Compliance Stuff

Applicable large employers (“ALEs”) are subject to reporting requirements under the Affordable Care Act (the “ACA”). To comply with the reporting requirements, an ALE must file a Form 1095-C with the IRS reporting certain information about the ALE’s offer of coverage to each full-time employee, identifying the employee, spouse, and dependents who are covered under the employer’s self-insured group health plan, and provide a copy of the Form 1095-C to each full-time employee. The reporting requirements provide information to the IRS that it uses to determine whether the ALE has complied with the offer of coverage rules under Section 4980H of the Internal Revenue Code of 1986, as amended (the “Code”) . If an ALE fails to offer affordable, minimum-value coverage to at least 95% of its full-time employees, it can be subject to a penalty under Code Section 4980H(a). If the ALE fails to offer affordable coverage to one or more full-time employees, the ALE can be subject to a penalty under Co...

  Recent legislative changes have brought significant relief to employers grappling with the complexities of Affordable Care Act (ACA) reporting. The  Employer Reporting Improvement Act (Act)  and the  Paperwork Burden Reduction Act , once signed into law by President Biden, will introduce several key modifications to the ACA’s reporting and enforcement rules.  Background: Current ACA Reporting Requirements   Under the current ACA regulations, plan sponsors, particularly ALEs, must report information about the health coverage they offer to employees using Forms 1095-B and 1095-C. These forms must be filed with the IRS and furnished to all full-time employees and employees receiving employer-sponsored coverage.     Current ACA enforcement includes a tight 30-day turnaround to respond to IRS proposed Employer Shared Responsibility Payments (ESRP) assessments. These assessments are sent via US mail, often taking time to reach employer contacts. Thi...