability 1095-B reporting and §6055 compliance software. << Read More >>
Account Ability 1095-C reporting and §6056 compliance software. << Read More >>
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