Under the Affordable Care Act (ACA), the IRS requires all employers and qualified health plan providers to report information about their offers of health coverage and health coverage enrollment using tax Forms 1095.
What is the Difference Between Forms 1095-A, 1095-B Form 1095-C?
- Form 1095-A
The 1095-A form (Health Insurance Marketplace Statement) is for people who have health insurance through the Health Insurance Marketplace, often called an exchange. These are individuals who do not have access to or participate in an employer-sponsored plan. - Form 1095-B
The 1095-B form (Health Coverage) is mailed to individuals by the insurer to report minimum essential coverage. The form details the type of coverage, the months of the year the coverage was provided and the names of those covered by the plan. - Form 1095-C
The 1095-C form (Employer-Provided Health Insurance Offer and Coverage Insurance) is issued to employees by companies with 50 or more full-time employees in the previous tax year. This form states the health insurance coverage the employer offered and whether the employee took advantage of it.
The IRS designates this size of company as an Applicable Large Employer (ALE) for reporting purposes and requires Form 1095-C, along with Form 1094-C (the 1095-C summary cover sheet), to also be filed with the IRS. The IRS will use this information to determine if an employer owes any payments under the ACA’s shared responsibility provisions or determine employee eligibility for the premium tax credit.
When and How to File Forms
An ALE member must file Forms 1094-C and 1095-C with the IRS by February 28, 2023 (or March 31, 2023, if filing electronically) for the 2022 calendar year.
ALE members using self-funded plans must furnish a Form 1095-C to each full-time employee by March 2, 2023, for the 2022 calendar year.
Human Resources Outsourcing (HRO) firms like MarathonHR, furnish Form 1095-B for clients who utilize a plan sponsor to offer health insurance by March 2, 2023, for the 2022 calendar year.
For help with understanding your reporting obligations under the ACA, please contact our office for guidance.