Affordable Care Act for Insurance Companies

Insurance companies that provide other businesses and organizations with various insurances including health and medical to their employees are required to give in a report of every individual's insurance coverage to the IRS. This requirement has been given under the ACA (Affordable Care Act).

The ACA requires the following information from the Insurance companies to file the insurance returns:

  • Transmittal of Health Coverage Information
  • Health Coverage
  • Transmittal of Employer-Provided Health Insurance Offer and Coverage
  • Employer-Provided Health Insurance Offer and Coverage

Filing Insurance Returns Online Is Easy

When the number of files being submitted is more than 10, the insurance companies are asked to file their insurance returns electronically rather than manually. The process of filing is easy via the AIR system, all you need is the following:

  • Software Developers
  • Employers
  • Insurance Carriers
  • Government Agencies
  • Third parties who hand in insurance return for either their own company or other companies.

As is written in the ACA on how to file Insurance return, if an individual provides the minimum insurance coverage he is mandated to send a copy of Form 1095-B or Form 1095-C according to the number of employees, to the IRS. Both forms list and define details about the insurance coverage on an individual's household as well.

Who Are Sponsors And Providers?

A sponsor is an employer who gives health coverage to an individual through a job to his employees. The provider is the company or the organization that is paying for health coverage.

A self–insured company is both a sponsor and a provider and so are required to send in 1095-B forms to the IRS.

The Intricacies Of Self-Insurance

When a company provides health insurance to its employees without interference from other companies where they would have pay premiums. In some cases, the self-insured company might employ another company to administer the health benefits but ultimately they are responsible for providing the insurance itself. There are many reasons why some companies prefer to self-insure rather than hire a private insurance company. The main reasons are:

  • A certain flexibility in the insurance coverage plan of their employees
  • Saving money on premiums
  • Avoiding the state taxes on premiums for insurance coverage
  • Choice of Federal regulation over state regulation

Insurance Forms B And C

There are two forms B and C under the Affordable Care Act which may be used to file insurance returns at the IRS. Usually, form 1095-B is used but under the ACA a company with more than 50 employees is required to send a detailed coverage of information on the 1095-C form.

On the other hand, self-insured companies with more than 50 employees may send a combination of Form 1095-B and 1095-C, in a mocked-up version of Form 1095-C to the IRS. This way all health coverage information is covered in a hybrid 1095-C form. Filing insurance via these forms electronically has never been easier.

Many companies rely on ACAreporter for their reporting needs. If you need any assistance in ACA reporting. Contact us!