ACA Reporting

As you know, employers defined as Applicable Large Employers (ALEs) are required to submit 1094/1095 C forms to the IRS.  ALEs are companies who average 50 or more full-time or full-time equivalent employees (FT/FTE).  This is determined each calendar year and is based on the average size of an employer’s workforce during the prior year.  If an employer has at least 50 full-time employees, including full-time equivalent employees, on average during the prior year, the employer is an ALE for the current calendar year. Employees sponsoring self-insured or level-funded health plans have these responsibilities regardless of size.

Forms to Employees

• The 1095-C is provided by ALEs with fully insured health plans to all employees who were employed for any month of the calendar year.
  • ALEs with fully insured health plans complete parts I and II of the form.
  • ALEs with self-insured health plans complete the entire form.**
• The 1095-B is provided by small employers (fewer than 50 full-time equivalent employees) sponsoring self-insured health plans to all employees who were employed for any month of the calendar year.

**Per the IRS, ALEs that offer self-insured health coverage to non-employees who enroll in the coverage may use forms 1094-B and1095-B, rather than form 1095-C, Part III, to report coverage for those individuals and other family members. For this purpose, a non-employee includes, for example, a non-employee director, an individual who was a retired employee during the entire year, or a non-employee COBRA beneficiary, including a former employee who terminated employment during a previous year. For information on reporting for non-employees enrolled in a self-insured health plan using forms 1094-B and 1095-B, see the instructions for those forms.

Forms to the IRS

• The 1094-C is submitted to the IRS by ALEs with fully insured health plans along with copies of all the 1095-Cs.
• The 1094-C is also submitted to the IRS by ALEs with self-insured health plans along with copies of all the 1095-Cs.
• The 1094-B is submitted to the IRS by small employers sponsoring self-insured health plans along with copies of all the 1095-Bs.

All reporting will be for the 2021 calendar year, even for non-calendar year plans.

​​Furnishing:

This is the 7th ACA reporting year and the first reporting year that the IRS has not issued a furnishing extension:

Furnishing Forms 1095-C to Employees

An ALE must furnish a Form 1095-C, or a 1095-B if self-funded, to each of its full-time employees by January 31, 2022.

​The penalty for failing to provide a correct statement is $280 for each statement for which the failure occurs, with the total penalty for a calendar year not to exceed $3,426,000.  There are special rules that apply that increase the per-statement and total penalty if the IRS believes there was intentional disregard of the requirements to furnish and file statements.

​​Filing:

When to File the 1094-B and 1095-B with the IRS

The return and transmittal form must be filed with the IRS on or before February 28, 2022 if filing on paper (March 31, 2022, if filing electronically).

When to File the 1094-C and 1095-C with the IRS

For calendar year 2021, Forms 1094-C and 1095-C are required to be filed by February 28, 2022, if filing on paper, or March 31, 2022, if filing electronically.

If you need a 30-day filing extension, you can complete IRS form 8809, Application for Extension of Time to File Information Returns.  The form may be submitted on paper, or through the FIRE System.  You must file 8809 on or before the due date of the returns to get the 30-day extension.

The penalty for failing to file a correct return is $280 for each return for which the failure occurs, with the total penalty for a calendar year not to exceed $3,426,000.  There are special rules that apply that increase the per-return and total penalty if the IRS believes there was intentional disregard of the requirements to furnish and file statements.