2015 Draft Instructions for 6055 & 6056: Reporting Now Includes HRA Clarifications

The Affordable Care Act (ACA) created new reporting requirements under Internal Revenue Code (Code) Sections 6055 and 6056. Under these new reporting rules, certain employers must provide information to the IRS about the health plan coverage they offer (or do not offer) or provide to their employees. Reporting is first required in 2016, related to coverage offered or provided in 2015. On Aug. 7, 2015, the Internal Revenue Service (IRS) released the following:

2015 draft Forms 1094-B, 1095-B, 1094-C and 1095-C were previously released on June 16, 2015. Except for a few minor changes and a number of clarifications, the 2015 draft forms and instructions are largely unchanged from the 2014 versions. However, the 2015 draft instructions also include:

  • A proposed automatic 30-day filing extension, upon request (under certain hardship conditions, reporting entities may apply for an additional 30-day extension); and
  • A proposed waiver from the requirement to file returns electronically.

These 2015 forms and instructions are draft versions only and should not be filed with the IRS or relied upon for filing. The IRS may make changes prior to releasing final 2015 versions. SUPPLEMENTAL COVERAGE AND HEALTH REIMBURSEMENT ARRANGEMENTS The 2015 draft instructions for Forms 1094-B and 1095-B included information about supplemental coverage. Providers are not required to report the following minimum essential coverage that is supplemental to other minimum essential coverage:

  • Coverage that supplements a government-sponsored program, such as Medicare or TRICARE supplemental coverage.
  • Coverage of an individual in more than one plan or program provided by the same plan sponsor (the plan sponsor is required to report only one type of minimum essential coverage).

According to the 2015 draft instructions, coverage isn’t provided by the same plan sponsor if they aren’t reported by the same reporting entity. Thus, an insured group health plan and a self-insured health reimbursement arrangement (HRA) covering the employees of the same employer aren’t supplemental. As such, employers sponsoring HRAs that are integrated with fully-insured major medical coverage are required to report for the HRA. Employers that have fewer than 50 full-time employees including full-time equivalents and sponsor a self-insured health plan (or a fully-insured health plan with an integrated HRA) will report using IRS Forms 1094-B and 1095-B. Employers that have 50 or more full-time employees including full-time equivalents will report using IRS Forms 1094-C and 1095-C. It’s important to note that employers with 50 or more full-time employees including full-time equivalents that sponsor a fully-insured plan that is integrated with an HRA are required to complete Part III of the 1095-C (which until recently, was reserved only for employers sponsoring self-insured major medical coverage).

As always, we are monitoring these reporting requirements on a daily basis.