The IRS has released draft instructions for the various Affordable Care Act reporting that will be done for calendar year 2015 and while the instructions provide much needed guidance for employers and insurers, they also confirm the daunting complexity of the reporting task.
Forms 1094-B and 1095-B are used by organizations that are not reporting to the IRS as large employers insurers and sponsors of multiemployer plans, for example. Forms 1094-C and 1095-C, meanwhile, are used by organizations that are subject to the employer mandate.
The instructions are voluminous and reflect the complexity behind the information, particularly that employers are going to have to provide, says Amy Bergner, managing director, human resource solutions at PricewaterhouseCoopers in Washington, DC.
The IRS released the draft forms a few weeks ago but without draft instructions, it was difficult to tell exactly what employers and insurers were going to have to do, she notes. Now we have these draft instructions that really walk through whats behind all of the reporting.
Bergner says employers should review the draft instructions as soon as possible with all third-party providers who help them with tax reporting. Even though these reports are not filed with the IRS or sent to employees until early in 2016, employers have to be capturing the information on a monthly basis starting in January 2015, she says.
The purpose of the forms is three-fold:
1. When individuals file their individual tax returns, theyre going to have to report whether or not they have health insurance as required by the ACAs individual mandate. The IRS can compare what the individual is reporting with what the employer is reporting.
2. The IRS can double check whether people who have received federal government subsidies to buy insurance on the exchanges were actually entitled to it. People who are offered employer-sponsored coverage are not entitled to the subsidy.
3. The IRS can enforce the employer mandate, which requires employers with 50 or more full-time employees to offer health insurance.
The instructions include many of the complicated and detailed rules about the employer mandate, details usually reserved for regulations or other technical guidance, says Bergner. We expect that many employers and insurers will need assistance decoding the instructions and the underlying rules to be able to ultimately provide timely and accurate reports.
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