Form 1095-B Information Requirements

We’ve been talking about Form 1095-C for a while, so why don’t we switch gears and talk a bit about the other ACA Form that’s due in the next couple months: Form 1095-B.

Form 1095-B
Form 1095-B, Health Coverage, is one of the forms created by the Affordable Care Act and the IRS for reporting coverage. Anyone who provides minimum essential coverage to individuals during the calendar year must file a Form 1095-B to report the coverage offered. Of course, this is anyone providing coverage who is not an Applicable Large Employer (ALE), because, as we all know, they file on Form 1095-C.

As with Form 1095-C, a copy of Form 1095-B should be filed with the IRS and a copy should be sent to the individual who received the offer of coverage.

Information Needed for Form 1095-B
So before you dive into working on Form 1095-B, make sure you have the following information:

• Part I: Responsible Individual. For each recipient of an offer of coverage, you’ll need to have their
• Name,
• Social security number,
• Date of birth (if their SSN is unavailable),
• Address, and
• The Origin of the Health Coverage code.
• Part II: Employer-Sponsored Coverage. If you provided employer-sponsored coverage, use Part II to enter information about the sponsoring employer. You’ll need to have their
• Name,
• Employer Identification Number (EIN), and
• Address.
• Part III: Issuer or Other Coverage Provider. Part III provides information about the coverage provider. For this section, you’ll need the provider’s
• Name,
• EIN,
• Address, and
• Contact number.
• Keep in mind that this phone number should be that of someone who can answer questions regarding the coverage information reported.
• Part IV: Covered Individuals. If your coverage offer extends to the recipient’s spouse and/or dependent(s), you’ll need the following information on them:
• Name,
• SSN,
• Date of birth (if their SSN is unavailable), and
• The months they were covered.

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What it Means: Form 1095-C, Line 16

Welcome back! We’re here for Part 2 of ExpressACAForms’s series on lines 14 and 16 of Form 1095-C, Employer-Provided Health Insurance Offer and Coverage.

And since we covered line 14 last time, this post is all about line 16!

Form 1095-C, Line 16
So, as you remember, line 14 indicates to the IRS the type of coverage you offered your employee. Line 16 takes that a step further and indicates to the IRS any safe harbor situations that applied to you/that employee with Code Series 2. It basically answers the “why” question for the type of coverage you chose to offer.

Tax Year 2016 Code Changes
If you remember filling out line 16 this past year, there’s a chance you remember entering code 2I. Not this year! The IRS got rid of code 2I on line 16 of Form 1095-C this year since the safe harbor it represented was exclusive to the 2015 tax year.

Code Series 2
On line 16 of Form 1095-C, you’ll use one code per month (or one code for all 12 months) as it applies to that employee. Here are those codes and what they mean:

• 2A. The employee was not employed during the month indicated. If the employee worked even one day of the month, you are not allowed to use code 2A. Additionally, code 2A should not be used for the month an employee is terminated.
• 2B. The employee was not a full-time employee during the month indicated. If the employee was not a full-time employee and did not enroll in MEC, use code 2B. You’ll also use 2B if the employee was a full-time employee whose coverage ended that month solely because the employee terminated employment.
• 2C. The employee enrolled in the coverage offered. Code 2C cannot be used if code 1G is in line 14 or if the coverage was not MEC. Code 2C also shouldn’t be used for months terminated employees are enrolled in COBRA continuation coverage.
• 2D. The employee is in a section 4980H(b) Limited Non-Assessment Period or an initial measurement period.
• 2E. Use code 2E for any month for which the multiemployer arrangement interim guidance applies to that employee, regardless of any other code in Code Series 2 that may apply.
• 2F. Enter code 2F if section 4980H Form W-2 safe harbor was used to determine affordability for the employee for the year. Code 2F must be used for all months of the year the employee was offered health coverage if it applies.
• 2G. Enter code 2G if section 4980H federal poverty line safe harbor was used to determine affordability for the employee for any months of the year.
• 2H. Enter code 2H if section 4980H rate of pay safe harbor was used to determine affordability for the employee for any months of the year.

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What it Means: Form 1095-C, Line 14

Hello there! Welcome to ExpressACAForms’s quick little two-part series on two of the more complicated lines of the Form 1095-C, Employer-Provided Health Insurance Offer and Coverage.

And by “complicated,” we mean it’s the information about your employee that might not be readily available on their W-9. Don't worry: it’s nothing too hard.

Form 1095-C, Line 14
Line 14 is where you indicate to the IRS what sort of coverage you offered to the employee for whom you’re completing the Form 1095-C. You do this using Code Series 1, and each code in the series lets the IRS know if the coverage you offered met minimum essential coverage (MEC), the minimum value (MV), and if the coverage was offered to the spouse and dependent(s), if any.

Tax Year 2016 Code Changes
Of course, since it’s the IRS, things are slightly different for this upcoming year than they were last year. Code Series 1. Code 1I was replaced with code 1J. They also added code 1K to the mix to help indicate more situations regarding your offers of coverage.

Code Series 1
On line 14 of Form 1095-C, you’ll use one code per month (or one code for all 12 months) as it applies to that employee. Here are those codes and what they mean:

• 1A. A Qualifying Offer was made to the employee, spouse, and dependent(s), if any. A Qualifying Offer provides MEC at MV and the Employee Required Contribution is equal to or less than 9.5% (as adjusted) of the mainland single federal poverty line.
• 1B. You offered MEC at MV to the employee only.
• 1C. You offered MEC at MV to the employee and dependent(s) but not the spouse.
• 1D. You offered MEC at MV to the employee and spouse but not dependent(s). BUT if the coverage for the spouse was offered conditionally, use code 1J instead.
• 1E. You offered MEC at MV to the employee, spouse, and dependent(s). BUT if the coverage for the spouse was offered conditionally, use code 1K instead.
• 1F. You offered MEC that did not meet MV to the employee, spouse, dependent(s), or any combination of the three.
• 1G. You offered coverage for at least one month of the calendar year to an individual who was not your employee at all during the year or to an individual who was a part-time employee. Note that code 1G must be used for all 12 months, so go ahead and put it in that “All 12 Months” box on the form.
• 1H. You didn’t offer any coverage to the employee that month.
• 1J. You offered MEC at MV to the employee and conditionally to the spouse but not to the dependent(s).
• 1K. You offered MEC at MV to the employee and dependent(s) and conditionally offered it to the employee’s spouse.

Stay tuned for Part 2 of What it Means with ExpressACAForms! And make sure to follow along for even more ACA and e-filing information.

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Form 1095-C Information Requirements

Form 1095-C is a pretty important form. It’s the form that all Applicable Large Employers (ALEs) use to report the health care coverage they offer their full-time employees each year.

So before you sit down to complete these important forms, you need to be sure to have all the information required. A lot of the data you’ll need can be gotten easily from your current payroll system but you’ll also be required to supply data on the coverage you offered each of your full-time employees.




To help get you prepared, here’s a list that breaks down all the information you need to complete Form 1095-C:

• Employee data. For each employee, you’ll need to have their
• Name,
• Social security number, and
• Address
• Applicable Large Employer data. That’s you. You’ll need your business’s
• Name
• Employer Identification Number (EIN)
• Address, and
• Telephone number
• Offer of coverage information. This is the part where you tell about the (at least) minimum essential coverage you offered your full-time employees. You’ll need
• The plan start month,
• An offer of coverage code for each month that identifies the type of coverage offered,
• The employee’s required monthly contribution to their coverage, and
• Any Section 4980H Safe Harbor information that applies, indicated by the safe harbor codes.
• Covered individuals’ information. If your coverage offer extends to the employee’s spouse and/or dependent(s), you’ll need the following information on them:
• Name,
• Social security number or date of birth, and
• Which months coverage was offered.

Once you have all the information you need, you can feel confident as you begin your Affordable Care Act filing.


You can feel even more confident in your ACA filing if you sign up with ExpressACAForms! We’re one of the IRS-authorized leaders in secure ACA Form e-filing. Visit our site or give us a call (704-839-2270) to learn more about how ExpressACAForms can help get your ACA e-filing done quickly and easily.

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The 1095 Forms

There are some pretty important forms you need to add to your tax season repertoire: the Affordable Care Act 1095 Forms.

Think of these forms as the W-2s of the health care coverage the ACA requires you to offer and report on each year. You’ll report certain information about the coverage you offered to each person you offered that coverage and with the IRS on these 1095 Forms.




Form 1095-C, Employer-Provided Health Insurance Offer and Coverage
We’re foregoing alphabetical order to better explain how these 1095 forms work. Form 1095-C is the form that’s completed by all Applicable Large Employers (ALEs) for their full-time employees. ALEs are employers with 50 or more full-time employees who are thereby subject to the ACA’s employer shared responsibility provisions.

To complete Form 1095-C, you’ll need:

• Employee information (name, SSN, address)
• Employer information (name, EIN, address, contact info)
• The Plan Start Month for each employee
• Offer of Coverage Codes for each employee
• The Employee Share of Lowest Cost Monthly Premium per month
• Spouse and dependent information (name, SSN/birth date, months covered)
• Section 4980H Safe Harbor Codes (if applicable)

Form 1095-B, Health Coverage
Form 1095-B is filed by everyone else who provides health care coverage throughout the year. That means small businesses, insurance agents, certain government agencies, and anyone else who provided minimum essential coverage to taxpayers.

To complete Form 1095-B, you’ll need:

• Filer information (name, EIN, address, phone number, and contact info)
• The total number of 1095-B Forms you’re filing
• Recipient information (name, SSN/birth date, address)
• Coverage type, broken down by month

If you’re using Form 1095-B to report Employer-Sponsored Coverage or coverage provided by another user, you’ll also need that other entity’s name, EIN, address, and contact information.

Form 1094, Transmittal Form
Each Form 1095 comes with its very own Form 1094 (B or C). This is the transmittal form that summarizes the 1095 return it’s accompanying to the IRS. That’s right, this one just goes to the IRS, not your employees/recipients.

When you e-file with ExpressACAForms, we’ll automatically create your 1094 Form for you based on the information that generates your 1095 Forms, all of which are IRS-authorized and made ready to e-file immediately. Check out our site to learn more about these and our various other features, all of which are designed to make your ACA filing as fast and simple as possible.


Questions? Just give us a call! We’re available by phone (704-839-2270) and live chat Monday through Friday, 9:00 a.m. to 6:00 p.m. EST, and by email 24/7 at support@ExpressACAForms.com.

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Section 6055 & 6056 Reporting

When it was enacted, the Affordable Care Act really shook things up with the IRS’s Internal Revenue Code. Namely, it added Sections 6055 and 6056 to the code to outline how employers must report the health insurance coverage they offer each year.

So just what do these new sections say? We’re glad you asked!

Section 6055 & 6056 Requirements
The Sections 6055 and 6056 go into a lot of detail about what it is you need to report to the IRS after you’ve offered health insurance to your full-time employees.

• Section 6055 says that employers with self-funded plans and insurers who manage fully-insured plans must report information about the organization providing coverage.
• Section 6056 says that employers must report information about the employer offering coverage.

Reporting Requirements
If you’re considered an Applicable Large Employer - that is, if you have at least 50 full-time employees - you’re subject to the Section 6055 and 6056 reporting requirements each year. That means the IRS requires you provide the following information on Forms 1094-C and 1095-C:

• Detailed information on each employee (name, address, Social Security Number)
• Your total number of full-time employees
• Whether or not the coverage you offered met minimum essential coverage and minimum value
• Whether or not the coverage you offered was affordable, as well as how much each employee was required to pay
• Whether or not the coverage was offered to all of your full-time employees and their dependents.

Getting Started Reporting
If you’ve got everything squared away and are ready to report your MEC-meeting coverage, check out ExpressACAForms! We can create and e-file your ACA reporting forms safely and securely using the data you already have. Sign up for an account or contact our stellar customer support team to learn more!

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ACA Reporting Requirements

A big part of Affordable Care Act compliance is making sure you report that compliance to the IRS and your coverage recipients. After all, if you don’t report it, how does anyone know your coverage was affordable? Or met minimum essential coverage (MEC)?

Reporting Requirements
When the ACA was passed, Sections 6055 and 6056 got added to the IRS’s Internal Revenue Code. These sections cover the reporting requirements of everyone who provides health insurance coverage to taxpayers each year.

• Section 6055: This section says that every provider of MEC has to report coverage information by filing Return Forms 1094-B and 1095-B with the IRS and furnishing Form 1095-B statements to individuals.
• Section 6056: This section says that Applicable Large Employers (ALEs) who provide MEC to their employees must report coverage information by filing Return Forms 1094-C and 1095-C with the IRS and furnishing Form 1095-C statements to employees.

Now, let’s take a moment to clarify those two points:

• Section 6055 requires health insurance issuers/carriers for insured coverage, plan sponsors of self-insured group health plan coverage, and the executive department/agency of a governmental unit that provides coverage under a government-sponsored program to report on Forms 1094-B and 1095-B.
• Section 6056 requires ALES, which are employers with 50 or more full-time employees throughout the year, to report on Forms 1094-C and 1095-C.

So now that you know whether or not you need to report, be sure to check out ExpressACAForms! We’re a full-service solution for your ACA e-filing, ensuring your forms are correctly e-filed with the IRS and sent out to your recipients.

And if you have any questions about the process or ACA reporting, just give our friendly customer support team a call! We’re available Monday through Friday, 9:00 a.m. to 6:00 p.m. EST by phone (704-839-2270) and live chat and available 24/7 through email at support@ExpressACAForms.com!

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Finding Employee Eligibility

A lot of being compliant with the Affordable Care Act (ACA) has to do with offering the right amount of coverage to the right employees.

We’ve talked in depth before about minimum essential coverage, minimum value, employer responsibilities, and even employee affordability and dependent coverage, all of which help determine that the coverage you offer is the right amount. Today we’re going to focus on the latter part of ACA compliance: the right employees.

According to the Employer Shared Responsibility Provisions, applicable large employers (ALEs) must offer coverage to all of their full-time employees.

So how do you figure out your full-time employees? Count their hours! But keep in mind that the IRS considers 30+ hours/week (or 130+ hours/month) to be full-time.

The hours you’re totaling should include:

• The employee’s hours worked
• Paid Family and Medical Leave of Absence (FMLA)
• Vacation days
• Sick days
• Jury duty
• Military duty

The employee’s hours of service when totaling who is full-time in the eyes of the IRS should not include:

• Volunteer hours
• Work-study hours (performed by students, interns)
• Hours paid with foreign-source income

Total up these hours one of three ways:

• By calculating the actual hours of service each month for each employee
• By totaling the number of days each month the employee did eight (8) hours of work
• By totaling the number of weeks each month the employee did 40 hours of work

Whichever way you choose, you have to stick with it for the entire calendar year. You can switch it up again though once the year is up.


Once you’ve determined those hours of service, it’s time to offer coverage and file those ACA Forms 1094 and 1095. ExpressACAForms can help you with all that and more! Create an account today or give our customer support team a call to answer any other questions you have.

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