1095B and 6055 Reporting Requirements FAQ

Under Obamacare, the IRS needs to know if your coverage met health care reform standards.  The 1095-B is issued by Insurers on behalf of fully insured members directly to the IRS and send members a copy.  In short you don’t have to do anything other than reviewing the info and confirming accuracy. 1095B and 6055 Reporting Requirements FAQ

The IRS will accept any number of items to prove that a member had insurance including:

  1. insurance cards
  2. explanation of benefits  statements from your insurer
  3. W-2 Form or payroll statements reflecting health insurance deductions
  4. records of advance payments of the premium tax credit
  5. other statements indicating that you, or a member of your family, had health care coverage

6055 chart

What information is on the 1095-B form?

For each person covered on your policy, the 1095-B lists:

  • Name
  • Address
  • Date of birth
  • Taxpayer identification number (most likely a Social Security number)
  • Months of coverage with us

If you are missing the taxpayer ID or Social Security numbers for anyone on your policy, the Insurer send you a letter. It’ll explain why they need the information and how to send it to Insurers  securely.

How do I know if I should get a 1095-B form?

Insuerers send you a 1095-B form if:

  • You bought your coverage directly  and did NOT go through healthcare.gov.
  • You get employer coverage and it met the health care reform standards.
6055-1095-b-logo6056-1095-c-logo
6055 Reporting on Form 1095-B6056 Reporting on Form 1095-C
Provided by Insurer for insured medical plan; by employer for a self-insured medical planProvided by applicable large employer (ALE)
Provided to each covered “responsible individual” (e.g., employee, COBRA QB, retiree)Provided to each full time employee
Provided by March 31, 2016 for coverage in prior calendar yearProvided by March 31, 2016 for coverage offered in prior calendar year
Transmitted with employer’s Form 1094-B to IRS by May 31, 2016 (June 30, 2016 if filed electronically)Transmitted with employer’s Form 1094-C to IRS by May 31, 2016 (June 30, 2016 if filed electronically)
RESOURCE:
1095-B FAQ – Oxford 1095B reform-reporting-requirements-6055-external-FAQs copy
1096-C FAQ – https://www.medicalsolutionscorp.com/compliance-consulting/form-1095-c-faq/
See IRS Extends 1094 and 1095 DEADLINE – https://www.medicalsolutionscorp.com/irs-extends-1094-and-1095-deadlines/

If your organization can use a helpful audit on ACA, Payroll and HR please contact us today  (855) 667-4621 or info@medicalsolutionscorp.com.

 

This communication is not intended, nor should it be construed, as legal or tax advice. Please contact a competent legal or tax professional for legal advice, tax treatment and restrictions. Federal and state laws and regulations are subject to change.