Health Care Reform Information Reporting Under Sections 6055 and 6056 Lisa Reed 11/3/2015

2015 Information Reporting Information reporting is used to determine compliance with the Affordable Care Act's individual mandate and pay or play provisions. While the information reporting requirements are first effective for coverage offered (or not offered) in 2015, the initial deadlines for reporting entities are in 2016.

Type of Reporting Entity TBR Institutions and System Office are "Section 6055 and 6056" Reporting Entities. Section 6055 requires self-insuring employers that provide minimum essential health coverage to report information on this coverage to the IRS and to covered individuals under section 6055 of the Internal Revenue Code. Section 6056 mandates that employers with 50 or more full-time employees are required to report information to the IRS and to their employees about their compliance with "pay or play" under Internal Revenue Code section 6056— even those that qualified for 2015 transition relief from the "pay or play" provisions.

Basics of Employer Reporting What are the information reporting requirements for employers relating to offers of health insurance coverage under employer-sponsored plans? The Affordable Care Act added section 6056 to the Internal Revenue Code, which requires applicable large employers to file information returns with the IRS and provide statements to their full-time employees about the health insurance coverage the employer offered. The IRS will use the information provided on the information return to administer the employer shared responsibility provisions of section 4980H. For further details about section 6056 information reporting and additional guidance on Form 1094-C, Transmittal of Employer- Provided Health Insurance Offer and Coverage Information Returns, and Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, see the Employer Information Reporting FAQs for Forms 1094-C and 1095-C on IRS.gov.Employer Information Reporting FAQs for Forms 1094-C and 1095-C

Basics of Employer Reporting When do the information reporting requirements go into effect? The information reporting requirements under section 6056 are first effective for coverage offered (or not offered) in What method of reporting will TBR institutions use? The general method of reporting will be used.

General Method of Reporting What is the general method of reporting? As a general method, employers may satisfy the requirement to file a section 6056 return by filing a Form 1094-C (transmittal) and, for each full-time employee, a Form 1095-C (employee statement). An employer that maintains a self-insured plan also uses a Form 1095-C to satisfy the reporting requirements under section The Form 1095-C has separate sections to allow employers that sponsor self-insured group health plans to combine reporting to satisfy both the section 6055 reporting requirements and the section 6056 reporting requirements, as applicable, on a single return. Under the general method, the section 6056 return (and, if the employer maintains a self-insured plan, the section 6055 return) also may be made by filing a substitute form but the substitute form must include all of the information required on Form 1094-C and Form 1095-C and satisfy all form and content requirements as specified by the IRS.

Reporting for Full-time employees The reporting requirement for full-time employees is covered in IRS Section This section of IRS code applies applicable large employers and is specific to reporting full-time employees (as defined by the ACA eligibility rule). Since retirees and COBRA participants are not full- time employees they are not required under Section HOWEVER, retirees and COBRA participants are required under Section 6055.

Reporting for Retirees and COBRA The reporting requirement for retirees and COBRA participants is covered in IRS Section This section of IRS code applies to any entity that provides minimum essential coverage and employers who offer self-insured group health plan coverage. Therefore, the TBR system is required to report coverage for Retirees and COBRA participants.

Electronic Statements Affirmative consent must be obtained from individuals/employees if the reporting entity plans to furnish statements electronically in Employers must ensure that affirmative consent is obtained from individuals/employees prior to furnishing the statement and must also ensure that certain notice, hardware, and software requirements are met.

Section 6055 Deadlines: Information reporting deadlines for calendar year 2015: Section 6055 First employee statements must be furnished on or before January 31, First information returns must be filed no later than February 29, 2016 (or March 31, 2016 if filing electronically).

Section 6056 Deadlines: Information reporting deadlines for calendar year 2015: Section 6056 First employee statements must be furnished on or before January 31, First information returns must be filed no later than February 29, 2016 (or March 31, 2016 if filing electronically).

Resources Answers-on-Reporting-of-Offers-of-Health-Insurance-Coverage-by- Employers-Section-6056#Methods%20of%20Reporting