Affordable Care Act (ACA) End of Year Checklist

DECEMBER 2015

With the Affordable Care Act (“ACA”) nearly fully implemented and agency enforcement now underway, employers must be clear which provisions of the ACA apply to them.  Any employer that sponsors a health plan for employees is subject to at least some aspects of the ACA.  Noncompliance may result in significant penalties.  Here's a list of ACA topics employers should be considering as 2015 winds down:

Employers of Any Size That Offer Health Insurance Coverage:

  • If you are reimbursing any active employee for the cost of health insurance they purchased in the individual market—STOP; the arrangement violates the ACA market reforms.
  • If you have ownership in more than one business, confirm that these businesses are not a controlled group or an affiliated service group, to make sure these businesses are not treated as a single employer with each business being treated as an “applicable large employer.”

Employers With 100 Or More Full-Time or Full-Time Equivalent Employees (FTEs):

  • If you are relying on any transition relief for your 2015 plan year check the applicable box on line 22 of your Form 1094-C.
  • Forms 1095-C must be furnished to employees by March 31, 2016*.  Forms 1094-C and 1095-C must be filed with the IRS no later than May 31, 2016* (June 30, 2016* if filing electronically). 

Employers With More Than 50 FTEs But Less Than 99:

  • The reporting requirements described above for larger employers apply to you even if you are not subject to the ACA employer mandate for your 2015 plan year due to a transition relief exemption. 

  • For the 2016 plan year you will be fully subject to the ACA employer mandate.

Employers With Less Than 50 FTEs:

  • Review your payroll to make sure you have properly determined that you are not an “applicable large employer,” and regularly monitor your FTE count going forward.
  • You may qualify for small employer health care tax credits.

Employers Offering Self-Insured Plans including Health Reimbursement Arrangements:

  • If you sponsored a self-insured group health plan for your employees in 2015, furnish Form 1095-B (if under 50 FTEs) or Form 1095-C with Part III completed to each covered employee, or other “responsible individual” by March 31, 2016*.  Forms 1094-B/1095-B must be filed with the IRS by May 31, 2016* (June 30, 2016* if filing electronically).
  • If you sponsor an HRA that covers employees who are not enrolled in your group health plan you must furnish and file the Forms 1095-B and 1094-B for these employees.

If you have any questions concerning the ACA reporting requirements, whether you are an Applicable Large Employer, or any other aspect about how the ACA applies to you, call Sharon Freilich (860)-424-4398 or George Kasper (203) 330-2119.

* These are new extended due dates per IRS Notice 2016-4, released December 28, 2015

Sharon K. Freilich and George J. Kasper at attorneys with Pullman & Comley, LLC in the Labor, Employment Law, & Employee Benefits Department.  2015 Pullman & Comley, LLC. All Rights Reserved.

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