Get Ready, Get Set, Go: ACA Reporting Deadlines Are Almost Here

Employers should start preparing now to be ready for Affordable  Care Act (ACA) reporting deadlines, with the first deadline on Jan. 31, 2016 for health benefit coverage provided in 2015.

John Barlament, a lawyer and partner with Quarles & Brady LLP, Milwaukee, presented an overview of employer reporting requirements during The Alliance Employer Benefits Roundtable at Monona Terrace on Dec. 1.

This is the first time that employers are required to send ACA-related reports to employees and the Internal Revenue Service (IRS).

Key Terms to Understand

Barlament highlighted these terms for employers:

• Minimum Essential Coverage (MEC): Coverage that U.S. citizens must have to avoid paying a tax under the ACA. Any person or entity providing MEC to another person must report that information to the federal government.
• Applicable Large Employer (ALE): An employer who had at least 50 full-time employees (FTEs) in the previous calendar year, based on Internal Revenue Service (IRS) guidelines. Employers who are too small to trigger ALE rules do not need to file ALE documents, but if they provide health coverage then MEC filing is still required.
• IRS Form 1094-B and 1094-C: These forms are “cover sheets” used by companies and insurance plans when submitting forms that indicate whether they provided MEC. Most of Barlament’s presentation focused on Form 1094-C, which is typically used by employers. However, employers may also use Form 1094-B in some circumstances, such as submitting information about health coverage for retirees.

When ACA Reporting Forms Are Due

Barlament noted that due dates for ACA reporting are similar to W-2 requirements. Key dates to remember include:

• Jan. 31 of the following year: The date when reports for the preceding calendar year should be sent to employees.
• Feb. 28 of the following year: The date for filing notice with the IRS about coverage during the preceding calendar year if that information is submitted using paper documents. The paper option is available only to employers who are filing less than 250 forms of a single type of form.
• March 31 of the following year: The date for filing notice with the IRS about coverage during the preceding year if that information is submitted electronically. Employers who file more than 250
  forms of one type of form must do so electronically.

Barlament added that those dates will be pushed back one day when filing in 2017 for 2016 coverage, as some deadlines fall on Sundays in 2017.

Filing Responsibility for Self-Funded Plans

Employers who are plan sponsors for a self-funded plan are responsible for filing MEC and ALE reports. There is an exception for governmental entities, where one governmental unit is allowed to designate another entity – the “Designated Governmental Entity (DGE)” – to assume legal liability for filing.

Each employer must submit the required reports independently, as rules about “controlled groups” do not apply to self-funded plans.

MEC requires reporting of an employer’s major medical coverage and generally applies to a “group health plan,” which may be self-funded or fully insured. But it does not include excepted
benefits, such as most dental plans, vision plans, employee assistance programs (EAPs) and health flexible spending accounts (FSAs). Health savings accounts (HSAs) are excluded. In most cases health reimbursement arrangements are exempt, although rules are unclear for some types of arrangements.

Use Tutorials and Webinars

Barlament’s encouraged employers to use these resources, especially if they plan to file their reports without vendor or software assistance:

• IRS Publication 5164, Test Package for Electronic Filers of ACA Information Returns
• IRS Publication 5165, Guide for Electronically Filing ACA Information Returns
• IRS Forms and Instructions:
  • 1094-C
  • 1095-C
  • 1094-B
  • 1095-B

Test Your Plans Now

Barlament emphasized that it’s essential to prepare in advance for ACA reporting.

“One of the strategies we have been recommending is to do hypotheticals,” Barlament said.

Even if employers are using a software vendor, he encouraged them to test their responses to various scenarios, “no matter how goofy,” to be ready when deadlines roll around.