ACA Compliance Reporting: Navigating Health Coverage Reporting Requirements

27 November

Posted at 10:13h in by

The Affordable Care Act (ACA), signed into law in 2010, introduced significant changes to the U.S. healthcare system, including new reporting requirements for businesses. Under the ACA, employers are mandated to provide health coverage and report on the health insurance offered to their employees. This reporting ensures compliance with the law and provides transparency in healthcare coverage. In this guide, we'll walk you through ACA compliance reporting for health coverage, explaining the requirements and how businesses can navigate them effectively. 

Employer Shared Responsibility Provision

The ACA's Employer Shared Responsibility Provision requires applicable large employers (ALEs) to offer affordable and adequate health insurance coverage to their full-time employees and their dependents. ALEs are those with 50 or more full-time equivalent employees. 

 

Forms 1094-C and 1095-C

To meet ACA compliance reporting requirements, ALEs must use Forms 1094-C and 1095-C to report information about the health insurance coverage offered to employees. Here's what you need to know about these forms: 

  • Form 1094-C: This is the transmittal form that summarizes the information reported on individual Forms 1095-C. It is submitted to the IRS along with copies of all Forms 1095-C issued to employees. 
  • Form 1095-C: ALEs must provide Form 1095-C to each full-time employee. This form outlines the details of the health coverage offered and helps the IRS determine compliance with the ACA. 

 

Information Required for Reporting

When completing Forms 1094-C and 1095-C, ALEs need to provide the following information: 

  • Employee and employer identification details. 
  • The months during which health coverage was offered to each full-time employee. 
  • The cost of the lowest-cost, self-only minimum essential coverage offered. 
  • Details about any safe harbor or other relief that may apply.

    Filing Deadlines

ALEs must submit Forms 1094-C and 1095-C to the IRS and provide Form 1095-C to employees by specific deadlines. These deadlines are typically in early spring for the previous tax year. It's essential to adhere to these deadlines to avoid penalties. 

 

Penalties for Non-Compliance

Failing to comply with ACA reporting requirements can result in significant penalties. Penalties may be assessed if ALEs do not offer coverage to eligible employees or if they do not provide accurate and timely reporting.

 

Using Third-Party Providers 

Many businesses opt to use third-party providers or ACA compliance software to simplify the reporting process. These providers can assist in accurately completing and filing the necessary forms and keeping track of compliance. 

 

 

ACA compliance reporting for health coverage is a crucial responsibility for applicable large employers. Navigating these requirements effectively not only ensures compliance with the law but also provides transparency and clarity for employees regarding their healthcare coverage. To streamline the process and avoid potential penalties, consider seeking professional assistance or using ACA compliance software to manage and report your health coverage accurately and on time. Stay informed about changes in reporting requirements and deadlines to ensure smooth ACA compliance for your business.