Who Reports What to the IRS and Employees under Section 6055 of the ACA?

Beginning this year and filing in 2016, employers, insurers and the insurance marketplace will be required to file forms to employees and/or the IRS indicating who had health insurance coverage and when during 2015.  The filing deadline for employers is January 31st, 2016 for statements given to employees/individuals and February 29th for transmittal's filed to the IRS (March 30th if you are filing over 250 employee statements to employees).  This is the information that the IRS will use to penalize the individual or the employer if they are not offering appropriate and affordable coverage and is used by the individual when preparing their personal tax returns.  

The big question is:  Are you as an employer responsible for filing these forms?

From irs.gov.........The Affordable Care Act added section 6055 to the Internal Revenue Code, which provides that every provider of minimum essential coverage will report coverage information by filing an information return with the IRS and furnishing a statement to individuals.


The answer is: yes and no  

If you have less that 50 full time equivalent employees and fully-insured then the health insurance carrier is responsible for the transmittal that is sent to the IRS (Form 1094B) and the Statement that is sent to the individual employee for their taxes (1094C).

If you have less than 50 full time equivelant employees and are self-insured, the employer is responsible for filing the Transmittal to the IRS (Form 1095B) and the  Statement to the employee (1095C)

If you are fully-insured or self-insured with over 50 full time equivalent employees then the employer is responsible for filing the Transmittal to the IRS (Form 1095B) and the Statement to the employee (1095C).

As a side-note, people with individual coverage directly with an insurance carrier or through the exchanges will receive a statement on form 1095A from either the Insurance Marketplace (Exchange) or from the Carriers.

Anthem Data Breach and Suspicious Voice Mail Alert

Anthem Data Breach and Suspicious Voice Mail Alert 

1. CareFirst BlueCross Blue Shield statement regarding Anthem data breach: CareFirst has been made aware by Anthem (like CareFirst, a Blue Cross Blue Shield company) of a cyberattack on Anthem’s information technology system and a resulting data breach. It is unknown at this time the extent to which the data breach may affect members of other Blue Cross Blue Shield plans. CareFirst is working with Anthem and the Blue Cross and Blue Shield Association as the breach is investigated, and will provide information as warranted about the breach and any impact on CareFirst members. Further information about the data breach may be found at www.AnthemFacts.com.

 2. Report of suspicious voice mails claiming to be from CareFirst: CareFirst has been informed that some members have received voice messages claiming to be from CareFirst, and asking the member to call back to a given phone number. That number connects the member to a company that offers information on vacation packages. CareFirst BlueCross BlueShield is not sponsoring or making these calls and is investigating this matter. 

Carefirst Blue Cross Blue Shield
February 5, 2015