United Benefit Advisors Insight and Analysis Blog

Highlights of Employer and Insurer Reporting Requirements

Posted by: Linda Rowings    Mar 3, 2015 12:00:00 PM

The Patient Protection and Affordable Care Act (PPACA) provides that individuals who do not have minimum essential (basic medical) coverage will owe a penalty unless they qualify for an exemption. Employers with 50 or more employees that do not offer affordable, minimum value coverage to their full-time employees also will owe a penalty. In addition, individuals who have lower incomes and meet other requirements may be eligible for advance tax credits to help pay for health coverage if they purchase coverage through a Marketplace. The Internal Revenue Service (IRS) is generally responsible for verifying that individuals have the required minimum essential coverage, individuals who request premium tax credits are entitled to them, and large employers are meeting their shared responsibility (play or pay) obligations. The IRS will be using IRS Forms 1094 and 1095 to gather the information it needs to administer penalties on those who owe them and to verify that tax credits are accurate.

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Topics: PPACA Affordable Care Act, IRS Form 1095, IRS Form 1094, PPACA reporting, minimum essential coverage