6055 / 6056 Reporting
Certain employers will be required to report information about their employees’ and their health care coverage to both employees and the IRS each year.
Internal Revenue Code (Code) Section 6055 requires every entity that provides Minimum Essential Coverage (MEC) to file an annual return reporting specific information for each covered individual. The 6055 reporting is applicable to insurers of insured major medical plans and plan sponsors of self-funded plans. Employers of any size that sponsor Minimum Essential Coverage must submit this report. As a general matter, only major medical coverage is considered Minimum Essential Coverage. Statements must also be provided to each individual whose name and information are reported on the annual return.
Under Code Section 6056, every employer that employed on average at least 50 full-time equivalent employees on business days during the preceding calendar year (“large employers”) must file a return that reports the terms and conditions of the health care coverage provided to the employer's full-time employees during the year. In addition, the report is required to include and certify detailed and specific information on the employer's full-time employees, including those who received the coverage and when they received it.
Large employers are responsible for the Section 6056 reporting regardless of whether the health care coverage is fully insured or self-funded. All employers in a controlled or affiliated service group are combined for purposes of deciding if the employer is “large”, but each employer in the group must file the Section 6056 report separately.
Under both 6055 and 6056, the first reporting will be for calendar year 2015 (regardless of plan year), and will be due in 2016. They are due to covered individuals by January 31 and to the IRS by February 28, or March 31 if filed electronically. Insurers will be responsible for the reporting requirements for insured plans under Section 6055 via Form 1095-B. Employers sponsoring insured plans will be responsible for the reporting under Section 6056 via Form 1095-C. Large employers that sponsor self-funded plans are required to report the information required under both Section 6055 and 6056 on a single combined form using Form 1095-C. Final regulations along with draft forms and instructions (available in the Additional Resources box below) have been published for review and comment.
6055/6056 Reporting Hot Topics & FAQs
- New Reporting Instructions Released
On August 28, 2014, the Internal Revenue Service (IRS) released draft instructions for completing and filing Forms 1094-B and 1094-C as well as forms 1095-B and 1095-C for reporting of health care coverage by insurers and employers as required by the Patient Protection and Affordable Care Act (ACA) under Internal Revenue Code Sections 6055 and 6056. Earlier this year, on July 24, the IRS released the draft forms that would be filed with the IRS and provided to employees annually.
Section 6055 and 6056 require insurers and employers to report information to the IRS and employees to manage the administration of the Individual Mandate, the Employer Mandate, and Premium Tax Subsidies. Although the first reports will not be due until early 2016, the reported data will be for the 2015 calendar year (regardless of the employer’s plan year). Employers will want to consider the data requirements now before the start of 2015 to make sure they have a process to capture the required information.
- Agencies Issue FAQ on Summary of Benefits and Coverage Requirements
On July 24, the Internal Revenue Service (IRS) released draft forms to be used by employers and insurers for reporting information regarding health care coverage and "minimum essential coverage" (MEC) as required under Health Care Reform. Final regulations were issued earlier in the year implementing the MEC reporting (Section 6055 of the Internal Revenue Code) and the reporting of health coverage (Section 6056). Instructions to the form have not yet been published. The reports are required for the 2015 calendar year regardless of plan year effective date and the first reporting will be due in early 2016. Learn more about the IRS reporting on our website.
- Final Section 6055 Regulations
- Final Section 6056 Regulations
- Form 1095-B: Health Coverage Employee returns to report Section 6055 information
- Form 1094-B: Transmittal of Health Coverage Information Returns To transmit employee Section 6055 information returns to the IRS
- Form 1095-C: Employer Provided Health Insurance Offer and Coverage Employee returns to report Section 6056 information
- Form 1094-C: Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Return To transmit employee Section 6056 information returns to the IRS
- Comparison of the Requirements of Section 6055 and Section 6056
- Draft 2014 Instructions for Forms 1094-B and 1095-B
- Draft 2014 Instructions for Forms 1094-C and 1095-C
American Fidelity Assurance Company does not provide tax or legal advice.