6055-Minium Essential Coverage (MEC)
Requires health insurers (carries0 and sponsors of self-insured health plans to provide covered individuals and the IRS with information on MEC for a calendar year (CY). Information in this report is used to administer the individual mandate.
6056-Applicable Large Employer (ALE)
Requires ALEs to provide full-time employees (FTEs) and the IRS with information regarding an offer of health plan coverage during the CY. Information in this report is used to administer the employer mandate.
FORMS
“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 CY
– 1094-B – Transmittal Form: cover page for submission of all forms 1095-B to the IRS
– 1095-B – identifies a specific individual’s (and any covered family member’s) health coverage
“C” Forms (1094-C and 1095-C)
-Used by ALEs to report offers of coverage to FTEs 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 employee/individuals and family members covered by the self-insured plan
Employer Reporting Obligations
EMPLOYER TO EMPLOYEE
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What Form/Parts?
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To Whom?
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When?
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Insured, under 50 FTEs
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No employer action. Carriers provide Form 1095B
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No employer action. Carrier provides Form 1095B to covered individuals by January 31.
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No employer action. Carrier provides Form 1095B to covered individuals by January 31.
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Self-insured, under 50 FTEs
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Form 1095B (all parts except II)
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Covered individuals
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January 31
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Insured (or no coverage), 50 or more FTEs
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Form 1095C (parts I and II)
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All FTEs
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January 32
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Self-insured, 50 or more FTEs
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Form 1095C (all parts)
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All FTEs and all covered employees/individuals
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January 31
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EMPLOYER TO IRS
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What Form?
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When?
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Insured, under 50 FTEs
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No employer action. Carriers obligation
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No employer action. Carrier obligation
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Self-insured, under 50 FTES
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Form 1095B (transmittal form)
All forms 1095B
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February 28 (April 2, if filing electronically)
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Insured (or no coverage), 50 or more FTEs
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Form 1095C (transmittal form)
All forms 1095C
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February 28 (April 2, if filing electronically)
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Self-insured, 50 or more FTEs
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Form 1095C (transmittal form)
All forms 1095C
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February 28 (April 2, if filing electronically)
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