5 Must-Know Obamacare Obligations for Every Entrepreneur

Obamacare

Obamacare or ACA compliance is real, it’s complicated and it’s here to stay. Business owners today face a new challenge to be at par with ever changing rules and their interpretations and to also act accordingly to track and report to the IRS.

Below we present a couple of factors that are a good start for analyzing the current status of a business owner in terms of liability towards ACA.

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Health Insurance Providers Must Report Certain Information to the IRS and Covered Individuals

Health Insurance Providers

With the new directives from the IRS, providers of minimum essential coverage are required to report certain information not only to the individual about their health coverage but also to the IRS, starting 2016.

To stay in-line with the individual shared responsibility criteria Taxpayers use the information stated in Form 1095-B, Health Coverage Information Return Form 1095-C, Employer-sponsored health offer and coverage whenever they file their tax returns. IRS would use this information to ascertain the number of months the individual has health coverage.

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IRS Health Care Tax Considerations for Small Employers with Fewer than 50 Employees

aca tax provisions

Health care tax, which is often known as Affordable Care Act (ACA) or ObamaCare not only affects individuals and families but also small and large businesses in the United States. The law was signed by President Barack Obama on March 23, 2010. However, the rules are a bit different for small and large businesses.

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1095 Filing – Deadlines for 2016

Self-insured employer, government agencies, issuer of health insurance and any other business entity that provides health coverage to a full-time employee are required to report the details of the coverage provided to the IRS. Business entities that are ALE’s (Applicable Large Employer) are supposed to report all the coverage information to the IRS that is pertinent to its full-time employees. IRS categorizes ALE’s (Applicable Large Employer) as one who has minimum 50 full-time employees.

1095 Filing Deadlines for 2016

You may file the 1095 Forms to the IRS using CheckMark 1095 software. The due dates for 1095 Filing as released by IRS are given below. Make sure that you mark them as reminders in your calendar. As per the requirements and conditions stated in this article you may decide to use CheckMark 1095 software with either the print or with E-Filing capability –

  • Companies handing over Forms 1095-B and 1095-C to individuals by Feb. 1, 2016.
  • Companies filing the Forms 1094-B, 1095-B, 1094-C and 1095-C with the IRS not later than Feb. 29, 2016 if filing on paper and March 31, 2016, if filing electronically.

ACA 1095 Deadlines

Health Coverage Providers – Reporting

Companies providing minimum essential health coverage for the calendar year must report an information return and a transmittal to the IRS. Mostly for this purpose transmittal Form 1094-B and information return Form 1095-B will be used. However, employers (including government employers) supporting self-insured group health plans will report about the coverage in Form 1095-C.

Employers having less than 50 full-time employees and who do not sponsor the employer shared provisions for health coverage, but do sponsor self-insured group health plans, should use Forms 1094-B and 1095-B to report coverage information about individuals.

As one of the striking features of CheckMark 1095 software – it is super easy to create as many employee entities in its database as you want at lightning fast speed.

Applicable Large Employers – Reporting

Business entities with 50 or more full-time employees (full-time equivalent employees) should use Form 1094-C for transmittal and Form 1095-C for reporting information required under ACA (Affordable Care Act) about various offers on health coverage and enrollment in health coverage of their employees.

Additionally, to report the health coverage that the employers offer, ALE’s (Applicable Large Employers) sponsoring self-insured health plans are supposed to use the Forms 1094-C and Forms 1095-C for reporting about the coverage that they provide to their enrolled employees.

Affordable Care Act – Explained

With Affordable Care Act (ACA) aka Obamacare in place certain employers are required to offer health insurance coverage to their full-time employees. These employers should send an annual statement to all the employees eligible for this coverage. The statement describes the insurance available for them.  Internal Revenue Service (IRS) Form 1095-C is used as that statement.

Who should file Form 1095-C?

The ACA clearly defines which employers have to offer health insurance to their employees. ACA refers to them as “applicable large employers,” (ALEs). A company/organization is an ALE if it has minimum 50 full-time employees. Full-time employee, as per ACA, is someone who works minimum 30 hour/week. Only ALEs are required to file Form 1095-C.

What is 1095-C
Employee of an ALE who is eligible for insurance should receive the form 1095-C. Eligible employees but declining to participate in employer provided health plan will still receive a 1095-C. The form typically includes:

  • Details of the employee and the employer.
  • Months of the accounting year the employee was eligible for insurance.
  • Cheapest premium cost that the employee could have paid.

1095-C will indicate the fact if an ALEs does not offer its employees with insurance coverage. But such ALEs may be subject to financial penalties.

When does 1095-B comes into picture

Where 1095-C only describes what kind of insurance coverage was made available to a full-time employee, form 1095-B contains the details about the employee’s actual coverage, including the details of the employee’s family dependents that are included in this insurance coverage. Form 1095-B is sent out by the insurance provider and not the employer.

Some companies pay medical bills for their employees themselves, meaning they are self-insured-

  • For such cases employer is the insurance provider, so it will send out 1095-B forms.
  • For such cases “B” and “C” forms can be combined and sent together by the employer.

When 1095-C is supposed to go
Starting 2015 tax year sending out 1095-C forms has been made mandatory. Employers have to send these out to their full-time employees and also to the IRS. Employees should receive them by the end of January — so in January 2016, forms for 2015 tax year will be sent.

Employers filing paper forms will have time till February 2016 and if they are filing electronically will have time till March 2016. Employers having employees 250 or more have to file the forms to IRS electronically only and those who have full-time employees less than 250 have the option to file in paper or electronically. Dates have to be maintained strictly to avoid any kind of penalty from IRS.