ACA reporting is an essential part of compliance for health insurance coverage providers. In this blog, we tell you everything about 1095-B filing requirements to help you comply with ACA reporting.<\/p>\n
It’s an information return that reports an individual’s minimum essential health coverage (MEC) as defined by the Affordable Care Act (ACA). It’s basically a receipt that documents who was covered, by whom, and for which months during the tax year.<\/p>\n
The form provides detailed information such as the health insurance coverage, the individuals covered under the plan, the insurance provider and coverage dates.<\/p>\n
Although the federal penalty for not having health insurance is currently $0, this form is still required. The IRS uses Form 1095-B to validate tax returns and make sure people have been provided minimum essential insurance under ACA requirements. It ensures ACA reporting compliance for both the payer\/filer and covered individuals. If no reporting was done or the form is missing or has errors, the IRS might assume coverage was not provided.<\/p>\n
Since there is no reporting threshold, the entity providing the minimum health coverage is responsible for filing Form 1095-B. That could be:<\/p>\n
Note: A large employer or an employer with 50+ full-time employees (FTE) do NOT file Form 1095-B, they file Form 1095-C.<\/p>\n
Before you start filing, make sure you’ve got all this information ready.<\/p>\n
Let’s walk you through the different sections of 1095-B. You need a separate form for each covered policyholder (their dependents get listed under them). For individuals enrolled mid-year, only report the months they actually had coverage.<\/p>\n
Enter the individual\u2019s name, Social Security Number (or DOB if SSN is missing), address and other contact details.<\/p>\n
Include the employer\u2019s name, address, and Employer Identification Number (EIN).<\/p>\n
Add the payer\u2019s or coverage provider\u2019s business name, EIN, contact information, and address.<\/p>\n
List everyone covered under the plan. For each person, provide their name, SSN or DOB, and mark the months they had coverage. If they were covered all year, check \u201cAll 12 months\u201d box.<\/p>\n
You must meet ACA 1095-B deadlines<\/b>. Missing any of them can result in penalties.<\/p>\n Note:<\/b> The penalties apply separately for IRS filings and the copies you send to individuals. So, it doubles the exposure.<\/p>\n Some states require separate state-level ACA reporting on top of federal filing. This makes staying compliant with different requirements way more complicated. For example, states like California, New Jersey, Rhode Island, and DC require ACA MEC reporting using Forms 1095.<\/p>\n A few states have their own reporting requirements. For example, Massachusetts require Form MA 1099-HC rather than federal Forms 1095-B or 1095-C.<\/p>\n States requiring ACA reporting have their own format requirements, sometimes using specific XML schemas. The deadlines and penalties may also differ. Always check the specific state filing requirements before filing or you can e-file with Tax1099 to get support where state reporting applies. Including e-filing to participating states directly or via the IRS CF\/SF program for eligible forms.<\/p>\n Filing 1095-B forms manually can be draining and prone to errors due to its complex reporting requirements. Here’s how Tax1099 simplifies ACA Form 1095-B filing.<\/p>\n Payers often trip up on specific details that can lead to IRS rejections and audits. Some of these mistakes are:<\/p>\n 1. Filing 1095-B when you should file 1095-C<\/b> 2. Forgetting to include dependents<\/b> 3. Incorrect SSNs or Names<\/b> 4. Reporting full-year coverage for partial-year employees<\/b> 5. Not sending recipient copies<\/b> Form 1095-B is used by small employers and insurers that provide minimum essential coverage, while Form 1095-C is used by large employers with 50 or more full-time equivalent employees provide minimum essential coverage.<\/p>\n There is no minimum dollar threshold for Form 1095-B. You must report all covered individuals regardless of the amount.<\/p>\n No, they are individually listed on the policyholder\u2019s form 1095-B.<\/p>\n Yes. In fact, the IRS mandates e-filing if you have 10 or more returns in total across all types, unless a waiver applies.<\/p>\n You’ll have to pay penalties. It ranges from $60 per return to $680 for intentional disregard.<\/p>\n Certain states such as California, New Jersey, Rhode Island, and DC require ACA Forms 1095 while some states like Massachusetts requires their own ACA Form MA 1099-HC instead of the federal 1095-B\/C.<\/p>\n Make 1095-B filing simple, accurate, and compliant with Tax1099.<\/p>\n\n
Penalties For Not Filing 1095-B On Time<\/h2>\n
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1095-B State Reporting Requirements<\/h2>\n
How Tax1099 Simplifies 1095-B Filing<\/h2>\n
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Common 1095-B Mistakes To Avoid<\/h2>\n
\nLarge employers (50+ FTEs) must file 1095-C. Filing 1095-B fails to satisfy the employer mandate reporting. Always double-check company size before filing.<\/p>\n
\nThe IRS record will show incomplete coverage if you omit dependents. Ensure that you verify all family coverage details.<\/p>\n
\nThe IRS validates the name against the SSN database. If it’s incorrect, IRS rejects your form. So, use the TIN-matching to validate the data before filing.<\/p>\n
\nThis creates a mismatch with enrolment records. You must report only the months where minimum essential coverage was provided.<\/p>\n
\nThe IRS imposes penalties for failure to furnish copies to the recipient. To avoid this, send Form 1095-B to recipients by March 2.<\/p>\nReal-Life Examples<\/h2>\n
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\n \nScenario<\/th>\n Correct Filing<\/th>\n Result<\/th>\n<\/tr>\n<\/thead>\n \n Insurance company covering 3,000 individuals<\/td>\n File separate 1095-B forms for all 3,000 covered individuals and e-deliver copies by March 2<\/td>\n IRS and recipients get accurate records<\/td>\n<\/tr>\n \n Small self-insured employer with 40 employees<\/td>\n File 1095-B for each employee plus their dependents<\/td>\n Meets ACA reporting requirements<\/td>\n<\/tr>\n \n Employer in New Jersey<\/td>\n File 1095-B with both IRS and NJ Division of Taxation<\/td>\n Avoids separate state-level penalties<\/td>\n<\/tr>\n \n Employee who joins in April<\/td>\n Report the coverage from April through December only<\/td>\n Prevents mismatch with enrollment records<\/td>\n<\/tr>\n \n Incorrect SSN was submitted<\/td>\n File a corrected Form 1095-B within 30 days<\/td>\n Avoids higher-tier penalties<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n FAQs<\/h2>\n
1. What\u2019s the difference between 1095-B and 1095-C?<\/h5>\n
2. What is the minimum dollar threshold for 1095-B?<\/h5>\n
3. Do dependents get separate forms?<\/h5>\n
4. Can I file 1095-B electronically?<\/h5>\n
5. What happens if I miss the deadline?<\/h5>\n
6. Are state filings required?<\/h5>\n
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ACA reporting doesn\u2019t have to be complicated.<\/h4>\n