No one really knows whether the Obama administration will stick to its current Patient Protection and Affordable Care Act (PPACA) procedural rules, or whether Congress will let the administration stick to them.
If the Internal Revenue Service (IRS) implements the current rules as planned, insurers will have to send 1095-B coverage notice forms for the 2015 plan year in early 2016.
Applicable large employers (ALEs) will have to send 2015 1095-C benefits notice forms in early 2016.
In theory, individual taxpayers will include copies of the forms with their own income tax returns, and the IRS will use the forms to verify whether the taxpayers have enough coverage to meet the PPACA “shared responsibility” requirements, or whether those taxpayers have to pay penalties.
The IRS could also use the form information to determine whether ALEs may have to pay penalties in connection with the PPACA employer shared responsibility provisions.
The U.S. Supreme Court ruled that the Obama administration could proceed with implementing PPACA in part because the shared responsibility provisions are taxes, or the equivalent of taxes, and a federal statute prohibits the courts from imposing injunctions blocking taxes before the taxes have taken effect. Once individuals and employers start paying employer mandate penalties, they may have an easier time fighting the penalty system in court.
Now the IRS has given tax policy watchers and tax preparation system companies something to think about by releasing draft versions of the 1095-B and 1095-C forms, and of the 1094-C form, which ALEs are supposed to use to summarize the information given in the 1095-C forms.
For a look at the forms, read on.
1. Form 1095-B: Health Coverage
This form gives the IRS information about a “responsible individual,” including that individual’s date of birth and Social Security number. It also gives the names, Social Security numbers and dates of birth of the covered individuals.
See also: IRS posts Form 1094-B draft
2. Form 1095-C: Employer-Provided Health Insurance Offer and Coverage
An employer must provide detailed information on this form, including the “employee share of lowest cost monthly premium, for self-only minimum value coverage” for each month in which the employee was offered coverage.
Employers could file 1095-C and send notices on a voluntary basis this year. For next year, the IRS intends to make employers’ lives easier by providing a continuation sheet for employers that need to report coverage for more than six people.
3. Form 1094-C: Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns
An ALE, or ALE member, and if an employer is part of a family of employers, is supposed to put this form with a package of 1095-C forms. For larger employers, the IRS has included room for conglomerates to list the names and employer identification numbers of up to 65 ALE members.