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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