Feb 11, 2025
Amwins Connect – February 2025 Question of the Month
Question
My company is considered an Applicable Large Employer (ALE) under the Affordable Care Act. Our company has 130 FTEs and offers fully insured medical benefits to our full-time employees. The carrier will provide 1095-B forms to our employees for the previous calendar year. Do we need to provide the 1095-C form to our employees and do we need to submit the information to the IRS?
Answer
The answer is Yes to both questions.
The carriers normally provide 1095-B forms to individuals enrolled in fully insured plans, no matter the size of the employer.
If the employer is an ALE then the employer is required to provide the 1095-C to individuals enrolled in the medical benefits. The 1095-C provides evidence of an offer of MEC coverage and affordability which is required for all ALEs. This applies to both fully insured and level funded plans offered by employers.
If the employer is offering a self-funded or level funded plan and has less than 50 FTEs, the 1095-B is required. The employer or broker should reach out to the carrier or the TPA to discuss their process for the reporting requirement.
Deadlines to Report
- Copies of Forms 1095s to full-time employees and covered individuals – March 3, 2025
- Submission of Form 1094 and All Form 1095s to IRS – March 31, 2025
There are a few important reporting changes. The detail is in information that was posted December 30, 2024.
More Resources
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