ACA Reporting Forms 1095-B and 1095-C

What is Form 1095-B?

Form 1095-B, a Health Coverage reporting form for employers and insurers who offering the individuals with the Minimum Essential Coverage (MEC). Filers will use Form 1094-B (Transmittal Form of 1095-B: Health Coverage) to submit IRS Forms 1095-B. Filers must furnish a copy of Form 1095-B to the ‘Responsible Individual’ who may be an employee or their dependents or individuals to whom Minimum Essential Coverage is needed.

What is Form 1095-C?

Form 1095-C (Employer Provided Health Insurance Offer & Coverage) is used to report about the offers of health coverage and enrollment in health coverage for their full time employees. Applicable Large Employer (ALE) must file separate IRS Form 1095-C for their each full time employees. Also the ALE's use Form 1094-C (Transmittal of Form 1095-C: Employer Provided Health Insurance Offer & Coverage) to complete their Form 1095-C and report informations to the IRS.

(1094-B & 1094-C) - Transmittal Form of ACA Reporting Forms

What is Form 1094 -B?

Form 1094-B, a Transmittal Form Health Coverage Information Returns are given to those who have employer-sponsored coverage. This form is required to be reported with the IRS that contains information of the individuals who got Minimum Essential Coverage (MEC). Applicable Large Employers (ALE) are required to e-file with the IRS, if they are filing for more than 250 returns to the IRS.

What is Form 1094-C?

Form 1094-C, a Transmittal Of Employer-Provided Health Insurance Offer and Coverage Information Returns is filed by Applicable Large Employers (ALE). An Employer must determine their status as an Applicable Large Employer(ALE) based on their average full time employees. ALEs are subject to Employer Shared Responsibility Provisions.

Employer Shared Responsibility Provisions:

Affordable Care Act’s employer shared responsibility provisions subjects ALEs to either offer Minimum Essential Coverage that is “affordable” and that provides “minimum value” to their full-time employees (and their dependents), or potentially make an employer shared responsibility payment to the IRS. The employer shared responsibility provisions are sometimes referred to as “the employer mandate”.

What are the Penalties if filers fail to get coverage for responsible Individuals?

A Large Employer must pay penalty for not offering coverage. Penalty includes

  • For returns that didn't file , the penalty for failure to file an information return generally is increased from $100 to $250 for each return for which such failure occurs. The total penalty imposed for all failures during a calendar year after December 15, 2015 cannot exceed $3,000,000.

  • The penalty for failure to provide a correct payee statement is $100 for each statement with respect to which such failure occurs, with the total penalty for a calendar year not to exceed $1,500,000.

  • The penalty for failure to provide a correct payee statement is increased from $100 to $250 for each statement for which the failure occurs, with the total penalty for a calendar year not to exceed $3,000,000.