Creditable Coverage Forms: 1095-C, 1095-B and Massachusetts 1099-HC

EMS ACA Reporting Tip: Preparing Benefit Eligible Employees to Anticipate and Understand ACA and Massachusetts Creditable Coverage Forms: 1095-C, 1095-B and Massachusetts 1099-HC The Affordable Care Act (ACA) requires that both employers and insurance companies send employees reports to demonstrate compliance with both the ACA’s employer and individual mandates. In 2023 the federal ACA penalty for not having insurance is $0.00. Separate from federal ACA mandates, Massachusetts also has an individual mandate requiring individuals to be insured or pay a penalty. In 2023 the Massachusetts penalty for not having proper coverage can be as high as $2,196 a year. Forms required to demonstrate compliance: The ACA requires employers with over 50 "full-time equivalent" employees to send each employee who worked full-time for a month in 2023 a 1095- C Form by January 31, 2024. Employers have a 30-day grace period which enables them to send the forms by March 1rst. Furthermore, insurance carriers are required to send members a Form 1095-B to show which employees and dependents were enrolled for at least one day in a month in 2023- regardless of the size of an employer. Carriers have a 30-day grace period which enables them to send the forms by March 1rst. In addition to the aforementioned 1095-B and 1095-C Forms, all carriers (regardless of whether the plan is fully or self-insured) are required to furnish each individual covered one day during the year with a 1099-HC Form to help individuals avoid the Massachusetts Individual Mandate. We have learned that employees get confused by the onslaught of forms (they may get 4-6 forms if they experience a carrier change mid-year). Some employees throw forms away thinking they already received their “form” as the various forms look similar in lay-out. Helping employees anticipate the various Health Insurance Forms: Below we have provided a link to a sample memo you may use to inform your employees that they will be receiving important tax forms in January or February. The memo is NOT required. It is offered to you as a way to better assist your employees as they navigate what is sometimes an onslaught of forms. We can assist in customizing a communication for your employees. Please email Mica Breen at [email protected] if you have any questions related to the forms and ACA reporting in general. Resources: 2023 EBS Sample Memo -1095-C Memo with mention of 1095-B and Massachusetts 1099-HC