Some Small Employers May Have Reporting Obligations Under the Affordable Care Act

By Nancy L. Farnam / Feb 17, 2016

The Patient Protection and Affordable Care Act ("ACA") imposes reporting requirements on providers of minimum essential coverage about the coverage provided. Self-insured employers - that is, employers who sponsor self-insured group health plans - are subject to these reporting requirements whether or not they are applicable large employers under the employer shared responsibility provisions. This means employers of any workforce size that self-insure health benefits must comply with these reporting requirements.

Small employers that self-insure health benefits (generally those with fewer than 50 full-time and full-time equivalent employees in the prior year) use IRS Form 1095-B and the transmittal Form 1094-B to meet these  reporting requirements.

Reporting is required for plans that provide self-insured medical coverage to both active and/or former employees. Therefore, although retiree only plans are exempt from some of the ACA requirements, they are subject to the reporting requirements. In addition, small employers that sponsor a health reimbursement arrangement ("HRA") that provides coverage for employees or retirees who are not covered by the employer's major medical plan will be required to report the HRA coverage on IRS Forms 1094-B and 1095-B. On the other hand, if the HRA only covers employees who were also covered by the employer's insured or self-insured major medical plan, reporting is not required for the HRA (as long as coverage under the major medical plan is reported).

Large employers (generally those with 50 or more full-time and full-time equivalent employees in the prior year) that self-insure health coverage should file IRS Forms 1094-C and 1095-C and report the minimum essential coverage information in Part III. 

The due dates for the 2015 reports are as follows:

  • The due date for providing the reports to full-time employees and others enrolled in coverage (IRS Forms 1095-B and 1095-C) is March 31, 2016.
  • The due date for filing returns with the IRS (IRS Forms 1094-B and 1094-C) is May 31, 2016 if filing on paper, and June 30, 2016 if filing electronically.

The reporting requirements and forms are complicated. Small employers should determine if they are required to file to report minimum essential coverage and all employers required to file should familiarize themselves with the reporting requirements. Additional information may be found in the February 11, 2016 alert from the IRS.

If you have any questions, please contact Nancy Farnam at (248) 530-6222 | nfarnam@clarkhill.com; Doug Ellis at (412) 394-2367 | dellis@clarkhill.com; Kristi Gauthier at (480) 684-1300 | kgauthier@clarkhill.com; Ed Hammond at (248) 988-1821 | ehammond@clarkhill.com; or another member of Clark Hill's Labor and Employment Practice Group.