District of Columbia Individual Mandates Reporting Requirements
District of Columbia Individual Mandates -
- Updated November 12, 2020 - 8.00 AM by Admin, ACAwise
After the elimination of the federal individual mandate under the Affordable Care Act (ACA) by Congress, The District of Columbia passed the State individual mandate, this went into effect on January 1, 2019.
This mandate requires D.C residents and their dependents to maintain “Minimum Essential Coverage” during each month of the calendar year. Alternatively, they must get an exemption or pay a penalty on their D.C. tax returns for the months that they did not maintain coverage.
Minimum Essential Coverage (MEC) includes ten categories of essential health benefits and services that each resident of D.C. must have in order to meet the ACA’s shared responsibility provision (individual mandate) and avoid facing a penalty.
Employer Responsibility for District of Columbia Individual Mandates
The D.C. law requires every employer who provides “Minimum Essential Coverage” to at least one D.C. resident during the calendar year must submit their ACA reporting to the D.C. Office of Tax and Revenue (OTR) every year.
These employers must also furnish a statement about the coverage to the covered employees (D.C. individuals) whose name appears on returns submitted to OTR.
What Form must be Filed?
Any business operating in or out of D.C. who employs DC residents must file the same information found in the 1094 and 1095-B/C federal Forms to the D.C Office of Tax and Revenue (OTR) electronically through MyTaxDC.
Note: Paper filings will not be accepted.
Employers offering fully insured plans, must submit 1094-C / 1095-C and to the D.C. OTR electronically and furnish 1095-C copies to their employees. Usually, insurance carriers will distribute Form 1095-B to these employees. If their insurance carrier fails to do this, employers must fulfill these obligations to avoid facing penalties.
Employers offering self-insured plans are responsible for submitting 1094 and 1095-B / 1095-C to the D.C. OTR and distributing the written statements about the coverage to their covered D.C. residents.
When to File ACA Form 1095-B/C with the State of District of Columbia
The deadline to distribute copies of Form 1095-B/C to employees:
March 02, 2021 - Employers must distribute written statements (Form 1095-B/C) to D.C. residents on or before the deadline.
2.The deadline to submit Form 1094 & 1095-B/C to the State:
April 30, 2021 - Employers are required to file information returns (1094 & 1095-B/C) to the D.C. Office of Tax and Revenue (OTR) electronically through MyTax.DC.gov, 30 days after submitting it to the IRS.
What Information to Report?
- Name, address, and SSN/TIN of the covered individual.
- Name, address, EIN, and contact info of the plan provider.
- For self-insured group health plans: name, address, EIN, and contact information of the plan sponsor.
- The offer of coverage code for each recipient/employee, broken down by month
- The recipient/employee’s premium share of coverage, by month
- Any safe harbor relief codes that are applicable
- The covered individual's spouse and dependent(s) information, if applicable (name, SSN or DOB, and months covered)
What are the Penalties for Failure to File Form 1095 with the District of Columbia?
As of this article’s publication, it is unclear whether there are any employer penalties for failure to fulfill these obligations. Once the District of Columbia establishes this information, we will provide an update accordingly.
ACAwise takes care of State Individual health care mandates reporting.
ACAwise is a comprehensive ACA reporting solution that completely takes care of the D.C. healthcare mandate reporting requirements for employers.
With extensive experience in handling the e-filing of both the federal ACA reporting and the State individual mandate reporting, ACAwise can accurately and quickly report your healthcare coverage information with D.C. OTR without any additional stress.
Send us your payroll, benefits, and employee census data through an excel template or use our own template. We will generate the Forms 1094 & 1095 and e-file it with the IRS and D.C. OTR. We can also handle your Form 1095 mailing to your employees before the recipient copy deadline.