The Internal Revenue Service (“IRS”) recently released final versions of the 2016 Forms 1094-C and 1095-C and associated instructions. These forms will be used in early 2017 by Applicable Large Employers (“ALEs”) to report whether the ALE offered (or did not offer) a full-time employee (“FTE”) health insurance coverage during the calendar year.
Additionally, for ALEs with self-insured plans, these Forms reflect coverage provided under a self-insured group health plan to individuals (FTEs and non-FTEs) during calendar year 2016. Generally, the forms and instructions are substantially similar to their draft versions and the 2015 forms, with the exception of two new reporting codes, removal of certain transition relief that is no longer available and additional clarifications contained in the instructions.
The Instructions – Aggregated ALE Groups
The instructions include an expanded discussion regarding instructions for filings made by ALE members that are part of an aggregated ALE group (i.e., controlled group or affiliated service group).
• There is no aggregated reporting or authoritative transmittal for all members of an aggregated ALE group (controlled group). Each ALE member must file its own Forms 1094-C and 1095-C under its own separate EIN, even if the ALE member is part of an aggregated ALE group.
• Only one Form 1094-C may be the authoritative transmittal for an ALE.
Counting FTEs for the ALE
Column (b) in Section III of Form 1094-C requests the number of FTEs for each month of the calendar year.
• Monthly measurement method. Employee should be counted as an FTE for a month if the employee satisfied the FTE definition under the monthly measurement method (as applicable) on any day of the month.
• Look-back measurement method. If the employee is identified as an FTE during the measurement period, then the employee is considered an FTE for each month of the stability period so long as the employee remains employed by the employer.
Be sure to use the definition under the employer mandate for an FTE (determined under one of the two applicable measurement methods) and not any other definition.
Additional Information
Additional information on this employer reporting may be found here: https://www.irs.gov/affordable-care-act/employers/questions-and-answers-about-information-reporting-byemployers-on-form-1094-c-and-form-1095-c
The 2016 instructions may be found here:
https://www.irs.gov/pub/irs-pdf/i109495c.pdf
The final Forms 1094-C and 1095-C can be found here:
https://www.irs.gov/pub/irs-pdf/f1094c.pdf
https://www.irs.gov/pub/irs-pdf/f1095c.pdf
The 2016 Forms 1094-B and 1095-B and Instructions have been released and are available here, https://www.irs.gov/pub/irs-pdf/i109495b.pdf. They are not addressed in this summary.