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The Affordable Care Act (ACA) has new reporting requirements in 2016, Codes 6055 and 6056, with IRS forms due 2/1/16 for the policyholder. Depending on the size of your employee group, some of this mandated reporting will be done by your insurer, and some must be done by you, the employer. If you are a small group, which is defined as employers with less than 50 full-time equivalent employees, and have a fully insured plan, your insurance company will report to the IRS and policyholder. If you are a large group (50+ full-time equivalent employees), then the employer must do the reporting, which can often be assisted by your payroll service. If you have a self-insured plan, the employer must do the reporting.

What is reported? Two things are basically reported: 1. That your employee has health insurance (required by ACA law or pay a penalty) and, 2. Your health plan meets Minimum Essential Coverage (MEC)-6055 for small group plans, and for large group, that you offer a plan and it is affordable (does not exceed 9.5% of employee income). Basically, if you're a small group employer you're not required to offer a health plan, but if you do, it must meet MEC standards. Your insurer will now confirm this with the IRS and your employees (policyholders). If you're large group, the employer must confirm to the IRS and policyholders that a health plan is offered to all full-time employees, and whether it is affordable (9.5% rule).

The IRS forms to be completed are 1094-B & 1095-B for small group and 1094-C & 1095-C for large group. The deadlines for reporting to the IRS have just been extended to 5/31/16. Your business accountant may be able to assist and answer questions, but we wanted to share how the reporting required depends on the size of your employee group, and may all be handled by your insurer. Let us know if you have questions, and Happy New Year!

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