Employer Mandate

Effective Jan. 1, 2016, under the employer mandate provisions of the Affordable Care Act (ACA), employers with 50-99 full-time employees and full-time equivalent employees (applicable large employers) must offer full-time employees (and dependents) minimum essential coverage that is affordable and provides minimum value or be subject to heavy penalties. Note: effective for the 2015 calendar year, such employers are subject to reporting requirements (refer to Reporting Requirements section below).

The employer mandate went into effect on Jan. 1, 2015 for employers with 100 or more full-time employees and full-time equivalent employees.

To learn more about the employer mandate and to determine if it applies to you, read the below resources:

• Employer mandate provisions and detailed questions and answers
• Determining if an employer is an applicable large employer
• Identifying full-time employees
  
• The two types of employer mandate penalties and how they are calculated

If you have further questions about the employer mandate, contact Sam Melamed, ABC Insurance Trust CEO, at [email protected] or (202) 595-1757. 

Reporting Requirements

Additionally, the ACA includes new onerous information-reporting requirements under Internal Revenue Code (IRC) sections 6055 and 6056 that apply to employers with 50 or more full-time employees and full-time-equivalent employees, as well as employers of any size that self-insure. Effective for the 2015 calendar year, employers are required to collect certain information about the health coverage they offer and, in the first quarter of 2016, report such information with the IRS. In addition to filing the information returns with the Internal Revenue Service (IRS) no later than Feb. 29, 2016, if filed on paper, or March 31, 2016, if filed electronically, an employer must provide a related statement to each full-time employee or covered individual by Feb. 1, 2016.

Must-read additional resources:

Applicable large employers (those with 50 or more full-time employees and full-time-equivalent employees) can learn more about section 6056, read a Q&A and access the following forms on the IRS website.

• 2015 Form 1095-C Employer-Provided Health Insurance Offer and Coverage
• 2015 Form 1094-C Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns
• 2015 Instructions for Forms 1094-C and 1095-C
• Questions and Answers related to Form 1094-C and 1095-C

Applicable large employers that file 250 or more information returns must file the returns electronically through the ACA Information Returns (AIR) program.

Self-insured employers can learn more about section 6055, read a Q&A and access the following forms on the IRS website.

• 2015 Form 1095-B Health Coverage
• 2015 Form 1094-B Transmittal of Health Coverage Information Returns
• 2015 Instructions for Forms 1094-B and 1095-B

Self-insured employers that are applicable large employers are subject to the reporting requirements of both section 6055 and section 6056 and are required to use Form 1095-C and Transmittal Form 1094-C. Self-insured employers with fewer than 50 full-time or full-time equivalent employees should use Form 1095-B and Transmittal Form 1094-B.

To learn more about the reporting requirements and important upcoming deadlines, register for the webinar on Jan. 27 at 2 p.m. EST, titled "Health Care Reform Update – Learn how the Affordable Care Act Will Impact your Company in 2016 and Beyond" and presented by ABC’s general counsel, Littler Mendelson.

*Employers are encouraged to consult counsel and/or their insurance brokers about complying with ACA.