ACA 6055 Reporting Requirements Explained

With tax season in full swing we have been getting questions about reporting to the IRS information relating to covered individuals that have been provided minimum essential coverage (MEC).  On March 10, 2014 the U.S. Department of the Treasury and IRS published final rules to implement the information reporting provisions for insurers and certain employers under the Affordable Care Act (ACA) that take effect in 2015.  To help answer some questions about 6055 reporting requirements I have included this FAQ from United Health Care.  Click here to see the document-

Our resident health expert Gauri Gupta has broken down the information with a few highlights.

Who is this for?

Employers who provide minimum essential coverage (MEC) during a calendar year are required to report to the IRS certain information about individuals covered by Minimum Essential Coverage and also to provide a statement to those individuals.

6055 Reporting

Section 6055 reporting is the required reporting to the IRS of information relating to covered individuals that have been provided MEC by health insurance issuers (issuers), certain employers, and other entities that provide MEC. A statement disclosing MEC information must also be furnished to responsible individuals (i.e., subscriber).

FORMS

To report coverage information to the IRS and the taxpayers the below forms will be used.  The forms contain identifying information about the employee or policy holder (i.e., the responsible individual) that is the primary subscriber of the MEC. In addition, in the case of employer-provided coverage, both forms will include the name, address, phone number and Employer Identification Number (EIN) of the employer sponsoring the coverage. Finally, both forms include identifying information about the health issuer or other entity that provides the coverage on behalf of the employer. The coverage information will be used by employees (and family members) to report on their tax returns that they had MEC for some or all months of the year.

1095-C

Employers with 50 or more covered full-time employees that are subject to the employer responsibility provisions will use form 1095-C.  The form contains information about the offer of health insurance coverage made to employee, the employee’s share of the lowest cost premium and other information related to the employer responsibility provisions.
Individuals that purchase health insurance coverage through the Individual Health Insurance Marketplace will use the information on form 1095-C to determine if they are eligible for a premium tax credit

1095-B

Form 1095-B is the return used for Reporting MEC under sections 6055 to the IRS and for furnishing coverage information to covered individuals.