Rhode Island Individual Mandates ACA Reporting Requirements
Rhode Island Individual Mandate - An Overview- Updated August 29, 2023 - 8.00 AM by Admin, ACAwise
After the elimination of the federal individual mandate under the Affordable Care Act (ACA) by Congress, Rhode Island passed the state individual mandate, beginning from
January 1, 2020.
Under this mandate, every Rhode Island resident must maintain “Minimum Essential Coverage” for each month of the calendar year. Alternatively, they must get an exemption or pay a penalty on their Rhode Island tax returns for the months that they did not maintain coverage.
Minimum Essential Coverage (MEC) is defined under the mandate as maintaining the ten categories of essential health benefits and services to comply with the Affordable Care Act’s (ACA)individual mandate. Individuals who fail to comply will face a penalty in early 2024 (for the 2023 tax year).
The penalty for failing to comply with the ACA’s shared responsibility provision (individual mandate) throughout the tax year is calculated at a rate of $695 per adult and $347.50 for each child under the age of 18, or 2.5% of gross income for people above the Rhode Island tax filing threshold, whichever is higher.
Employer Responsibility for Rhode Island Individual Mandate
These employers must also distribute written statements to the primary insured employee (R.I. resident) containing the name, address, and contact information of the person required to complete their tax returns.
What Form to File?
Rhode Island employers or out-of-state employers who employ Rhode Island residents must file the same information found in the 1095-B/C federal forms to the State of R.I. using the R.I Division of Taxation webpage.
There is no pre-registration required to access this webpage. You can just navigate to the webpage from the R.I. Division of Taxation website and enter your company’s information, your contact information, and information about the file when you are ready to upload your file(s).
Once you successfully upload your files, you will receive a real-time confirmation. If any issues are found with the file(s), you will be contacted using the contact information you provided during the file upload process.
Employers offering fully insured plans, must submit 1094-C / 1095-C to the state 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 with self-insured plans are solely responsible for submitting Forms 1095 and 1094-B/C to the state and distributing written statements to the primary insured employee.
When to File ACA Form 1095-B/C with the Rhode Island State?
The deadline to distribute copies of Form 1095-B/C to employees:
March 04, 2024 - Employers must distribute written statements (Form 1095-B/C) to employees (and former employees covered during the prior plan year 2021) on or before the deadline.
We prepare forms, e-file it with State, and distribute employee copies.Request Quote
The deadline to submit Form 1094 & 1095-B/C to the State:
April 01, 2024 - Employers are required to file 1095-B/C federal forms to the State of R.I. using the R.I Division of Taxation webpage.
Let us E-file for you with the State of Rhode Island!Sign Up Now
What Information To Report?
To file Forms 1095 &1094-B/C with the state and furnish written statements to the residents of Rhode Island, the employer must have the
- Name, address, and a TIN of the primary insured
- Name, TIN, SSN, or DOB of each other individual acquiring coverage under the policy.
- The dates or months for which the individual was covered under MEC throughout the calendar year.
- Name, address, EIN, and contact info of the plan provider.
- For self-insured group health plans, the 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
What are the Penalties for Failure to File Form 1095 with Rhode Island?
As of this article’s publication, it is not clearly mentioned whether there are any employer penalties for failure to fulfill these obligations. Once the IRS 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 Rhode Island healthcare mandate reporting requirements
With extensive experience in handling the e-filing of both the federal ACA reporting and the State individual mandate reporting, ACAwise can quickly and accurately report your healthcare coverage information to the state of Rhode Island without any additional effort from your end.
Send us your payroll, benefits, and employee census data, using an excel template or use our own template. We will generate your Forms 1094 & 1095 and e-file it with the IRS and the state of Rhode Island. We can also handle the mailing of your Form 1095 copies to your employees before the recipient copy deadline.