1. Affordable Care Act Guide For 2015 (Powerpoint Presentation) 1

2.  Individual Mandate  Each individual must have Minimum Essential health care Coverage (MEC)  Individuals can obtain coverage from providers  Marketplace/Exchange  A marketplace run by the state or federal government (or both) for people to buy a health plan  Insurers (Directly or Sponsored by Employer)  Self-Insured Employer Employer Mandate Employers with at least 50 Full Time (FT) employees (including FT equivalents) must offer affordable Minimum Essential health care Coverage (MEC) Mandates 2

3.  Full-Time Employee  An individual who is employed an average of at least 30 hours per week for a calendar month, OR  130 service hours in a calendar month  Full-Time Equivalent (FTE) Employee  A combination of individuals, each of whom by themselves is not treated as a FT employee because they are not employed on average at least 30 hours of service per week, but who in combination are counted as the equivalent of a FT employee (solely for purposes of determining whether the employer is an ALE)  Example: 40 FT employees (working 30 or more hours per week) + 20 employees working 15 hours per week = 50 FTEs Definitions - Employee 3

4. Applicable Large Employer (ALE)— An employer that employed an average of at least 50 FT employees (including FTEs) on business days during the preceding calendar year Aggregated ALE Group - Two or more companies that have a common owner or are otherwise related  This would include companies that do not employ enough employees to meet the threshold of an ALE but when combined, as a result of having a common owner, would qualify as an ALE. Self Insured or ‘Self-Funded’— An employer that has the liability for all claims incurred and pays for each claim.  The employer controls what is or is not covered and often customizes their plan design.  The claims are processed and paid by the employer or through the use of a third party administrator (TPA)  “Self-Insured = Provider” Definitions - Employer 4

5. Insurer — A company that processes and pays the claims. This could be the company to whom the employer pays a fixed premium to transfer claims liability.  Marketplace/Exchange - A marketplace run by the state or federal government (or both) for people to buy a health plan Definitions – Insurer / Marketplace / Exchange 5

6.  1095-A—Information return filed by the Exchange  Broker Forms is not supporting Form 1095-A  This form is provided by the government to the individual being insured  1095-B—Information return filed by Insurers and Self-Insuring Employers with less than 50 FTEs  This document allows the individual/employee to prove they were covered by MEC as well as gives the IRS a mechanism to validate that the individual/employee was covered by MEC  This form is sent to the IRS as well as to the individual being insured  1094-B—Transmittal for 1095-B (with 3 free included in the order containing 1095-B items)  Broker Forms is supporting both 1095-B and 1094-B  1095-C—Information return filed by Applicable Large Employers (ALEs) or employers with 50+ FTEs  This document allows the individual/employee to prove they were covered by MEC as well as gives the IRS a mechanism to validate that the individual/employee was covered by MEC  This form is sent to the IRS as well as to the individual being insured  1094-C—Transmittal for 1095-C (with 3 free included in the order containing 1095-C items)  Broker Forms is supporting both 1095-C and 1094-C ACA Forms 6

7. IRS INDIVIDUA L INSURERS & SELF- INSURING EMPLOYERS WITH LESS THAN 50 FTE’s EMPLOYERS WITH 50+ FTE’s EXCHANGE S B A C 1095- 7

8.  Purpose: To allow the taxpayer/employee to establish and IRS to verify that the taxpayer/employee was covered by MEC  The type of customer that will use this form is the employer that has less than 50 FT employees and is also self-insured. 1095-B Key Points 8

9. 9 Official IRS Form – 1095-B Health Coverage (# B1095B05)

10. Official IRS Form – 1095-B Health Coverage Continuation Form (# B1095BCON05) 10

11. Official IRS Form – 1094-B Transmittal of Health Coverage Information Returns ( # B1094B05) 11

12.  Customer is self insured and has 40 FT employees. 5 employees have more than 6 people covered by the insurance plan – Customer needs to order 1095-B as well as the 1095-B continuation page and the 1094-C.  Customer is self insured and has 30 FT employees none of which have more than 6 people covered by the insurance plan – Customer needs to order the 1095-B and 1094-B What form(s) would the customer order? 12

13.  Purpose: To help employees determine whether they can claim a premium tax credit and to assist IRS in determining whether the employer owes a penalty (Employer Shared Responsibility Payment) 1095-C Key Points 13

14. Official IRS Form – 1095-C Employer – Provided Health Insurance Offer and Coverage ( # B1095C05) 14

15. Official IRS Form – 1095-C Employer – Provided Health Insurance Offer and Coverage – Continuation Form (# B1095CCON05) 15

16. Official IRS Form – 1094-C Transmittal of Employer – Provided Health Insurance Offer and Coverage Information Returns (# B1094C105) 16

17. Official IRS Form – 1094-C Transmittal of Employer – Provided Health Insurance Offer and Coverage Information Returns – page 2 ( # B1094C205) 17

18. Official IRS Form – 1094-C Transmittal of Employer – Provided Health Insurance Offer and Coverage Information Returns – page 3 (# B1094C305) 18

19.  Form 1095-C must be provided to all FT employees (who work on average at least 30 hours per week)  Example: 40 FT employees working 30 or more hours per week; 20 employees each working 15 hours per week = 50 FTEs— only have to provide 1095-C to the 40 FT employees  If the employer is self-insured and has 50+ FTEs, the employer must issue Form 1095-C to any employee enrolled in the self-insured coverage  FTEs are counted when determining ALE status, not for issuing 1095-Cs unless the FTE received coverage from a self-insured employer For which employees do I need to provide Form 1095-C? 19

20.  Customer has 150 FT employees none of which have more than 6 people covered by the insurance plan and is not self insured nor a commonly owned company – Customer needs 1095-C and the 1094-C page 1  Customer has 150 FT employees. 10 of those employees having more than 6 people covered by the insurance plan. In addition the company is self insured but not a commonly owned company – Customer needs 1095-C, 1095-C continuation page as well as the 1094-C page 1 and page 2 What form(s) would the customer order? 20

21. Self-Insured50+ FTEsRequired Form Yes 1095-C YesNo1095-B NoYes1095-C No -- “I’m an employer. What 1095 am I required to file?” 21

22.  Do you have 50+ FTEs?  If Yes, then the customer should purchase the Form 1095-C  If No, then ask the next question related to being self-insured  Are you self-insured?  If Yes, then the customer should purchase the Form 1095-B  If No, then the customer does not have a 1095 reporting requirement  What are your reporting obligations?  IRS  Employee  Company record keeping of ACA information for 3 years Will your company be e-filing or paper filing? What forms will your software provider supporting?  IRS Official Documents  Broker Forms Custom Documents (preprinted or blank) Discussion Points with the customer: 22

23.  Customer has 40 FT employees - have to ask additional questions before determining what form(s) need to be ordered  Is the customer is commonly owned?  If yes, then they need to indicate how many FTE employees exist between companies as it may give them 50+ FT employees total which means that they would need the 1095-C and 1094-C  If no, then they need to indicate if they are self-insured.  Are they self-insured?  If yes, then they need the 1095-B and 1094-B  If no, then they have no reporting requirement What form(s) would the customer order? 23

24.  There are no specific ACA correction forms. Depending on when the error is found and on what document the error occurred a ‘Corrected’ check box may be marked or left blank.  Since there are no specific correction forms the customer/employer would order additional 1095 or 1094 forms depending on which form the error occurred. In some cases a corrected form will be sent to the recipient/employee as well as the IRS and in other cases a corrected form will be sent only to the IRS. ACA Correction Forms 24

25.  Paper In addition to the Official IRS landscape formats, Broker Forms will be offering additional formats of the 1095-B and 1095-C:  Custom Recipient Copy Designs with Compatible Envelopes  Pressure Seal Recipient Copy  Perforated Paper with Instructions Broker Forms’ PRODUCT OFFERING 25

26.  This is a custom form developed by Broker Forms for the 1095-C (there is also a half page design for the 1095-B # B95BHPREC05)  This form is NOT being accepted by the IRS Half Page Design (# B95CHPREC05) 26

27.  This is a custom form developed by Broker Forms for the 1095-B (there is also a full page design for the 1095- C # B95CFPREC05)  This form is NOT being accepted by the IRS Full Page Design (# B95BFPREC05) 27

28. Blank Paper (# B95BLANK) 28 Can be used for the 1095-B or 1095-C and will have Instructions on back. A separate blank form will also be offered that will have a fold perforation to allow for ease of folding for insertion into an envelope designed by Broker Forms.

29. Envelopes 29 An envelope designed by Broker Forms to be used only with Broker Forms custom designed forms. The Official IRS Landscape forms WILL NOT fit in this envelope. Moisture (# 95DWENV05) as well as self-seal (# 95DWENVS05) envelopes are offered.

30. Pressure Seal Forms 30 Pressure Seal Forms designed by Broker Forms will be offered. Blank (# 81650) 1095-B (# 81651) 1095-C (# 81652)

31.  Customer needs 1095-C and the 1094-C – need to ask what their software is supporting  Only the IRS Official Landscape forms  Both the IRS Official Landscape forms and the Broker Forms custom forms What form(s) would the customer order? 31

32.  Due dates for 2015 forms:  A filer/employer can apply for an automatic 30-day extension of time to file to IRS (this is extension follows the same process as the W-2s/1099s)  An extension of time to furnish recipient statements is available by writing a letter to IRS  Electronic Recipient Delivery is allowed  E-file threshold: 250  No signature required when filing electronically FORMS 1095-B & 1095-C 32 To RecipientTo IRS via paperTo IRS via e-file February 1, 2016February 29, 2016 March 31, 2016