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Extensions for ACA 1094/1095 Information Reporting

On December 28, 2015, the Treasury Department and the Internal Revenue Service (IRS) issued Notice 2016-4, which extends certain Affordable Care Act (ACA) deadlines for reporting offers of health coverage and enrollment in the health plans. This Alert summarizes the key provisions of Notice 2016-4, the complete text of which is found at https://www.irs.gov/pub/irs-drop/n-16-04.pdf.

Extended Due Dates

The ACA information reporting deadlines for 2015 forms are extended as follows:

  • Employee Statements (2-month extension): The deadline for health coverage providers and employers to issue statements to employees on Form 1095-B or Form 1095-C is extended from February 1, 2016 to March 31, 2016.

  • Transmittal Forms (3-month extension): The deadline for health coverage providers and employers to report information to the IRS on Form 1094-B or Form 1094-C is extended from February 29, 2016 to May 31, 2016 for paper filings, and from March 31, 2016 to June 30, 2016 for electronic filings.

Provisions that allow automatic 30-day and permissive extensions of time for filing and furnishing the information forms will not apply to the new extended due dates for 2015 forms. Notice 2016-4 only applies to 2015 forms and does not apply to the 2016 forms and later years.

Action Needed Now: Health coverage providers and employers have the ability to adjust their data gathering and forms preparation schedules to the new deadlines as necessary.

Background

The ACA added provisions to the Internal Revenue Code (Code)1 that required health coverage providers and "applicable large employers2" to report to employees and to the IRS if coverage was offered and if the employee had coverage. The IRS issued final regulations in 2014 that set forth deadlines for filing that information and issued Forms 1094-B, 1094-C, 1095-B and 1095-C, which are to be used for the reporting of this required information.

The health coverage provider is the health insurance company if the plan is insured. If the plan is self-insured, the health coverage provider is the plan for multiemployer plans and the employer for single employer plans.

The 1094 forms are provided to the IRS, and the 1095 forms are provided to employees. In general, the "B" forms state who has health coverage and are provided by the health coverage provider. The "C" forms state who was offered coverage and are provided by the employer. However, employers with less than 50 full-time employees are exempt from this requirement. A large employer that has only a self-insured plan will only need to use the "C" forms and does not need to file "B" forms.

Therefore, employees of a small employer with insured coverage will only receive a 1095-B. Employees of a large self-insured employer will receive only a 1095-C. All other employees should receive both a 1095-B from their coverage provider and a 1095-C form from their employer.

One of the reasons for the extension is that the testing protocols for IRS's electronic system for filing the ACA returns (known as the AIR system3) were not issued until November 2015. Accordingly, many stakeholders requested more time to prepare their systems for filing the returns. Notice 2016-4 provides this additional time.

Penalties

Employers and coverage providers that do not comply with the extended due dates will be subject to penalties under Code sections 6721 or 6722 for failure to timely furnish and file. However, for 2015 reporting, the IRS will not impose penalties on entities that timely file incomplete or incorrect returns, e.g., containing incorrect taxpayer identification numbers or dates of birth, provided the entities can show that they made good faith efforts to comply with the reporting requirements. In addition, the IRS may abate the penalties for late filers who substantiate that the late filing was due to reasonable cause.

Guidance for Individuals

Notice 2016-4 also provides guidance to individuals who, because of the extended deadline, might not receive a Form 1095-B and/or Form 1095-C by the time they file their 2015 income tax returns. For 2015 only, individuals who rely upon other information received from employers or coverage providers about their offers of coverage for purposes of completing their income tax returns need not amend their returns once they receive the Form 1095-B or 1095-C, or any correction thereof. Individuals need not send the information relied upon to the IRS but should keep it with their tax records.

Cheiron Observation: These extended deadlines help with implementation of the information reporting to support the "pay or play" provisions of the ACA, but do not relieve plan sponsors of the need to offer coverage to a sufficient number of full-time employees that is both affordable and provides minimum value if the plan sponsors are to avoid assessable penalties.

Cheiron consultants can assist you with your ACA reporting obligations.

Cheiron is an actuarial consulting firm that provides actuarial and consulting advice. However, we are neither attorneys nor accountants. Accordingly, we do not provide legal services or tax advice.


1Code sections 6055 and 6056.

2Generally, employers with 50 or more full-time employees (including full-time equivalent employees).

3For ACA Information Returns.

 
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