More Employers Subject to Healthcare Documentation Rules in 2016

With 2016 upon us, all companies with at least 50 full-time equivalent (FTE) employees must offer affordable health coverage to full-timers and their dependents or pay a fine.  The employer’s insurance plan must also provide “minimum value,” which is designed to pay at least 60% of the cost of covered health benefits and provide substantial coverage of inpatient hospital and physician services. In 2015 this applied to companies of 100 or more FTE workers.
 
Fines for noncompliance are as follows:
Companies that don’t offer coverage to at least 95% of full-time workers (and their dependent children) in 2016 if even one full-timer opts to buy insurance through a government exchange and receives a subsidy to help pay the premiums.        
 
  • For 2016 the fine equals $2,160 times the number of full-time employees, excluding the first 30 employees.
  • Firms offering unaffordable insurance also owe a higher penalty – $3,240 for each full-time employee who gets a tax credit for buying coverage on an exchange.
Employer Reporting
 
  • Beginning in 2016, companies with 50 or more FTE employees must use IRS Form 1095-C to report 2015 insurance data for each full-time employee to the IRS and the worker.
  • Firms will also file with the IRS Form 1094-C which requires information on monthly employee counts and essential coverage
  • Business with fewer than 50 employees that provide self-insured medical coverage must also comply – they will use Form 1095-b to transmit the health returns to the IRS.
 
Forms are due to employees by March 31 and to the IRS by May 31 (June 30 if e-filing)
Note:  Employers will not be given additional time to make these filings.
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