On March 5, the US Department of the Treasury and the Internal Revenue Service (IRS) released final rules to implement the information reporting provisions for insurers and certain employers under the employer mandate provisions of the Affordable Care Act (ACA), effective in 2015.
The rule announces a single, combined form for information reporting which will be filed with the IRS. This form will include two sections, section 6055 and 6056.
- Clubs with fewer than 50 full-time employees will not be required to file this information.
- Clubs with more than 50 full-time employees and that "self-insure" will complete both sections of the combined form for information reporting.
- Clubs with more than 50 full-time employees, but that do not "self-insure," will complete only the top section of the combined form (section 6056).
In section 6055, qualifying clubs will need to provide information about the entity providing coverage, including contact information and which individual employees are enrolled in coverage, with identifying information and the months for which they were covered.
In section 6056, qualifying clubs will need to provide about the employer offering coverage (including contact information and the number of full-time employees). For each full-time employee, information about the coverage (if any) offered to the employee, by month, including the lowest employee cost of self-only coverage offered will be required.
Further, the rule allows for simplified reporting on employees if a club makes a "qualifying offer." A qualifying offer is defined as "an offer of minimum value coverage that provides employee-only coverage at a cost to the employee of no more than about $1,100 in 2015 (9.5 percent of the Federal Poverty Level), combined with an offer of coverage for the employee’s family."
- For employees who receive qualifying offers for all 12 months of the year, employers will need to report only the names, addresses and taxpayer identification numbers (TINs) of those employees and the fact that they received a full-year qualifying offer. Clubs will also provide the employees a copy of that simplified report or a standard statement indicating that the employee received a full-year qualifying offer.
- For employees who receive a qualifying offer for fewer than all 12 months of the year, clubs will be able to simplify reporting to the IRS and to employees for each of those months by simply entering a code indicating that the qualifying offer was made.
- For 2015, in an effort to provide a phased-in approach, clubs certifying that they have made a qualifying offer to at least 95 percent of their full-time employees will be able to use an even simpler alternative reporting method. Those qualifying clubs will be able to use the simplified, streamlined reporting method for their entire workforce, including for any employees who do not receive a qualifying offer for the full year. Those clubs will provide employees with standard statements relating to their possible eligibility for premium tax credits.
The final regulations also give clubs the option to avoid identifying in the report which of its employees are full-time, and instead only include in the report those employees who may be full-time. To take advantage of this option, the club must certify that it offered affordable, minimum value coverage to at least 98 percent of the employees on whom it is reporting.