Under the Affordable Care Act, Applicable Large Employers (ALE’s) must provide affordable minimum essential coverage if they have 50 or more full-time employees (or full-time equivalent employees). If an employer fails to do so, they must pay a penalty. The ALE’s must also report that coverage to the IRS and their employees every year, using the forms 1094 and 1095.
¿Qué son los formularios 1094 y 1095?
El formulario 1094 actúa como portada del formulario 1095 y solo se debe enviar al IRS. El formulario 1095 se enviará tanto al empleado como al IRS. Estos formularios ofrecen información detallada sobre el seguro médico que ofrece y lo que ha elegido cada empleado.
¿Para qué sirven los formularios?
This mandated reporting helps the IRS monitor employee coverage and cost of coverage to ensure enforcement of the Employer Shared Responsibility Provision (ESRP). The forms help determine if an ALE is subject to the Employer Shared Responsibility Provision penalties and also determine if employees are eligible for a premium tax credit.
What form to file…
There are several types of the 1095 form – A, B, and C. The type of insurance you offer determines the type of form that will be required.
- El formulario 1095-A es para personas que han recibido seguro del mercado en lugar de su empleador y, por lo tanto, no es un requisito para los empleadores presentarlo.
- 1095-B is for ALE’s who offer self-funded insurance. The issuer or carrier delivers this form to covered individuals only, including non-employees.
- 1095-C is filed by ALE’s who offer either fully insured or self-funded coverage, but they must provide the form to all full time employees, whether they have enrolled or not.
Small employers who aren’t subject to the Employer Shared Responsibility Provision will use form 1094-B and 1095-B to report information about covered individuals.
Cuándo presentar la solicitud
The forms must be filed and mailed before February 28th. Electronic filing can be done by March 31. A 30 day extension can be requested by completing a good faith transition relief form and submitting before the 1094 and 1095 forms are due. It is very important to keep copies of the forms for your records, in the case that you may need to reproduce them.
Informar sobre sanciones
Existen sanciones por no presentar ni informar las declaraciones de cobertura. Nuestros agentes pueden ayudarlo a evitar estas sanciones o ver si se cumplen ciertos criterios para que se eximan las sanciones. Comuníquese con Primary Care Insurance Solutions si necesita ayuda.
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