#aca reporting

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TEMPLATE: Affiliate Template with Latest RPP Episode

TEMPLATE: Affiliate Template with Latest RPP Episode

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Health Care Reform: How should employers disburse medical loss ratio (MLR) rebates from insurance carriers?

Health Care Reform: How should employers disburse medical loss ratio (MLR) rebates from insurance carriers?

Recently a number of clients have received notices and/or checks for their organizations’s Medical Loss Ratio, or MLR rebates. Below is some helpful information from SHRM for understanding how these rebates can be used or distributed.

According to the U.S. Department of Labor’s Technical Release No. 2011-04, the employer’s responsibility for distributing the rebate to participants is dependent on…

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DOL Penalties Increase for 2018

DOL Penalties Increase for 2018

In 2015, Congress passed the Federal Civil Penalties Inflation Adjustment Act of 2015 (the “Inflation Adjustment Act”) to direct federal agencies to adjust the civil monetary penalties for inflation every year. Civil penalties ensure compliance with federal regulation by incentivizing employers not to violate federal regulation and providing federal agencies the power to ensure compliance.…

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IRS Begins ACA Reporting Penalty Process

Repeal and replacement of the Affordable Care Act (ACA) by the American Health Care Act (AHCA) may be underway in Washington D.C., but until a final version of the AHCA is signed into law, the ACA is the law of the land. In fact, the IRS is currently issuing notices to employers that require them to disclose whether they complied with ACA large employer reporting duties, or their excuse for not doing so, where applicable.

The ACA required large employers to furnish employee statements (Forms 1095-C) and file them with the IRS under transmittal Form 1094-C, and the Internal Revenue Code (“Code”) imposes separate penalty taxes for failing to timely furnish and file the required forms. Large employer reporting was required for 2015 and 2016, even if transition relief from ACA penalty taxes applied for 2015. The potential penalties can be very large – up to $500 per each 2015 Form 1095-C statement ($250 for not furnishing the form to the employee and $250 for not filing it with IRS) – up to a total annual penalty liability of $3 million. The penalty amounts and cap are periodically adjusted for inflation.

Employers that failed to furnish Form 1095-C and file copies with Form 1094-C may receive the IRS notices, called “Request for Employer Reporting of Offers of Health Insurance Coverage (Forms 1094-C and 1095-C)” and also known as Letter 5699 forms. Forms may be received regarding reporting for 2015 or 2016. Employers that receive a Letter 5699 form will have only thirty days to complete and return the form, which contains the following check boxes:

Employer already complied with reporting duties;

Employer did not comply but encloses required forms with return letter;

Employer will comply with reporting duties within ninety days (or later, if further explained in the form);

Employer was not an Applicable Large Employer for the year in question; or

Other (requiring a statement explaining why required returns were not filed, and any actions planned to be taken).

  The Letter also provides: “[i]f you are required to file information returns under IRC Section 6056, failure to comply may result in the assessment of a penalty under IRC Section 6721 for a failure to file information returns.”

Employers receiving Letter 5699 forms should contact their benefit advisors immediately and plan to respond as required within the thirty-day limit; it may be necessary to request an extension for employers that are just realizing that they have reporting duties and need to prepare statements for enclosure with their response. In this regard, the IRS offers good faith relief from filing penalties for timely filed but incomplete or incorrect returns for 2015 and 2016, but relief from penalties for failures to file entirely for those years is available only upon a showing of “reasonable cause,” which is narrowly interpreted (for instance, due to fire, flood, or major illness).

Large employers should not look to coming ACA repeal/replacement process for relief from filing duties and potential penalties. The House version of the AHCA does not change large employer reporting duties and it is unlikely the Senate or final versions of the law will do so. This is largely because procedural rules limit reform/repeal provisions to those affecting tax and revenue measures, which would not include reporting rules.   Thus the reporting component of the ACA will likely remain intact (though it may be merged into Form W-2 reporting duties), regardless of the ACA’s long-term fate in Washington.

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Learn About HIPAA Implication for Completing Forms 1095-C

Learn About HIPAA Implication for Completing Forms 1095-C

2016 is the year of ACA Reporting! All the employers have reporting requirements at the top of their priority list and leaving no stone unturned to execute it perfectly!

Thus, you must be extra cautious while completing and submitting the reporting forms-1094/95. Form 1095-C is the crucial one as it is used by the employers to report their minimum essential coverage offerings to employees (Part…

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How Small Business Can Easily Manage The New ACA Compliance & Reporting Requirements?

How Small Business Can Easily Manage The New ACA Compliance & Reporting Requirements?

Obamacare has been bringing a lot of changes for small business owners, and they can expect a lot more of that in the coming years. Since the enactment of Affordable Care Act, there have been several modifications in the law, which has required small business owners to struggle to remain compliant.

2016 is no exception to these modifications. This year more SMBs are required to offer coverage to…

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IBC: Distribution of Tax Forms

IBC: Distribution of Tax Forms

Information about distribution of 1095 tax forms

Beginning February 8, Independence Blue Cross will begin mailing IRS 1095-B tax forms on a rolling basis to subscribers who purchased plans individually off-exchange and to subscribers of fully insured group employers.

The purpose of these forms is for individuals to verify that they had minimum essential health care coverage during the previous…

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Make ACA Reporting Smoother Since ACA reporting is in its first year, thus possibilities are extremely high that employers are totally unaware of what is actually going to happen.