All employers should be finalizing their health care reform reporting compliance strategy. Form 1095, if required, must be distributed by March 31, 2016.
An employer that is an applicable large employer (ALE) must provide Form 1095-C to its full-time employees. An ALE is an employer with 50 or more full-time employees (including full-time equivalent employees) in the previous calendar year.
An ALE that has a self-funded plan provides Form 1095-C to its full-time employees and to its employees covered under the self-funded plan. A form must be furnished to any employee of the ALE who is a full-time employee for one or more months of the calendar year.
An ALE that has an insured plan provides Form 1095-C to its full-time employees. The insurance company distributed Form 1095-B to anyone covered under the insured plan.
A small employer (one with less than 50 full-time employees (including full-time equivalent employees) in the prior calendar year will have to distribute Form 1095 if the small employer has a self-funded medical plan. The form to be distributed is Form 1095-B. A small employer with a fully-insured plan will not have a health care reform reporting obligation.
Employers have one more week to make sure any required forms are distributed timely.
|
|
Large Employer |
Not Large Employer |
Self-Funded Plan Offered |
Insured Plan Offered |
Full-Time Employee |
Not Full-Time Employee |
Covered Under Plan |
|
Form 1095-C |
x |
|
x |
|
x |
|
x |
|
Form 1095-C |
x |
|
x |
|
x |
|
|
|
Form 1095-C |
x |
|
x |
|
|
x |
x |
|
No Form |
x |
|
x |
|
|
x |
|
|
Form 1095-C |
x |
|
|
x |
x |
|
x |
|
Form 1095-C |
x |
|
|
x |
x |
|
|
|
No Form (insurance company sends B) |
x |
|
|
x |
|
x |
x |
|
No Form |
x |
|
|
x |
|
x |
|
|
Form 1095-B |
|
x |
x |
|
x |
|
x |
|
No Form |
|
x |
x |
|
x |
|
|
|
Form 1095-B |
|
x |
x |
|
|
x |
x |
|
No Form |
|
x |
x |
|
|
x |
|
|
No Form (insurance company sends B) |
|
x |
|
x |
x |
|
x |
|
No Form |
|
x |
|
x |
x |
|
|
|
No Form (insurance company sends B) |
|
x |
|
x |
|
x |
x |
|
No Form |
|
x |
|
x |
|
x |
|
