Form 1095-C Changes for the 2016 Tax Year

It’s almost time to start filing those ACA Forms for 2016!

And for all you applicable large employers (ALEs) out there planning to file Form 1095-C, have we got some news for you:

Form 1095-C is going through a few changes for the 2016 tax year, specifically to the code series used for lines 14 and 16.

Code Series 1 Changes
On line 14 of Form 1095-C, filers use Code Series 1 to indicate information about the coverage they offered to their employees. Last year, this series was coded 1A through 1I for each option, but for 2016 codes 1J and 1K have been added.

So it’s important to note that since code 1I only applied for 2015 transitional relief options, it’s been marked as “reserved” by the IRS and should not be used on any future 1095-C Forms.

The new codes, codes 1J and 1K represent the following scenarios:

• Code 1J: Minimum essential coverage (MEC) providing minimum value (MV) was offered to the employee; at least MEC was conditionally offered to the employee’s spouse; nothing was offered to the employee’s dependent(s).
• Code 1K: MEC providing MV was offered to the employee and his/her dependent(s); at least MEC was conditionally offered to the employee’s spouse.

Code Series 2 Changes
On line 16 of Form 1095-C, filers use Code Series 2 to indicate the safe harbor relief that applies to the employee’s scenario, if applicable. Similar to Code Series 1, Code Series 2 initial had codes for 2A through 2I to describe different safe harbor relief options. This year and for future years, code 2I has been “reserved” by the IRS and may no longer be used as it only applied to tax year 2015.

Deadline Changes
Initially, the ACA Forms deadlines were the same as other information return deadlines:

• January 31, recipient/employee copies must be mailed out
• February 28/29, IRS copies that are being paper filed must be mailed
• March 31, IRS copies that are being e-filed must be transmitted

However, last year, the IRS extended the deadlines to give filers a bit of a break with the new forms. That timeline looked like this:

• March 31, 2016: recipient/employee copies must be mailed out
• May 31, 2016: IRS copies that are being paper filed must be mailed
• June 30, 2016: IRS copies that are being e-filed must be transmitted

This year, for 2016 tax year filing, the deadlines look like this:

• February 28, 2017: IRS copies that are being paper filed must be mailed
• March 2, 2017: recipient/employee copies must be mailed out
• March 31, 2017: IRS copies that are being e-filed must be transmitted

Stay tuned with ExpressACAForms for all of your up-to-date ACA information! And don’t forget to sign up with us to e-file your ACA Forms accurately and on time!

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The Facts on Obamacare

The Affordable Care Act, also known as Obamacare, can be pretty overwhelming. And the vast amount of new rules and regulations mean that just about everyone in the US has been affected by it.

Regardless of what happens in the future, Obamacare is still the law of the land, so make sure to keep these facts in mind to stay ACA compliant:

All American Taxpayers Must Get Health Insurance
The individual mandate and employer shared responsibility mandate lay out the rules for how everyone is required to obtain medical insurance that meets minimum essential coverage and how certain applicable large employers (those with 50 or more full-time employees) are now required to provide it to their full-time employees. This minimum essential coverage must also meet a certain minimum value, which is determined based on the federal poverty line each year.

Where You Can Get MEC
In addition to the coverage provided by employers (which is required to meet MEC), the ACA has ensured individuals can find insurance that meets minimum essential coverage through:

• Marketplace coverage,
• Most major medical coverage,
• Medicare, and
• Medicaid.

When You Can Enroll
Barring a job change or other major life change (like moving or getting married), you can only purchase qualifying coverage during open enrollment. Other exceptions to the open enrollment period are Medicaid and CHIP, which you can enroll in based on your income at any point during the year.

The Obamacare Forms
In order to prove coverage was obtained, providers of the insurance must report to the IRS and their employees (or coverage recipients) details of the coverage offered on Forms 1094-B and 1095-B or Forms 1094-C and 1095-C.

And that’s something ExpressACAForms can help with! We help you e-file your ACA Forms with the IRS securely, easily, and quickly. And we can also mail your forms to your recipients for you! Check out our site or give us a call for more information on completing your 2016 ACA return.

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Why Employers Face Affordable Care Act Mandates

The Affordable Care Act employer mandates are not to be trifled with.

While there’s a lot of legal and IRS jargon going on in the ACA, the employer mandates basically boil down to:

1. Applicable Large Employers (ALEs), those with 50 or more full-time employees, must offer full-time employees health insurance or pay a per-employee fine.
2. The health insurance coverage offered by ALEs must meet minimum essential coverage (MEC) at a set minimum value (MV).
3. The health insurance coverage offered by ALEs to full-time employees must also be offered to full-time equivalent employees.
4. The health insurance coverage offered by ALEs must cover the employee’s dependent(s) up to age 26, if applicable.

So what’s the deal? Don’t employers have enough to deal with? Why did the ACA implement these mandates?

Well, believe it or not, one of the main reasons the Affordable Care Act was enacted was to ensure all US taxpayers have access to (ahem) affordable health insurance coverage. And since many employers already provide health benefits to their employees, making it so that the coverage they offer meets certain requirements was one way to get most of America’s taxpayers into the “receives affordable coverage” category.

Lawmakers then added the Affordable Care Act’s safe harbor relief options, which help employers shoulder some of the financial burdens of their new coverage offers.



Stay tuned with ExpressACAForms for more information about the Affordable Care Act and ACA reporting! We’re here to help spread the ACA knowledge and help get your ACA e-filing done. And if you have any questions about either, don’t hesitate to reach out to us! We’re available Monday through Friday, 9:00 a.m. to 6:00 p.m. EST, by phone (704-954-8420) and live chat and offer 24/7 assistance through support@ExpressACAForms.com.

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The IRS Has Extended the Deadline for Your ACA Recipient Forms

Don’t forget that, along with the 1095-B or 1095-C Forms you’ll file with the IRS, you also have to send a copy to each of your recipients or employees that reflects the health insurance coverage offer they received from you in the previous year!

You may remember that this past year the IRS extended the deadline for these recipient forms from January 31 to March 31 in an effort to give employers and insurance providers more time to get them done correctly. Well, they’ve done something similar for the 2016 tax filing season in early 2017.

Initially, the deadlines for the ACA Forms were set back to their original dates, which are:

• January 31, 2017, for recipient/employee copies of Form 1095-B/C,
• February 28, 2017, for paper filing Forms 1094 and 1095 with the IRS, and
• March 31, 2017, for e-filing Forms 1094 and 1095 with the IRS.

But a couple weeks ago, the IRS sent out a notice that they’d be extending the deadline for recipient copies of Form 1095-B and 1095-C from January 31 to March 2, 2017. This gives filers just over a month’s time more to complete and mail these forms to each of their coverage offer recipients.

ExpressACAForms can help make sure you meet this new recipient deadline as well as the e-filing deadline for ACA Forms! Not only do we provide fast and easy (and secure!) e-filing, we also provide postal mailing for our e-file users. That means we’ll send out your recipient forms for you while also e-filing your 1094 and 1095 Forms with the IRS.

If you have any questions about starting with ExpressACAForms or would like to know more, don’t hesitate to contact us! We’re available Monday through Friday, 9:00 a.m. to 6:00 p.m. EST, by phone (704-954-8420) and live chat. We also provide 24/7 customer service through support@ExpressACAForms.com.

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ExpressACAForms: A Market Leader in ACA Form Reporting

Did you know that you can e-file your Affordable Care Act Forms right where you get all of your up-to-date ACA information?

(We mean here, at ExpressACAForms, of course!)

This past year, ExpressACAForms was one of the first IRS-authorized e-file providers for the ACA Forms 1094 and 1095. And we put every bit of our online filing and cloud-based software know-how into ensuring we were (and still are) one of the best too!

We’re certainly one of the easiest e-file service providers, at any rate. It only takes five steps - from start to e-file - to have your forms reported to the IRS with ExpressACAForms:

Now, you may be thinking, “Yeah, yeah, so you’re fast, what else you got?” To that, we say, “Just check this out!”

And then we’ll point you to this list of our awesome features that make e-filing a cinch:

• Bulk upload any file your ACA data is already in.
• Our bulk upload feature goes beyond those of our competitors. Not only can you upload everything you have at once, but you can do it with whatever file you already have.
• Got a PDF? Great! Excel spreadsheet? Throw it on in there! XML file? Go crazy! If it’s all together and in one file, you can use it.
• Cloud-based software means you-can-access-it-anywhere software!
• With our cloud-based software, anywhere you have access to the internet and a browser, you have access to your ExpressACAForms account and all the information in it.
• Plus, there’s no need to download any external software onto your computer to access your account!
• There’s a print center in your account!
• You can use this to print your official forms whenever you need them! 
• We also do postal mailing!
• You know how you’re supposed to mail your 1095 Forms to your employees/recipients? Well, you could, or you could authorize us to do it for you!
• You’ll still have access to the forms in your print center if you need them, but if you select postal mailing, we’ll print and mail your forms for you from our offices in Rock Hill, SC by the next business day.
• Plus, you can’t beat our friendly expert customer support team!
• We’re located right here in the US, so anytime you call in, you’ll be connected with a real person you understand.
• And we have round-the-clock contact options! Our phone (704-954-8420) and live chat lines are open Monday through Friday, 9:00 a.m. to 6:00 p.m. EST, and we provide 24/7 email support through support@ExpressACAForms.com.

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Get to Know the ACA Penalties

The Affordable Care Act penalties are no joke.

And while there’s been a lot of talk about the ACA going away, it won’t be going away in time to avoid IRS penalties if you don’t file.

So it’s best to arm yourselves with some knowledge about these ACA penalties and how you can avoid them!





Information Reporting Penalties
That’s the official name of the penalties you’d incur from the IRS if you didn’t file. And, boy, are they every bit as impending as they sound:

• The penalty for failing to file a Form 1095-B or 1095-C with the IRS is $260 per missing form, not to exceed $3,193,000 in a calendar year.
• The penalty for failing to provide a Form 1095-B or 1095-C to your recipients is $260 per missing form, again, not to exceed $3,193,000 in a calendar year.

And don’t forget, the IRS has this in its rules and regulations for the ACA Forms:

“Special rules apply that increase the per-return and per-statement and total penalties with no maximum limitations if there is intentional disregard of the requirement to file the returns and furnish recipient statements.”

In other words, if you intentionally don’t file, the IRS is going to try to come for a lot more than $3 mil.

But on the Flip Side
Your penalties may be waived if you can prove to the IRS that failure to file was due to reasonable cause (think life-or-death, emergency type situation) and not willful neglect.

You also have ExpressACAForms to help make sure you get those forms filed on time! This is especially important because those penalty fees start going up the longer you wait to file after the deadline.

Just head on over to our website or contact our friendly support team to get started and see how ExpressACAForms can help you avoid ACA penalties. We’re available to help by phone (704-954-8420) and live chat Monday through Friday, 9:00 a.m. to 6:00 p.m. EST and available 24/7 at support@ExpressACAForms.com!

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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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Determining Employee Affordability

One of the main provisions of the Affordable Care Act is that it requires the health insurance taxpayers have to be affordable. It should go without saying, then, that the health insurance you provide as an employer must be affordable to your employees.

But, as always, the IRS is going to spell it out for us anyways.

In order to be considered “affordable” under the employer shared responsibility provisions, the employee’s share should cost no more than 9.5% of their annual household income.

Since you’re not likely to know the entire household income of all of your employees, the IRS has come up with three safe harbor techniques to determine whether or not the coverage you offer is affordable.

Keep in mind that you can choose to use one or more of the safe harbors for all of your employees, but you must do so on a consistent basis for all of your employees.

The Form W-2 Wages Safe Harbor
This form of safe harbor bases affordability on whether or not the employee’s cost of the lowest-cost, self-only coverage exceeds 9.5% of the calendar year wages reported in Box 1 on Form W-2.

The Rate of Pay Safe Harbor
The rate of pay safe harbor involves a bit more math: coverage for an hourly employee is affordable if the employee’s contribution for the calendar month does not exceed 9.5% of an amount equal to 130 hours times the lower of

• The employee’s hourly rate of pay on the first day of the coverage OR
• The employee’s lowest hourly rate of pay during the calendar month.

The Federal Poverty Line Safe Harbor
With the FPL safe harbor, for coverage to be considered affordable, the employee’s contribution cannot exceed 9.5% of the Federal Poverty Line for the calendar year divided by 12.



Once you’ve determined your employee affordability, it’s important to have a plan put in place to report that coverage to the IRS! And one of the easiest, most secure ways to do that is with ExpressACAForms! We’re a full-service, IRS-authorized e-file provider, which means we handle creating your forms and e-filing them once you’ve approved them. Give us a call today or sign up on our website to get started.

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Why You Should Be Covering Your Employees' Dependents

If you read the fine print of the Affordable Care Act (or the summary on the IRS’s website), you’ll notice it doesn’t just mention your full-time employees when talking about to whom you’re required to offer minimum essential coverage.

In order for the health insurance you offer to meet minimum value - and therefore ACA compliance - it must also extend to the dependents of your full-time employees. And under the ACA, dependents include children and adopted children, up to the age of 26.

Even if you offer health insurance to all of your full-time employees, if it fails to cover their dependents, you can still incur an ACA penalty. Not covering the dependents of your employees signals that the coverage doesn’t meet minimum essential coverage and value, a.k.a. isn’t in compliance with the ACA.

And when you aren’t compliant with the ACA, you start incurring IRS penalties, in this case, the Employer Shared Responsibility Payment.

When you sign on with ACAwise, our year-round compliance software can help you keep on track with your coverage offers. We’ll alert you to any risks that may indicate your compliance is slipping, and after creating your 1094 and 1095 Forms, we’ll run them through a series of error checks to ensure your ACA reporting is correct.

With ACAwise, there’s virtually nothing to worry about when it comes to your ACA compliance, so why not get started today? Request a demo or sign up now to get everything squared away for the upcoming ACA filing season and beyond!

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Are You Reporting Your Employee Health Coverage Plans to the IRS?

Employers with fifty or more full-time employees have had to deal with a few changes over the past few years thanks to the Affordable Care Act. Not only have you been required to offer health insurance coverage to your full-time employees, but earlier this year you had to start reporting that coverage to the IRS.

For the 2015 ACA filing period, the IRS had a bit more leniency for those reporting coverage. They extended the reporting deadlines, offered safe harbor qualifications for an easier transition, and even offered to forgive late filing penalties, depending on the circumstances.

This year, they’re a little more like the scary, impending IRS we’ve come to know and try to avoid too much contact with. ACA Forms 1094-C and 1095-C for the 2016 year will need to be turned in, correct and on time, or you’ll face some serious consequences.

So it’s incredibly important to have a plan in place for your 2016 and future ACA filing. We’re a little biased and recommend ExpressACAForms for the job! ExpressACAForms is chock full of state-of-the-art e-filing features to ensure your ACA Forms 1094 and 1095 are filled out correctly and sent to the right places at the right time.

Of course, what really sets us apart is our friendly and always available customer support team, based right here in Rock Hill, South Carolina. Give them a call or send an email to learn more about e-filing with ExpressACAForms!

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ACA Requirements for Employers

There’s a lot of information going around about the Affordable Care Act. With all the insurance and filing requirements now in place for individuals, employers, and insurance providers, it can be hard to keep up with what you need to do to keep your business compliant.

Well rest easy, you’ve found ExpressACAForms and we’ve brought you the Employer Shared Responsibilities straight from the horse’s mouth!

(This horse, of course, is the IRS.)


The Employer Shared Responsibility Provisions
So the first thing to know about employer shared responsibility is that it applies to Applicable Large Employers (ALEs), or employers with 50 or more full-time employees. So the vast majority of employers aren’t liable for these provisions, but they are:

• ALEs must offer minimum essential coverage (MEC) of affordable health insurance that provides minimum value OR
• Make an employer shared responsibility payment to the IRS.

These provisions went into play January 1, 2015, so you may be a little familiar with one or the other already.

Avoiding the Payment by Meeting the Provisions
There are two ways an ALE can be made to pay an employer shared responsibility payment:

1. If the employer does not offer MEC to at least 95% of its full-time employees and their dependents, and
2. If at least one full-time employee receives the premium tax credit for purchasing coverage through a Health Insurance Marketplace.

The reasoning behind the first way to incur a payment is a little obvious; you’re directly disobeying the ACA and IRS’s rules about providing health insurance.

The second way’s reasoning is a little more nuanced. You see, even if you offer insurance to your employees, you still have to make sure it meets all the ACA’s minimum value and affordability requirements. If it doesn’t, when your employees go to a Health Insurance Marketplace to get more coverage, they become eligible for and receive a premium tax credit. This alerts the IRS that you become eligible for and receive an employer shared responsibility payment for not meeting ACA requirements.

Employer Reporting Requirements
So not only do you as an ALE have to provide affordable health insurance that meets all these MEC and minimum value requirements, but you have to report you did all that to the IRS each year as well with Forms 1094-C and 1095-C.

Think of them as W-2s for your employees’ health insurance coverage. You use these forms to report the coverage you offered them, the coverage they accepted, and their (and their dependents) basic information. And in January each year, you send a copy to each of your employees so they can use it for their records, and in March you e-file a copy with the IRS to show your compliance.

By the way, one of the easiest, most secure, and most accurate ways to e-file these forms is right here with ExpressACAForms! And if you’re worried about staying ACA compliant throughout the year, check out our sister product ACAwise; it tracks your compliance, alerts you of any discrepancies, and e-files your return each year for you!

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What is a Health Care Marketplace?

With all this Affordable Care Act talk going around, you’ve probably heard the term “Health Care Marketplace,” or maybe even “ObamaCare Marketplace,” dropped once or twice. But just what is this mythical marketplace?

Is it an actual place where insurance salesmen hawk different insurance packages all wrapped up in paper and string? Sort of! But not exactly.

The Health Insurance Marketplace is your state’s price comparison website for subsidized health insurance. Each year during the annual open enrollment period, you can enroll in a plan, switch plans, or apply for cost assistance.

If you don’t receive insurance from your employer, the Health Insurance Marketplace is where you can go to be sure you’re getting health insurance that meets minimum essential coverage and minimum value. And those are things you want to make sure you have, otherwise, you'll have to pay a pretty hefty fine.

As we mentioned earlier, each state has a different marketplace. And you’ll want to make sure you’re on the right website for your state. If you’re in:

• Arkansas, use the Arkansas Health Connector,
• California, use Covered California,
• Colorado, use the Connect for Health Colorado site,
• Connecticut, use Access Health CT,
• District of Columbia, use the DC Health Link,
• Hawaii, use the Hawaii Health Connector,
• Idaho, use Your Health Idaho,
• Kentucky, use Kentucky’s Healthcare Connection,
• Maryland, use the Maryland Health Connection,
• Massachusetts, use the Health Connector,
• Minnesota, use MNsure,
• Nevada
• Individuals: HealthCare.gov
• Employers shopping for employee health plans: Nevada Health Link
• New Mexico, use BeWellNM,
• New York, use the New York State of Health,
• Oregon
• Individuals: HealthCare.gov
• Individuals applying for Medicaid and CHIP: Cover Oregon
• Rhode Island, use HealthSourceRI,
• Utah
• Individuals: HealthCare.gov
• Small businesses and their employees: Avenue H
• Vermont, use the Vermont Health Connect, and
• Washington, use the Washington Healthplanfinder.

If you live in any other state, you’ll use the official Health Insurance Exchange Marketplace website, www.HealthCare.gov. If you live in one of the US territories (American Samoa, Guam, Northern Mariana Islands, Puerto Rico, or the Virgin Islands), you’re not eligible to use the Marketplace to apply for health insurance and should check with your territory’s government offices to learn about your options.




While our software is designed to help employers and third party providers e-file ACA returns, we’re also committed to providing accurate, up-to-date ACA information, so stay tuned for more from ExpressACAForms!

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What is Minimum Value?

Last week we went over minimum essential coverage (MEC) and how it’s important to offer coverage that meets it. Another requirement of Affordable Care Act compliant coverage is that it also meet a minimum value.

What is Minimum Value?
Minimum value is a standard of minimum coverage that applies to health plans employers offer. If the plan you offer meets this standard as well as the MEC standard, you’re considered ACA compliant in the coverage you offer.

A health plan meets the minimum value requirement if:

• It’s set up to pay at least 60% of the total cost of medical services for a standard population and
• Its benefits include substantial coverage of physician and inpatient hospital services.

Reporting Minimum Value
Don’t forget that you have to report the coverage you offer that meets MEC and minimum value requirements on Forms 1094 and 1095! And ExpressACAForms can help you e-file those forms quickly, easily, and securely!

If you’re looking for something a little more in-depth (think features to help make sure your coverage meets minimum requirements and is offered on time) in your ACA reporting, try out our sister product, ACAwise! You can sign up for a free demo today over at www.ACAwise.com or by calling (704) 954-8420.

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