Tax & Accounting Blog

Understanding data elements needed for ACA reporting

1099, Blog, ONESOURCE July 9, 2015

It’s mid-way through the year and by now you’re probably deep into building your Affordable Care Act (ACA) implementation strategy, including understanding what data is required for Form 1095-C.

Under the new healthcare act, Applicable Large Employers (ALE) with more than 50 full-time employees are required to report annually to the IRS regarding the health care coverage they offer to full-time employees using Form 1095-C.

The new form is separated into three sections: name and address of the employee and employer as well as spouses and dependents of employees, their social security numbers and/or dates of birth, and months of coverage. This is all pretty straight forward, but there is some necessary data that could present challenges, such as Tax Identification Numbers, which we’ll discuss in a follow up blog post.

The second section provides the IRS with health coverage details offered by the employer. It also allows the IRS to understand which employees are eligible for premium tax credits if they chose to purchase health coverage through a health insurance marketplace.

1095-C Employer-Provided Health Insurance Offer and Coverage

  • Box 14: An offer of coverage code for each month of the year (or all 12 months if identical).  This code relates to whether or not an offer of coverage was provided to an employee and/or their spouse and dependents or whether the employee was a full time employee for coverage periods.
  • Box 15: The monthly contribution made by the employee if they select the lowest cost plan for just themselves (no spouse or dependent coverage).  Most companies do not track this at an employee level, but that information can usually be derived from a table which lists plan types and their related salary bands (for employers who determine employee contribution based on salary levels).
  • Box 16: The code for most, if coverage is provided, is 2C.

Click image below to enlarge:

It is doubtful the data elements in the form above are readily accessible. Therefore, choosing a starting point may be helpful to understand just what data you currently track and whether it allows you to derive the necessary data. The earlier that process is started the more time is available to address any gaps or challenges.

Visit 1095-C for more information, including FREE webinar recordings!

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