The ACA added section 6056 to the Internal Revenue Code (IRC), which requires Applicable Large Employers (ALEs) to file information returns with the IRS and provide statements to their full-time employees about the health insurance coverage the employer offered (or did not offer). The IRS will use the information provided on the returns to determine if the employer complied with the Employer Mandate to offer insurance coverage to a certain part of its full-time work force, or a certain level of coverage to each full-time employee. The IRS will also use the information provided as part of the determination of whether an employee is eligible for the premium tax credit.

We believe that proactive preparation is the best way to successfully deal with these complex government-reporting obligations.

Clients who sign-up for our comprehensive ACA government reporting solution bypass the hassle of having to comb through and consolidate payroll and insurance information across several sources while still fulfilling their government reporting obligations.

Compliance is simple when you have the right partner.

Additional information, including released 1094-C/1095-C Forms, is available at the following government agency specific websites:

IRS:

Federal Register:

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Do ALEs have to report on properly treated loan-outs?

No. Properly treated loan-out personnel are not common law employees and therefore do not count under the Employer Mandate.


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Do employees who are working overseas need to be included (shoot crew) in government reporting?

Employee hours worked oversees on a project are not included towards their full-time eligibility. However, employees that have hours of service in the USA and hours of service abroad may be included if the hours worked in the USA determine them to be full-time.


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How does an employer confirm if the multi-employer union plan is ACA compliant?

An employer can request certification from the union plan that its plan offers ACA compliant insurance coverage. Most major industry multi-employer plans are.


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If I’m an EP Cares customer, will EP also handle my government reporting obligations?

No, unless you are subscribed to our Government Reporting solution. EP offers a bundle of services as part of our ACA solutions. EP Cares and Government Reporting are two distinct subscription-based services. Employers are welcome to sign up for one or both services.


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Is an ALE member required to report under section 6056 if the ALE member has no full-time employees?

No. If an ALE member (defined on an EIN-by-EIN basis) did not have at least one full-time employee in any month in 2015, it is not required to report in 2016 for calendar year 2015.


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Is there a duty to file corrected forms?

For purposes of section 6056 reporting, if the information reported on a return (including a transmittal) or a statement required by this section is incomplete or incorrect as a result of a change in circumstances (such as a retroactive change in coverage), a failure to timely file or furnish a corrected document is a failure to file or furnish a correct return or statement under sections 6721 and 6722. The IRS has published procedures on corrected forms in the latest release of the 10954-C/1095-C instructions.


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Line 15 Form 1095-C, do we include optional coverage or just premium for the lowest-cost coverage?

An employer should enter the amount of the employee share of the lowest-cost monthly premium for self-only minimum essential coverage providing minimum value that is offered to the employee on line 15 in the form 1095-C.


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May an employer hire a third party to file returns and furnish statements required under section 6056?

Yes. Reporting arrangements between ALE members, issuers, and other parties are not prohibited. However, entering into a reporting arrangement does not transfer the ALE member’s potential liability and does not transfer the potential liability for failure of the ALE member to file returns and furnish statements under section 6056.


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Please define full-time employee as it relates to production (e.g. freelancers).

A full-time employee is one that works on average at least 30 hours per week or 130 hours per month.


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Regarding Form 1094-C, Pt. IV, is this for different entities such as union/non-union companies?

It is not necessarily limited to union/non-union entities. An employer must complete this section if it checks “Yes” on line 21. If the employer was a member of an Aggregated ALE Group for any month of the calendar year, it will need to enter the name(s) and EIN of up to 30 of the other Aggregated ALE Group Members.


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Should reporting EIN match EIN on individual’s W-2 (except in cases third party payroll service)?

There is no requirement that the EINs match. In fact, if the employer is using a statutory employer to pay its production workers, the EINs on the Form 1095-C (which relate to the employer entity filing the form) will differ from the EIN on the employee’s W-2 (which relate to the payroll company).


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What about spouse/family?

Dependent coverage is reported in Part III of the Form 1095-C but only for those employers who are self-insured.


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When do the information reporting requirements go into effect?

The information reporting requirements under section 6056 are first effective for coverage offered (or not offered) in 2015. An ALE member must file information returns with the IRS and furnish statements to employees beginning in 2016 that will report information about its offers of health coverage to its full-time employees for calendar year 2015.


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Why do we have to do this?

The Affordable Care Act added section 6056 to the Internal Revenue Code, which requires applicable large employers (ALEs) to file information returns with the IRS and provide statements to their full-time employees about the health insurance coverage the employer offered (or did not offer). The IRS will use the information provided on the returns to determine if the employer complied with the Employer Mandate to offer insurance coverage to a certain part of its full-time work force or a certain level of coverage to each full-time employee. The IRS will also use the information provided as part of the determination of whether an employee is eligible for the premium tax credit.


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Will multi-employer funds provide data or will we provide a list of full-time individuals?

Employers will need to make the full-time designation for all employees and likely will have to provide this list to the plans; however, insurance offers, enrollment information and cost will have to be obtained from the multi-employer plans, if the IRS deems is necessary.


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Will the IRS delay the government reporting for year end 2015?

The IRS issued Notice 2016-4, which extends the due date for:

1 – Furnishing to individuals the 2015 Form 1095-B (Health Coverage) and the 2015 Form 1095-C (Employer-Provided Health Insurance Offer and Coverage) from February 1, 2016, to March 31, 2016

2 – Filing with the Service the 2015 Form 1094-B (Transmittal of Health Coverage Information Returns), the 2015 Form 1095-B (Health Coverage) the 2015 Form 1094-C (Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns) and the 2015 Form 1095-C (Employer-Provided Health Insurance Offer and Coverage) from February 29, 2016, to May 31, 2016, if not filing electronically, and from March 31, 2016, to June 30, 2016 if filing electronically.


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Will union/multi-employer benefit plans file forms for employers?

There is no authority under section 6056 or elsewhere in the Code that would permit imposing such a requirement on a multi-employer plan. It is unlikely that industry multi-employer plans will take on this responsibility for employers but they have indicated that if required they will provide necessary information to employers for them to complete their reporting forms.


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Will you be distributing the PPT deck?

At this point the PPT deck is not available for distribution. However, we have prepared materials summarizing the deck and the 6056 requirements that we can make available to our clients


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Would EP provide reporting for an employer that did NOT use EP Cares as the insurance?

Yes, EP is handling government reporting for individuals not paid by EP or that did not participate in EP Cares.


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