Improving health is our policy
Requires employers with over 50 employees to report to HHS whether it offers minimum essential coverage to its employees and their dependents. Employers must also report any waiting periods they impose, the lowest cost option in each plan category offered by the employer, and the employer’s contribution to the costs of the plans offered. These large employers must also report to HHS the full names of all employees receiving coverage from the employer.
2012
The IRS issued a Notice in April 2012 regarding implementation of this provision. Additional guidance is expected in 2013.
2013
On July 2, in a blog posting on the Treasury Department’s website, the Administration announced the delay – until 2015 – of mandatory insurer and employer information reporting requirements and thus also postponed enforcement of the employer mandate and associated penalties.
On July 9, Assistant Secretary of the Treasury for Tax Policy Mark Mazur wrote to Rep. Fred Upton (R-MI), Chairman of the Energy and Commerce Committee, regarding the employer mandate and information reporting requirement delay, citing the Department’s “longstanding administrative authority to grant transition relief when implementing new legislation like the ACA.”
On July 9, the IRS released a Notice providing transition relief for 2014 from information reporting and the employer mandate – with no reporting requirements or penalties until 2015, although voluntary reporting in 2014 is encouraged – while noting that this release has “no effect on the effective date or application of other Affordable Care Act provisions,” including Exchange subsidies or the individual mandate.
On July 9, congressional Republicans wrote to President Obama inquiring about the employer mandate delay.
On July 10, congressional Republican leaders sought a CBO estimate of the delays’ budgetary effects.
Several congressional committees held hearings on the delays, including two by the House Ways and Means Health Subcommittee on July 10 (testimony) and July 17 (testimony), the latter of which included a Treasury Department official. The House Energy and Commerce Oversight and Investigations Subcommittee held a hearing on July 18 at which J. Mark Iwry, Senior Advisor to the Secretary and Deputy Assistant Secretary for Retirement and Health Policy, testified. On July 23, the House Education and Workforce Subcommittee on Health, Employment, Labor, and Pensions – as well as the Subcommittee on Workforce Protections – held a joint hearing, “Examining the Delay and Its Effect on Workplaces.”
On July 30, the Congressional Budget Office today released an analysis estimating that the Administration’s recently announced 1-year delay of employer and insurer information reporting requirements and employer mandate penalties will increase the net federal cost of the Affordable Care Act’s coverage-related provisions by $12B over 10 years.
On July 23, Treasury noted in its semi-annual regulatory agenda that it intends to propose a rule on ACA information reporting requirements under section 6056 of the Internal Revenue in December 2013; the proposed rule will “provide guidance on rules that require applicable large employers to file certain information with the Internal Revenue Service on coverage under an eligible employer-sponsored health plan and furnish to individuals statements that set forth the information required to be reported to the Internal Revenue Service,” the Department said.
On September 9, following the one-year delay of employer mandate enforcement and associated information reporting requirements, the IRS published a proposed rule on information reporting for applicable large employers under section 6056 of the Internal Revenue Code (IRC) relating to employers’ offers of health insurance coverage and employee statements used in premium tax credit administration, among other requirements, as well as a proposed rule on information reporting for those offering minimum essential coverage. A Treasury Department fact sheet included farther below provides an overview of select provisions of both rules, including specific proposals the Department says present a “variety of options to potentially reduce or streamline information reporting.” The IRS proposes that these information requirements take effect for calendar years (CYs) beginning after December 31, 2014 (i.e., in CY 2015)—affirming previously issued transition relief; voluntary compliance is encouraged for 2014. Comments are due on November 8.
2014
On March 5, the IRS finalized “streamlined” ACA reporting requirements for employers and insurers (see here and here) pursuant to sections 6055 and 6056 of the Internal Revenue Code. Among other provisions, the IRS indicates that self-insured employers will be able to meet the ACA reporting obligations via a single, consolidated form for purposes of reporting information pertaining to sections 6055 and 6056.
On April 29, the IRS published technical corrections (available here and here) to previously issued information reporting final regulations.
On July 24, 2014, the IRS released draft tax forms to be used for reporting health coverage status, including an employer’s compliance with the ACA’s employer mandate, construed as evidence that the Administration is moving forward with the employer mandate after having delayed it. The IRS said “we anticipate that draft instructions relating to the forms will be posted to IRS.gov in August,” adding “both the forms and instructions will be finalized later this year.” Forms include:
On Aug. 28, the IRS posted draft instructions for completing the forms through which employers and insurers report health coverage information to employees and individuals, as well as the IRS. The ACA-driven information reporting enables employer mandate implementation and, as previously announced, filing is voluntary for tax year 2014. Drafts include:
OPM recently released guidance to facilitate its compliance under employer information reporting requirements.
2016
On May 8, the Treasury Inspector General for Tax Administration issued a report finding that IRS’ delay in employer and insurer information reporting “reduces the IRS’s ability to determine whether taxpayers and their dependents” have ACA minimum essential coverage.” It explores the agency’s individual mandate enforcement mechanisms and recommends that the penalty calculator, known as the Shared Responsibility Payment Calculation Tool, be added to IRS.gov for the 2016 filing year.
On May 6, the IRS highlighted the approach to determining applicable large employers for the mandate and information reporting requirements.
On June 24, 2016, the IRS posted a Test Package for Electronic Filers of ACA Information Returns (AIR) for the 2015 Processing Year.
On July 8, 2016, the IRS published a proposed rule on the premium tax credit and individual mandate. The IRS explains that it “address[es] various issues regarding: (1) eligibility for the premium tax credit (including how opt-out arrangements affect an employee’s required contribution); (2) the due date for payment of premiums in the case of retroactive enrollments; (3) the premium assistance amount when certain coverage is terminated mid-month; (4) the benchmark plan premium (including how pediatric dental benefits affect the benchmark plan premium); (5) the reconciliation of advance payments for an individual whom no one claims as a dependent; and (6) certain information reporting rules [applicable to Exchanges].” Comments are due by Sept. 6, 2016.
‘‘SEC. 6056. CERTAIN EMPLOYERS REQUIRED TO REPORT ON HEALTH
INSURANCE COVERAGE.
[Heading revised by section 10108(j)(3)(A)]
‘‘(a) IN GENERAL.—[As revised by section 10108(j)(1)] Every applicable
large employer required to meet the requirements of section
4980H with respect to its full-time employees during a calendar
year and every offering employer shall, at such time as the
Secretary may prescribe, make a return described in subsection (b).
‘‘(b) FORM AND MANNER OF RETURN.—A return is described in
this subsection if such return—
‘‘(1) is in such form as the Secretary may prescribe, and
‘‘(2) contains—
‘‘(A) the name, date, and employer identification number
of the employer,
‘‘(B) a certification as to whether the employer offers
to its full-time employees (and their dependents) the opportunity
to enroll in minimum essential coverage under
an eligible employer-sponsored plan (as defined in section
5000A(f)(2)),
‘‘(C) [As revised by section 10108(j)(3)(B), including
addition of clause (v)] if the employer certifies that the
employer did offer to its full-time employees (and their dependents)
the opportunity to so enroll—
‘‘(i) in the case of an applicable large employer,
the length of any waiting period (as defined in section
2701(b)(4) of the Public Health Service Act) with respect
to such coverage,
‘‘(ii) the months during the calendar year for
which coverage under the plan was available,
‘‘(iii) the monthly premium for the lowest cost option
in each of the enrollment categories under the
plan,
‘‘(iv) the employer’s share of the total allowed
costs of benefits provided under the plan, and
‘‘(v) in the case of an offering employer, the option
for which the employer pays the largest portion of the
cost of the plan and the portion of the cost paid by the
employer in each of the enrollment categories under
such option,
‘‘(D) the number of full-time employees for each month
during the calendar year,
‘‘(E) the name, address, and TIN of each full-time employee
during the calendar year and the months (if any)
during which such employee (and any dependents) were
covered under any such health benefits plans, and
‘‘(F) such other information as the Secretary may require.
[Sentence added by section 10106(g)] The Secretary shall have
the authority to review the accuracy of the information provided
under this subsection, including the applicable large employer’s
share under paragraph (2)(C)(iv).
‘‘(c) STATEMENTS TO BE FURNISHED TO INDIVIDUALS WITH RE- SPECT TO WHOM INFORMATION IS REPORTED.— ‘‘(1) IN GENERAL.—Every person required to make a return
under subsection (a) shall furnish to each full-time employee
whose name is required to be set forth in such return under
subsection (b)(2)(E) a written statement showing—
‘‘(A) the name and address of the person required to
make such return and the phone number of the information
contact for such person, and
‘‘(B) the information required to be shown on the return
with respect to such individual.
‘‘(2) TIME FOR FURNISHING STATEMENTS.—The written
statement required under paragraph (1) shall be furnished on
or before January 31 of the year following the calendar year
for which the return under subsection (a) was required to be
made.
‘‘(d) COORDINATION WITH OTHER REQUIREMENTS.—To the maximum
extent feasible, the Secretary may provide that—
‘‘(1) any return or statement required to be provided under
this section may be provided as part of any return or statement
required under section 6051 or 6055, and
‘‘(2) [As revised by section 10108(j)(3)(C)] in the case of an
applicable large employer or offering employer offering health
insurance coverage of a health insurance issuer, the employer
may enter into an agreement with the issuer to include information
required under this section with the return and statement
required to be provided by the issuer under section 6055.
‘‘(e) COVERAGE PROVIDED BY GOVERNMENTAL UNITS.—[As revised
by section 10108(j)(3)(D)] In the case of any applicable large
employer or offering employer which is a governmental unit or any
agency or instrumentality thereof, the person appropriately designated
for purposes of this section shall make the returns and
statements required by this section.
‘‘(f) DEFINITIONS.—[Replaced by section 10108(j)(2)] For purposes
of this section—
‘‘(1) OFFERING EMPLOYER.—
‘‘(A) IN GENERAL.—The term ‘offering employer’ means
any offering employer (as defined in section 10108(b) of the
Patient Protection and Affordable Care Act) if the required
contribution (within the meaning of section
5000A(e)(1)(B)(i)) of any employee exceeds 8 percent of the
wages (as defined in section 3121(a)) paid to such employee
by such employer.
‘‘(B) INDEXING.—In the case of any calendar year beginning
after 2014, the 8 percent under subparagraph (A)
shall be adjusted for the calendar year to reflect the rate
of premium growth between the preceding calendar year
and 2013 over the rate of income growth for such period.
‘‘(2) OTHER DEFINITIONS.—Any term used in this section
which is also used in section 4980H shall have the meaning
given such term by section 4980H.’’.
(b) ASSESSABLE PENALTIES.—
(1) Subparagraph (B) of section 6724(d)(1) of the Internal
Revenue Code of 1986 (relating to definitions), as amended by
section 1502, is amended by striking ‘‘or’’ at the end of clause
(xxiii), by striking ‘‘and’’ at the end of clause (xxiv) and inserting
‘‘or’’, and by inserting after clause (xxiv) the following new
clause: [Clause revised by section 10108(j)(3)(E)]
‘‘(xxv) section 6056 (relating to returns relating to
certain employers required to report on health insurance
coverage), and’’.
(2) Paragraph (2) of section 6724(d) of such Code, as so
amended, is amended by striking ‘‘or’’ at the end of subparagraph
(FF), by striking the period at the end of subparagraph
(GG) and inserting ‘‘, or’’ and by inserting after subparagraph
(GG) the following new subparagraph: [As revised by section
10108(j)(3)(F)]
‘‘(HH) section 6056(c) (relating to statements relating
to certain employers required to report on health insurance
coverage).’’.
(c) CONFORMING AMENDMENT.—The table of sections for subpart
D of part III of subchapter A of chapter 61 of such Code, as
added by section 1502, is amended by adding at the end the following
new item: [As revised by section 10108(j)(3)(G)]
‘‘Sec. 6056. Certain employers required to report on health insurance coverage.’’.
(d) EFFECTIVE DATE.—The amendments made by this section
shall apply to periods beginning after December 31, 2013.
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