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Home» Compliance Cue Cards™ – Minimum Essential Coverage Reporting (§6055) and Shared Responsibility (§6056) Reporting and Disclosure

Compliance Cue Cards™ – Minimum Essential Coverage Reporting (§6055) and Shared Responsibility (§6056) Reporting and Disclosure

Minimum Essential Coverage Reporting (§6055) and Shared Responsibility (§6056) Reporting and Disclosure

Download the Minimum Essential Coverage Reporting (§6055) and Shared Responsibility (§6056) Reporting and Disclosure Compliance Cue Card

Download the Minimum Essential Coverage Reporting (§6055) and Shared Responsibility (§6056) Reporting and Disclosure Limit Compliance Cue Card

The Affordable Care Act (ACA) added additional reporting and disclosure requirements. This Compliance Cue Card© provides an overview of the requirements relating to the individual mandate and employer shared responsibility. Refer to regulations1 for complete information. (See ErisaALERTs 2014-04, 2014-09 for background information and ErisaALERT December 2020 for information relating to Notice 2020-76.) The regulations require that the employee statements be provided by January 31 and reported to the IRS by February 28 (March 31 if filed electronically). Automatic extensions of up to 30 days can be obtained by Filing Form 8809. The reporting requirements are based on the calendar year regardless of the plan or policy year.

Note:California, District of Columbia, Massachusetts, New Jersey, Vermont and Rhode Island require information reporting.


[1] MEC §6055 reporting final regulations; ALE §6056 reporting final regulations

  §6055 Information Reporting of Minimal Essential Coverage (MEC) §6056 Information Reporting by Applicable Large Employers (ALE) on Health Insurance Coverage offered under employer sponsored plans.
Purpose
  • To allow taxpayers to establish MEC and the months covered
  • To allow the IRS to verify individual MEC
  • To facilitate compliance with administration of premium tax credit
  • To provide statements with specific information to individuals
  • To report to IRS compliance with the employer shared responsibility
    provisions of §4980H
  • To facilitate compliance with administration of premium tax credit
  • To provide statements with specific information to individuals
Who Any “person” that provides minimal essential coverage.

 

  • Insurance company in the case of insured plans
  • Employer in the case of self-insured plans
  • Applicable large employers (generally 50 or more full time
    employees, including full-time equivalent employees in the prior
    year)
What To the IRS:

 

  • Name, address and EIN of the reporting entity
  • Name, address, TIN (or date of birth if TIN not available) of primary
    insured
  • Names, dates of coverage and TIN (or date of birth if TIN not
    available) and months of coverage for each individual covered
    under the policy or program
  • Other information as the Secretary may provide

To the individual:
In addition to the above information, the information reported to an individual must include:

  • Name, address, EIN of employer sponsoring the Plan
  • Whether the coverage is a Qualified Health Plan enrolled in through
    SHOP and the SHOP’s unique identifier
  • Other information as Secretary may provide
  • ALE Name, date, EIN, name and telephone number of contact
  • Calendar year for which information is being reported
  • A certification as to whether the employer offers to its full-time
    employees (and their dependents) the opportunity to enroll in MEC
    under an eligible employer sponsored plan, by calendar month
  • If the employer certifies that MEC was offered, the return must
    include:

     

    • months during the calendar year for which MEC
      under the plan was available
    • full-time employee’s share (self-only) of lowest cost
      monthly premium for minimum value coverage
      offered by calendar month
  • The number of full-time employees for each month during the
    calendar year
  • The name, address, TIN of each full-time employee during the
    calendar year and the months, if any, during which the employee
    was covered
  • Other information as the Secretary may provide
To Whom
  • IRS and
  • A written statement to each individual listed on return
  • To IRS
  • A written statement to each employee whose name is required to
    be recorded in the return that shows name, address, phone number
    of the information contract and the information reported with respect
    to the individual
How
  • Form 1095-B or another Form designated by the IRS
  • Form 1094-B Transmittal Form
  • Form 1095-C or another Form designated by the IRS
  • Form 1094-C – Transmittal Form
When
  • March 2, 2022 to the individual
  • February 28, 2022 to IRS if filed on paper
  • March 31, 2022 if filed electronically
  • March 2, 2022 to the individual
  • February 28, 2022 to IRS if filed on paper
  • March 31, 2022 if filed electronically
  Penalties
  1. IRC §6721 applies to the return and IRC §6722 applies to the individual statements. Refer to https://www.irs.gov/government-entities/federal- state-local-governments/increase-in-information-return-penalties for the latest penalties.

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