Applicable large employers (ALE) must report to the IRS with information about the health care coverage, if any, they offered to full-time employees. The IRS will use this information to administer the employer shared responsibility provisions and the premium tax credit.
ALEs also must furnish to employees a statement that includes the same information provided to the IRS. Employees may use this information to determine whether, for each month of the calendar year, they may claim the premium tax credit on their individual income tax returns.
This information reporting provision requires an ALE to report information about health insurance coverage offered to its full-time employees (and their dependents). ALEs are required to report to the IRS, as well as to their full-time employees, regardless of whether the ALE actually offers health insurance coverage.
Below are Employer Reporting Requirements:
6055 – Minimum Essential Coverage (MEC)
Information in this report is used to administer the Individual Mandate. This requires health insurers and sponsors of self-insured health plans to provide covered individuals and the IRS with information on MEC for a calendar year.
6056- Applicable Large Employer (ALE)
Requires Applicable large employers to provide full-time employees (FTEs) and the IRS with information regarding an offer of health plan coverage during the calendar year. Information in this report is used to administer the Employer Mandate.
“B” Forms (1094-B and 1095-B)
Used by health insurance carriers, small employers with self-insured (level funded) health plans, and multiemployer plans to report individuals who had MEC in the calendar year.
1094-B-Transmittal Form-cover page for submission of all Forms 1095-B to the IRS.
1095-B-Identifies a specific individuals (and any covered family member’s) health coverage.
“C” Forms (1094-C and 1095-C)
Used by ALE’s to report offers of coverage to FTE’s to satisfy the employer mandate and by self-insured ALEs to report MEC.
1094-C-Transmittal Form-cover page for submission of all Forms 1095-C to the IRS.
1095-C-identifies each FTE and information regarding the offer of coverage; also provides information on employees/individuals and family members covered by self-insured plan.
Employer Reporting Obligations:
Employer to Employees
What Form/Parts To Whom When?
Insured No employer action. No employer action. Carrier provides January 31
under 50 FTE’s Carrier provides Form 1095-B Form 1095-B to covered individuals
Self insured, Form 1095-B (all parts except II) Covered individuals January 31
under 50 FTE’s
Insured (or no coverage), Form 1095-C (all parts) All FTEs January 31
50 or more FTE’s
Self-insured, Form 1095-C (all parts) All FTEs and all covered employees January 31
50 or more FTE’s and individuals
Employer to IRS
What Form/Parts When?
Insured, No employer action. Carrier obligation No employer action. Carrier obligation
Under 50 FTEs
Self-insured, Form 1094-B (transmittal form) February 28 (April 2 if filing electronically)
Under 50 FTEs All Forms 1095-B
Insured(or no coverage) Form 1094-C (transmittal form) February 28 (April 2 if filing electronically)
50 or more FTEs
Self-insured Form 1094-C (transmittal form) February 28 (April 2 If filing electronically)
50 or more FTEs All Forms 1095-C
Cosmo Insurance Agency wants you to be prepared when dealing with health insurance. We are happy to provide information and guidance. Call us to discuss health insurance options, 732-363-3888. We provide creative solutions and unparalleled service.