What Your Clients Need to Know About Form 1095-C

Form 1095-C
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It’s the second year of employer reporting under the Affordable Care Act (ACA), and while the law might soon be altered or replaced, for now the process remains the same.

Which unfortunately means there’s still a lot of confusion surrounding the form known as the 1095-C, Employer-Provided Health Insurance Offer and Coverage.

With the reporting season already underway and the distribution window set to close on March 2, your business clients and their employees may have several questions regarding this notoriously tricky form.

What Exactly is a 1095-C?
Despite the large number of employees due to receive one of these forms in the early months of 2017, few of them actually know what it is. In the simplest terms, the 1095-C is a form distributed to employees and shared with the IRS. It documents and confirms that employers are providing the appropriate offer of health care – either fully insured or self-funded – to the proper employees at an affordable price.

There are three sections of the form. The first documents basic information, such as the employee’s name, address, and Social Security number. The second includes notice of whether any insurance was offered or provided, if it was affordable, and any notable exceptions. The third, only applicable if the company’s insurance is self-funded, documents who is covered on the employee’s health plan.

Who Should Get a 1095-C?
First of all, your business clients need to determine if, as an employer, they need to distribute 1095-Cs at all. If they have 50 or more full-time-equivalent employees in the preceding calendar year, then they should be offering company health coverage and will need to distribute the forms or face fines.

The employees who should be receiving Form 1095-C are as follows:

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About Arthur Tacchino

Arthur Tacchino

Arthur Tacchino is a healthcare reform expert and chief innovation officer at SyncStream Solutions LLC, a healthcare reporting and compliance company.


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