Help With ReportingWhat does Section 6056 Reporting and the 1095 Form Mean to Me?

Section 6056 Reporting is the required reporting of information to the IRS relating to offers of health insurance coverage by applicable large employers (ALE) that are subject to the Employer Shared Responsibility Provisions (Employer Mandate often referred to as “Pay or play”). This documentation will support compliance of those who sponsor qualified group health plans. Note this is only for fully insured plans, and does not apply to self-funded. 

**Exceptions – If the employer is under 50 (small group) and has a self-funded plan, then corresponding 6055 reporting is required and will use forms 1095-B. More information below.

The 1095-C form is a statement disclosing information about the offer of coverage, and must be furnished to full-time employees by January 31, 2016. This document must be provided to each employee, just like a W2, and the employee will need to retain for use when filing their individual 2015 taxes. Those enrolled in COBRA will also receive a 1095-C.

The 1094-C form is the IRS’ cover sheet for their copies of the 1095-C forms and must be submitted either paper format by February 28, 2016 or electronic format by March 31, 2016.

Timing:

The information reporting requirements under section 6056 are first effective for coverage offered (or not offered) in 2015. An ALE must file information returns with the IRS (1094-C) and furnish statements to employees (1095-C) beginning in 2016, to report information about its offers of health coverage to its full-time employees for calendar year 2015. These forms were available for 2014, but not mandatory.


Questco is here to assist with the complexities of the Employer required 6056 reporting,
new for 2016. We are generating the necessary forms for the IRS and your employees,
and sending by the required dates.
Rest assured that your 6056 reporting needs are completely covered by Questco.



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Other Information related to employer reporting, but not required for employers:

  • Section 6055 Reporting is the required reporting by Medical Carriers (labeled as Insurers in the chart below). The employer does not have a responsibility for this reporting unless it is a self-funded plan. This report will show each individual that is covered under the plan.
  • 1095-A form is used by the Marketplace to send coverage information
  • 1095-B form is used by a few different scenarios like SHOP marketplace and off-marketplace plans. The most significant group includes small employers with under 50 that have a self-funded plan. Also note that the medical carrier will be sending out individual 1095-B for those fully insured ALE plans as well as the above employer reporting.