Compliance News Week Ending February 7, 2025

Compliance News Week Ending February 7, 2025

In this Article

1. ACA Employer Reporting Tips 
2. 2025 Brings a Few New Changes Under the Affordable Care Act

ACA Employer Reporting Tips 

When are the ACA employer reporting forms (Form 1094 and Form 1095s) due? 

Copies of Form 1095s (1095-B or 1095-C) must be provided to full-time employees and individuals covered under a self-funded (or level-funded) plan by March 3, 2025. The options for distribution of the 1095s are: 

• hand delivery; 
• mail; 
• electronically if individuals consent to electronic delivery; or 
• NEW - post a notice of availability and then only deliver if requested. 

The Form 1094 (1094-B or 1094-C) along with all Form 1095s (1095-B or 1095-C) must be submitted to the IRS electronically by March 31, 2025. 

What is the penalty for failing to prepare and submit Forms 1094 and 1095 (B or C)? 

Employers that fail to file, file late, or file incorrect/incomplete forms with the IRS by March 31, 2025 could face penalties of up to $330/form under §6721. 

The penalty is reduced to $60 per form if correct forms are submitted within 30 days of the reporting deadline, and $130 per form if correct forms are submitted by August 1 of the year in which the filing is due. 

In addition, failure to timely distribute copies of Form 1095s to full-time employees and covered individuals by March 3, 2025 could result in penalties of up to $330/form under §6722. 

2025 ACA Employer Mandate Deadlines and Penalties

2025 Brings a Few New Changes Under the Affordable Care Act

Since the implementation of the Affordable Care Act in 2010, there have been many changes. With the new year upon us, there are a few more to highlight. 

Expanded Subsidies for Premium Assistance 

• Expanded Eligibility for Subsidies – households with higher incomes now qualify for premium assistance 
• Increased Subsidy Dollars – lower-income families could receive greater financial support which could reduce their monthly premium even more 

Changes to Preventive Care – Calendar year plans must cover the following without cost-sharing effective January 1, 2025 

• Anxiety Disorder Screenings – this has been expanded to include adults aged 64 and younger and includes pregnant and postpartum individuals 
• Poliovirus vaccine – this has been expanded to include persons 18 and older who are known to suspected to be unvaccinated or incompletely vaccinated against polio 
• Respiratory Syncytial Virus (RSV) – this new requirement must be covered for: 
  • Adults aged 60 and older 
  • Infants up to eight (8) months old who are entering their first RSV season, and for children between eight (8) and 19 months who are at increased risk during their second RSV season 
• Mpox (Monkeypox) vaccine – this new requirement must now be covered for individuals aged 18 and older who are at increased risk for mpox. 

Stay tuned as some of this could change under the new administration. Amwins Connect will be keeping a watchful eye on the news and regulation changes regarding the Affordable Care Act and Employee Benefits.

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