A range of tools and resources are available to help you prepare for this requirement.
The Affordable Care Act (ACA) requires that employers, insurers and healthcare exchanges report certain information to the Internal Revenue Service (IRS) in early 2016. Health coverage providers, including certain employers, will file information returns with the IRS and furnish statements to individuals in 2016 to report group health coverage information for calendar year 2015. Reporting is optional for calendar year 2014.
The IRS requires reporting to determine whether employees have been offered affordable, minimum essential coverage, and whether the employer is subject to shared responsibility payments under the Internal Revenue Code.
Who is required to report?
Employers who are considered an applicable large employer (ALE) are subject to reporting requirements. Additionally, any person or organization that provides minimum essential coverage to an individual must report to the IRS and furnish statements to individuals. This includes:
- Health insurance issuers;
- Plan sponsors of self-insured group health plan coverage; and
- The executive department or agency of a governmental unit that provides coverage under a government-sponsored program.
Plan sponsors in a group of companies with common ownership or an affiliated group of companies (a controlled group) that are not an ALE, and providers (such as issuers) that are not reporting as employers, may report as separate entities or have one entity report for the controlled group.
What qualifies as an ALE?
An ALE is an employer that employed an average of at least 50 full-time employees and full-time equivalents (FTEs) during the preceding calendar year. All ALEs must file the report, regardless of whether the employer is a tax-exempt or government entity (including federal, state, local and tribal governments).
A full-time employee generally includes anyone who was employed on average at least 30 hours of service per week or 130 hours per month. Full-time equivalents are determined by adding up all of the part-time hours in a month (up to 120 hours/employee) and dividing by 120. For example, if six employees work 20 hours/week, the employer would have four FTEs.
What is an ALE required to report?
The ALE is required to report its contact information, a certification that it offered its full-time employees (and their dependents) the opportunity to enroll in minimum essential coverage under an eligible employer-sponsored plan, and the number of its full-time employees for each month during the calendar year. For each full-time employee, the ALE must report the months during the calendar year for which minimum essential coverage under the plan was available and the employee’s share of the lowest-cost monthly premium for self-only coverage (before any wellness discount).
Employers should take the following steps to prepare for the ACA information reporting:
- Determine if you are an ALE.
- Determine if you need to file and what needs to be filed.
- Confirm the health benefits provided.
- Decide how the required information is being tracked.
- Decide who will prepare the IRS filings and statements.
A range of tools and resources are available to help you prepare for this requirement—check with your accountant or financial advisor for more information. iBi
Rick Krueger is manager of employee benefit plans for CliftonLarsonAllen. He can be reached at [email protected] or (309) 671-4500.