Frequently Asked Questions
Form 1095-C, also referred to as the Employer-Provided Health Insurance Offer and Coverage, is an IRS tax form used to report to the IRS any information regarding an employee's health coverage offered by an Applicable Large Employer (ALE).
Any employer with 50 or more full-time employees and full time equivalent employees is typically known as Applicable Large Employers.
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1095 Forms are used to report the health coverage offered to the individuals. The major difference between these Forms is the purpose of the form and who actually sends it.
Difference between the Forms 1095-A, 1095-B, and 1095-C
|Form 1095-A||Form 1095-B||Form 1095-C|
If recipients were enrolled in insurance coverage through a federal or state marketplace or exchange, they would receive Form 1095-A.
If recipients were enrolled in insurance coverage obtained through an employer-sponsored plan or if obtained an individual policy, they would receive Form 1095-B.
If recipients were enrolled in employer sponsored health insurance coverage, they would receive Form 1095-C.
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The IRS ACA deadlines for Tax Year 2019 are:
- Postmarked 1095 recipient copy to the employees: March 2nd, 2020.
- If you choose to file by paper with the IRS, then the deadline is February 28th, 2020.
- If filing the 1094/1095s to the IRS electronically, the due date is on March 31st, 2020.
Failing to furnish Form 1095-C to your employees and the IRS on time can result in heavy penalties.
For each 1095 you fail to file correctly with the IRS or fail to furnish employee copies, the IRS penalizes you $270 per employee.
An ALE Member that offers a self-insured health plan should complete Part III (Covered Individuals details) of Form 1095-C for employees and dependents who enroll in the self-insured coverage.
To complete this Part III, ALEs must be aware of the 1095-C Offer of Coverage & Safe Harbor Codes.
The IRS has created two sets of codes in order to inform employers about any offers of health coverage and Safe Harbor codes.
Each code represents a different scenario regarding an offer of coverage (Line 14) and safe harbor (Line 16), or explains why an employer should not be subject to a penalty for a particular employee, for a given month.
Click here to learn more about the codes in detail.
Unaware of 1095-C Codes?
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If you are an ALE, the information required by the IRS for Form 1095-C:
- The covered employee's details (Name, address and SSN/TIN)
- The ALEs details (Name, address, EIN and contact info)
- The offer of coverage code for each employee, broken down by month
- The employee contribution
- 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)
Although an ALE member may file multiple Forms 1094-C and 1095-C to the IRS, each ALE must file one (and only one) Authoritative Transmittal with the IRS, reporting updated information about that ALE and its employees.
When filing its Authoritative Transmittal, or Form 1094-C, an ALE must report their name, address, EIN and contact information on Form 1094-C lines 1-8, and on line 19 the ALE Member checks the box to confirm this is their Authoritative Transmittal.
The ALE continues to complete Parts II, III, and IV of the Form 1094-C, as applicable.
An ALE who sponsors a self-insured health plan, should complete Part III of Form 1095-C for employees, employees spouse and dependents who enroll in the self-insured coverage.
ALEs are not required to file Form 1095-C for the following employees (unless the employee or the employee’s family member was enrolled in a self-insured plan sponsored by an ALE Member):
- an employee who was not a full-time employee in any month of the year; or
an employee who was in a limited non-assessment period for all 12 months of the year
- for instance, a newly hired variable-hour employee, still in an initial training period
Letter 226-J is the initial letter issued by the IRS to ALEs (Applicable Large Employers) notifying them if they may be liable for an Employer Shared Responsibility Payment.
Click here to Learn more about Letter 226J.
Our experts are ready to assist you in responding to the Letter.
Form 1095-B, Health Coverage, reports information about an individuals health insurance plan, if recipients are enrolled in coverage with an insurance provider.
Mail your 1095 paper-filed returns to:
|If your primary business, office, company or private residence is located in:||Use the following address:|
Alabama, Arizona, Arkansas, Connecticut, Delaware, Florida, Georgia, Kentucky, Louisiana, Maine, Massachusetts, Mississippi, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Texas, Vermont, Virginia,
Department of the Treasury
|If your primary business, office company or private residence is located in:||Use the following address:|
Alaska, California, Colorado, District of Columbia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Maryland, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, North Dakota, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Utah, Washington, Wisconsin, Wyoming
Department of the Treasury
If your private residence or primary place of business, office or company is outside the United States, file with the Department of the Treasury, Internal Revenue Service Center, Austin, TX 73301.
The IRS encourages you to e-file Form 1095-C to expedite processing your returns. For instant returns, choose IRS Authorized e-file provider ACAwise for handling your ACA Form 1095.
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