ACA Compliance and
Employer Shared Responsibility
Disclaimer: This website is intended to provide helpful information for your agency as you comply with the Affordable Care Act. This information is not legal advice. You should work with your legal team before proceeding. Failure to comply with the provisions of the Affordable Care Act may result in a penalty(s) to the employer by the IRS.

IRS Releases Final 2015 1094 and 1095 Forms and Instructions

In September, the IRS released final 2015 1094 and 1095 Forms and Instructions. Beginning in 2016, Forms 1094-B and 1095-B (“B Forms”) will be used by small employers (i.e., those with fewer than 50 full-time and equivalent employees) sponsoring self-insured plans to report on coverage provided to plan participants and their families to the IRS as required by the Patient Protection and Affordable Care Act (“PPACA”). Whereas, applicable large employers will use Forms 1094-C and 1095-C (“C Forms”) to report to the IRS regarding offers of employer-sponsored health coverage made to its full-time and full-time equivalent employees. Although the final 2015 Instructions are largely unchanged when compared to the 2014 Instructions, they do contain some important clarifications. The final 2015 Instructions also contain new guidance regarding the logistics of the reporting and disclosure requirements, such as extensions of time and correction procedures.

BACKGROUND

The Affordable Care Act (ACA) was passed in 2010, and created a variety of new provisions and requirements for individuals, employers, employees, and insurers.

Beginning in 2015, some employers will be subject to the Employer Shared Responsibility Provisions that require applicable large employers to offer affordable minimum essential health coverage that provides minimum value to their full-time employees (defined as employees who average 30 or more hours of service per week). If appropriate health coverage is not offered, employers may be subject to additional penalties if an employee purchases health coverage through the Health Insurance Marketplace and receives a premium tax credit.

In 2015, two additional reporting obligations become effective for the 2016 reporting deadlines:

Internal Revenue Code Section 6055 requires insurers and sponsors of self-insured health plans to prepare annual reports regarding “minimum essential coverage” (“MEC”).
Internal Revenue Code Section 6056 requires an “applicable large employer” to prepare annual reports regarding the health coverage offered to their employees.

REQUIRED REPORTING

Most employers who offer OGB health plans will be required to collect and report specific information about full-time employees and whether health coverage was offered to full-time employees beginning January 1, 2015. (If you have less than 50 employees, you may be exempted from this requirement. Please consult your legal counsel for specific guidance.)  
As an OGB participating agency, you will also be required to report specific information about every individual actually covered by your self-insured major medical plan. This includes dependents, retirees, COBRA-qualified beneficiaries, and survivors.  
The annual report requires specific data for each month of the calendar year.
You will be required to collect the necessary data, which will include information about your agency and health plans as well as demographic information on full-time employees and all other individuals covered under an OGB health plan.

RESPONSIBILITIES

OGB:
OGB will provide a data file on covered individuals and their dependents to all OGB participating employers. This will include the period of coverage and whether the plan is fully-insured or self-insured. The data file will be made available on your respective, secure Agency section of the OGB website. Agencies will be notified once the data file is available.
EMPLOYER:
LaGov HCM paid agencies:
If you are a LaGov HCM paid agency, please refer to OSUP’s website for ACA implementation information. Note: The Office of State Uniform Payroll (OSUP) is the registered owner of the Employer Identification Number (EIN) for all LaGov HCM paid agencies. OSUP will be responsible for reporting to the IRS. The agencies under OSUP’s Employer Identification Number (EIN) will be responsible for ensuring the data that will be included on the IRS forms is accurate and complete.
Non-LaGov HCM paid agencies (non-ISIS):
If you are the registered owner of an Employer Identification Number (EIN) assigned by the Internal Revenue Service, you are responsible for ACA reporting for your employees and all the agencies/employees reported under your EIN.

REPORTING DATA

TO REPORT DATA TO THE IRS, YOU MUST:

➢  Review the ACA regulations (4980(H), 6055, 6066) to determine your employer responsibilities.
➢  Review ACA reporting forms and instructions.
➢  Review ACA required reporting data elements and determine appropriate source of data for each
➢  Retrieve data file from OGB website.
➢  Identify and capture missing data required to complete IRS forms. This includes requesting Social Security numbers for all covered dependents.
➢  Develop a mechanism for storing, where necessary, all of the required data.
➢  Work with technical team to create programs to populate the data onto the required IRS form(s).
➢  Provide applicable IRS forms to all full-time employees and covered individuals.
➢  Submit data to the IRS.

TIMELINE

➢  January 1, 2015 - Employer Shared Responsibility Provisions became effective
➢  August 1, 2015 - OGB begins posting data files to OGB website
➢  March 31, 2016 - Deadline for applicable IRS forms to be mailed to employees/covered individuals
➢  May 31, 2016 - Deadline for employers to transmit data to the IRS if not filing electronically
➢  June 30, 2016 - Deadline for employers to transmit data to the IRS if filing electronically


 
RESOURCES
  
  
QUESTIONS?
➢   If you have questions about the Employer Shared Responsibilities provisions and your reporting requirements, please consult with your legal counsel.
 
➢   If you have questions regarding the data OGB will be providing to complete your reports, contact Monique Fisher
(225) 342-9669.
  
  
DOWNLOADS

IRS Extends Deadline for 2015 Information Reporting Requirements

In late December, the IRS extended certain Affordable Care Act (ACA) data reporting deadlines for applicable large employers as well as for employers with self-insured plans.