Today, the U.S. Department of
the Treasury and the Internal Revenue Service published Final Rules to
implement the information reporting provisions for insurers and certain
employers under the Affordable Care Act ("ACA"), which will take
effect in 2015.
Final Rules apply to Sections 6055 and 6056 of the Internal Revenue Code
("IRC"), which describe employer reporting for the purpose of
monitoring whether an employer is compliant with the ACA's Employer Mandate.
The Employer Mandate generally requires employers with 50 or more full-time
employees to offer their full-time employees coverage that meets minimum
value and affordability standards under the ACA or pay a penalty, though
compliance has been pushed back one year for certain employers. Employers with
50 to 99 full-time employees will not be subject to penalties under the
Employer Mandate for failing to provide health insurance coverage to employees
in 2015. Moreover, employers with 100 or more full-time employees need only
offer coverage to 70% of their full-time employees in 2015 to be compliant with
the regulations. Despite these delays, the information reporting provisions
take effect in 2015, and employers should begin to familiarize themselves with
6055 describes reporting requirements for self-insuring employers, insurers and
certain other providers of minimum essential coverage, while IRC 6056 describes
reporting requirements for applicable large employers. Under the Final Rules,
reporting for both IRC 6055 and 6056 will be made on the same form with the
stated goal of eliminating duplicative filings by employers. Large employers
that self-insure (employers that pay their employees' medical costs directly,
instead of joining a traditional plan) will fill out both sections of the form.
Large employers that do not self-insure will only fill out the top half of the
form, for reporting under IRC 6056.
to the Final Rules, for IRC 6055, an employer must generally report information
about the employer, the employees insured, and information on the minimum
essential coverage provided. IRC 6056 requires applicable large employers to
report information about themselves, such as the number of full-time employees
for each month during the calendar year, to certify whether they offered
coverage to their full-time employees, and to provide certain information about
the plan offered, such as the monthly premium for the plan.
Final Rules also simplified the reporting obligations of employers who make
qualifying offers of coverage to their employers. According to the
Treasury press release, a qualifying offer of coverage is "an offer of
minimum value coverage that provides employee-only coverage at a cost to the
employee of no more than about $1,100 in 2015" combined with an offer of
coverage to the employee's family, which would not need to meet the cost
threshold. The Final Rules allow employers to report different information
based on whether or not a given employee was offered coverage for all 12 months
of a year or for fewer than 12 months in a year. For employees receiving a
qualified offer for all 12 months, "employers will need to report only the
names, addresses and taxpayer identification numbers" of such employees.
For employees receiving a qualifying offer in fewer than 12 months in the year,
employers will be able to report such employees "for each of those months
by simply entering a code."
you have any questions about the Final Rules or other health or
employment-related issues, please feel free to contact the attorneys in our Health Law