The Affordable Care Act or Patient Protection and Affordable Care Act, also known as Obamacare is a U.S healthcare system coverage and regulation. Since its inception in the year 2010, it has been one of the most important and expansive along with the Medi
It requires the health insurance provider and employers to file IRS, reporting that they are providing an affordable and dependable health insurance plan to their full-time employees, thereby providing detailed health coverage information of each covered person to the IRS.
Large employers must be able to prove that they provide healthcare benefits to their employees or else they will be subjected to pay or play penalties. The taxpayers must be able to substantiate that they and their dependents are covered under the Health Care Exchange or through any credible healthcare benefit.
Taxpayers working for a large employer will receive two forms to report to IRS, i.e., 1095 B and 1095 C. They will receive 1095 from their insurance provider and 1095 C from their employer. They have to give a detailed account of covered people, their, and the health benefits. Failing to do so will make them liable for paying penalties. Taxpayer working for a small firm and getting their healthcare benefits from Healthcare Exchange will only have to report 1095 A form.
Before proceeding with the reporting requirements of Section 6055 and 6056 reporting requirements, lets us talk about the forms that are filled in these sections :
1095 A: This form is utilized by Healthcare Exchange and includes information to know if the taxpayer has received advance credit payments. Details like: level of coverage are also included in it.
1094 B: This is the transmittal form, identifying and authenticating the establishment submitting forms 1094 B and 1095 C.
1095 B: The employee statement, having detailed information on the individual policyholder like name, months of coverage, etc.
1095 C: These forms, called insurance return are to filled by taxpayers working under large employers. The details to be included in this forms is the identification number of each employee and the type of coverage provided.
Following are the reporting requirements of the Internal Revenue Code Section 6055 and 6056 to be filed by the providers of essential coverage and the employer regarding the individual covered under the healthcare benefit services.
Section 6055 reporting requirements:
It requires insurers, self-insuring employees, and other healthcare insurance provider to give information regarding the covered individuals and the covering entity to the IRS. The data could be:L the name, address, dates of coverage under the policy. Report whether or not the individual is covered in minimum essential healthcare and they have to fill out the 1094 B and 1095 B forms.
The providers have to mention only the details of minimum essential health care coverage and not the supplemental benefits.
If the healthcare benefits are established and being provided by more than one employer, each employer is a Plan Sponsor, and they have to report on the covered individuals.
Name, tax ID of the covered individual and responsible individual. Details of plan sponsor such as name, address, employee identification number.
Section 6056 reporting requirements:
Information regarding whether or not Applicable large employers, that are the employers with a minimum of 50 full-time employees, have their full-time employees and their dependents covered under the essential healthcare benefit plan.
The applicable large employers have to fill out both the 1095 C and 1095 c form to conform to the reporting requirements of both section 6056 and 6055.
Name and number of the representative from the side of large employers
Name, address, employee identification number of the large employer.
Number of full-time employee for each calendar month along with the months that were given the coverage
The determinants by which the coverage was offered or not offered to the employees
These are just the basics of ACA and their reporting requirements which will help you in giving a start to get yourself covered by health insurance. But these section code, the associated legal policies, and the consequential penalty proceeding are complicated, and hence you would require the help of experienced insurance solution provider that would help in reducing the hassle and take a load off the employers as well the insurers.