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What are the ACA Reporting Requirements?

The Affordable Care Act (ACA) imposes certain reporting requirements on applicable large employers (ALEs) and health insurance providers. The purpose is to promote transparency and ensure compliance with the ACA provisions. Here are the key reporting requirements:

  1. Employer Shared Responsibility Provision (ESRP) – Form 1094-C and 1095-C:
    • Applicable Large Employers (ALEs) with 50 or more full-time employees or equivalents are required to provide information about the health coverage offered to full-time employees.
    • The 1095-C form is used to report information about each employee’s coverage.
  2. Individual Shared Responsibility Provision – Form 1095-A, 1095-B, and 1095-C:
    • Health insurance providers must report information on individuals covered by minimum essential coverage.
    • Form 1095-A is issued by Health Care Exchange or Marketplace medical plan.
    • Form 1095-B is issued by a health insurance provider, or an employer that is not an ALE, but offers a self-insured medical plan.
    • Form 1095-C is used by ALEs to report coverage provided to their employees.
  3. Reporting by Health Insurance Providers – Form 1094-B and 1095-B:
    • Insurance providers must report information about individuals covered by minimum essential coverage.
  4. Information Reporting by Applicable Large Employers on Health Coverage Offered Under the ACA – Form 1094-C and 1095-C:
    • ALEs must report information about health coverage offered to full-time employees.
  5. Small Business Health Care Tax Credit – Form 8941:
    • Small employers eligible for the Small Business Health Care Tax Credit must file Form 8941.

These forms are filed annually, and the information is used by the IRS to assess compliance with the individual mandate and employer mandate. It’s crucial for ALEs and health insurance providers to meet these reporting requirements to avoid costly penalties.

As tax regulations are always evolving, make sure to check for any updates or changes to the reporting requirements each year.