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ACA 1095 Filing for Employers

Updated: Jan 17

Employers with More than 50 Full Time Equivalent Employees (including commonly owned companies) or who offer a Self-Funded Medical Plan (of any size) Must Report Health Coverage Offered to the IRS for 2023.



Employers and Carriers will be required to provide reporting on the health coverage they offer so the IRS can verify that employers are meeting their responsibility; and ensure that individuals who request premium tax credits are entitled to them. Employers who offer medical coverage and have more than 50 Full Time Equivalent Employees are required to file 1094C & 1095C. Employers who are on a self-funded medical plan (of any size) are required to file 1094B & 1095C.


2023 Form 1094 and 1095 Due March 1, 2024 (or April 1, 2024, if filing electronically) Paper Copies to Employees are Due February 28, 2024. All eligible employees should receive a 1095 even if they waived coverage.


Calculate your Full Time Equivalent Employee Count (Large Group ALE):


Here are two online calculators to help you determine your Full Time Equivalent count and qualify as an Applicable Large Employer. If you are classified as an ALE for 2022 you need to prepare and file a 1095 this year. Click the links below

Small Group Self-Funded Medical Plan


If you offer a Self-Funded medical plan to your employees, no matter your size, you will need to file a 1094B & 1095B.


Is My Plan Affordable?


Applicable large employers are required to offer coverage that provides minimum value to 95% of their full-time employees. Also, the coverage must be affordable. There are three safe harbors to calculate affordability. You should use the same method from year to year. Federal Poverty Level (FPL) Safe Harbor, W2 Safe Harbor, and Rate of Pay Safe Harbor.

Need to find out if your plan is affordable?



How Can I Get More Details About 1095 Reporting?




I need help! What Resources are available to help me produce my 1095’s and file them with the IRS this year?


We have compiled the following list of resources to help you complete and file your 1095:

IRS Information on the Pay or Play rules




Robin Sellers

Agent

Robin@Benefitguru.com


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