News & Articles

News from TJS Deemer Dana

What’s New in Healthcare Reporting Requirements for 2015


What’s New in Healthcare Reporting Requirements for 2015
By: Brandi P. Dykes

Beginning in tax year 2015, ALL employers who provide healthcare coverage to an individual during the calendar year must file a healthcare reporting information return (Form 1095-B or 1095-C) and a transmittal return (Form 1094-B or Form 1094-C).  The quantity of full-time employees (and full-time equivalents) employed by a particular individual or company, which is based on a 30 hour work-week, dictates which form should be used.

Companies who qualify as Applicable Large Employers (having 50 or more full-time employees or full-time equivalents) AND those who offer employer-sponsored self-insured health coverage  will be required by law to file Forms 1094/1095 “C”.   Companies employing less than 50 full-time workers will use Forms 1094/1095 “B”.  Each company will submit ONE Form 1094 which will provide totals of information on the 1095s submitted.   Form 1095 must be filed and distributed to each employee per employer.

Form 1094-B (transmittal) will require the following:

  • Filer’s name, EIN, telephone number, person of contact and complete address
  • Total forms 1095-B being transmitted

The employee statement (Form 1095-B) should present the following information:

  • Policy Holder/Responsible Individual:
    –    Name, SSN, DOB, complete mailing address
    –    Origin of the policy (indicated by pre-defined letters)
  • Employer Sponsored Coverage (only to be completed if letters ‘A’ or ‘B’ were coded in the above section)
  • Issuer/Coverage Provider
    –    Name, EIN, mailing address
  • Covered Individuals
    –    Name, SSN, DOB of EACH covered individual
    –    Indication of health coverage on a per month basis, per individual

Due to the “shared responsibility” requirement for ALE’s, Form 1094-C will require the following supplementary data:

  • An indication as to whether or not the company provided minimum essential coverage to at least 95% of its full-time employees as well as their dependents  for each of the 12 calendar months
  • Total number of full-time employees (and equivalents) that were employed throughout the calendar year for each month
  • Total number of ALL employees for each month of a calendar year

Form 1095-C should report the following additional items):

  • Health insurance offer and coverage per month (Specific codes will be provided as to indicate minimum essential coverage (or not) and who was covered, whether it was employee only, employee and spouse, or employee, spouse and dependents)
  • Employee share of lowest cost monthly premium

Additional information on healthcare reporting as provided by the IRS can be found here.

Stay tuned for further clarification on reporting requirements as the end of the year arrives!!

Leave a Reply