Q. I had an employee come to me today and ask for “Form 1095” so she could complete her taxes. I had never heard of this form! What is it, and how do I get it for the employee?
A. Form 1095-C is the employer reporting form that enforces the employer mandate of the Affordable Care Act and informs the IRS of coverage offered to employees for the individual mandate. There are two other versions of Form 1095 sent to individuals:
- Form 1095-A—Individuals who went to the health care exchanges and received a tax credit get this form from the Exchange.
- Form 1095-B—Insurance companies use this form to report those they covered with health insurance.
Reporting under Form 1095-B and 1095-C is voluntary in 2015, and the final versions of these forms were just released on February 4, 2015. Your employee can prove she was covered by showing the insurance card or her pay stub, which would show her employee contribution, should she choose to report this year.
If you have 50 or more Full-Time Equivalent (FTE) Employees, or (regardless of size) you self-fund your health insurance, you don't have to worry about reporting your group health insurance information until January 2016. Next year, you'll be required to submit a report containing information regarding your offered group health insurance. Under the ACA, plans must meet “minimum value” and “affordable” standards.
If your school chooses not to offer group health insurance this year, your report will confirm that no plans were available for employees. If group health insurance was offered to an employee, the report will show whether he or she enrolled in the plan.
You can download the forms and voluntarily report this year. To voluntarily report in 2015, you'll need health insurance information for each month in 2014, employee counts, as well as the required forms from the IRS (see links below).
Even if you are not voluntarily reporting this year, you can download the forms so you know what information you’ll need to collect this year.
To comply with the reporting requirement in 2016—and avoid a $100 fine per report—here is the information you’ll need in 2016:
- the cost to your employees for their shares of the employee-only premium of your lowest priced health insurance plan;
- the number of FTE employees by month;
- the months your employees were offered and enrolled in your group health insurance that is “minimum value;” and
- whether the coverage was only offered to the individual employees or the employees and their dependents, including spouse or individual and dependent children.
Click these links if you need Form 1095-C and instructions to facilitate proper filing.
Curious about your school's health care policies and the reform's changes? Ask ISM’s Health Care Reform Expert a question. We respect your privacy. You can also view ISM’s health care solutions.
