Final regulations released on minimum essential coverage reporting (Sec. 6055)
Update to previous alert from July 26, 2013: IRS issues formal notice delaying employer mandate and coverage reporting until 2015
May 21, 2014
On March 5, 2014, the U.S. Department of the Treasury and the Internal Revenue Service (IRS) released final rules to implement the information reporting requirements for insurers and certain employers under the Affordable Care Act (ACA).
These final rules are meant to simplify the process of information reporting to the IRS while making it easier for employers and insurers of all sizes to provide quality, affordable health coverage.
Reporting requirements under IRS Section 6055 affect health insurance issuers, employers, government entities and other persons that provide minimum essential coverage to individuals. Section 6055 requires annual reporting of the following information to the IRS and to individuals:
- Name, address and employer identification number for the entity required to file a return;
- Name, address and taxpayer identification number (SSN/ITIN/TIN) of the policy holder and each individual covered under the policy
- Date of birth if taxpayer identification number is not available;
- Months for which, for at least one day, the individual was enrolled in coverage and entitled to receive benefits; and
- If minimum essential coverage is provided by a health insurance issuer through a group health plan:
- Name, address and EIN of the employer sponsoring the plan; and
- Whether the coverage is a qualified health plan enrolled in through the Small Business Health Options Program and the SHOP’s unique identifier.
The final rule provides penalty relief for 2015 information (reported in 2016) if filers show they made a good faith effort to comply with information reporting requirements. However, this relief is not available for entities that fail to file accurate returns or provide accurate statements.
The required reporting form (Form 1095-B) will be released in draft form in the near future. Reports must be filed with the IRS by Feb. 28 (March 31 if filed electronically) and statements must be provided to responsible individuals on or before Jan. 31 of each year.
This rule is applicable to calendar years beginning after Dec. 31, 2014. The first reporting will occur in 2016 for 2015 plan years.
More information can be found at:
The information on this website is based on BCBSM's review of the national health care reform legislation and is not intended to impart legal advice. Interpretations of the reform legislation vary, and efforts will be made to present and update accurate information. This overview is intended as an educational tool only and does not replace a more rigorous review of the law's applicability to individual circumstances and attendant legal counsel and should not be relied upon as legal or compliance advice. Analysis is ongoing and additional guidance is also anticipated from the Department of Health and Human Services. Additionally, some reform regulations may differ for particular members enrolled in certain programs such as the Federal Employee Program, and those members are encouraged to consult with their benefit administrators for specific details.