The Wagner Law Group
Wagner Law Group, A Professional Corporation, is a nationally
recognized ERISA & employee benefits, estate planning,
employment, labor & human resources practice.
in 1996, The Wagner Law Group has 25 attorneys engaged
exclusively in employee benefits, estate planning and
employment law. Six of our attorneys are AV rated by
Martindale-Hubbell as having very high to preeminent legal abilities
and ethical standards. The firm is among the largest ERISA boutiques
in the country. Our practice is national in scope, with clients in
more than 40 states and several foreign countries.
Wagner Law Group
Fax: (561) 293-3591
7108 Fairway Drive
Palm Beach Gardens, FL 33418
East Kennedy Boulevard
Tampa, FL 33602
Francisco, CA 94104
100 South 4th Street, Suite 550
St. Louis, MO 63102
October 13, 2016
Health and Welfare Law
Final Version of ACA Reporting Forms for 2016
has released final 2016 Forms 1094-C and 1095-C along with
instructions for each. They confirm that the Affordable Care
Act ("ACA") reporting requirements for 2016 are similar to
those for 2015, except for several minor changes, some of which are explained
Background. The ACA requires Applicable Large
Employers ("ALEs") to report to the IRS on whether they
offer full-time employees and their qualified dependents the
opportunity to enroll in minimum essential coverage ("MEC")
through their group health plans.
NOTE: ALEs are employers who had 50 or more full-time
employees or full-time equivalent employees (collectively,
"FTEs") during the preceding calendar year. An
employer will determine its monthly FTE count by adding: (i) each
employee who works more than 30 hours per week (i.e., full-time), and
(ii) the total number of hours worked during a month by employees who
are not full-time, divided by 120. Monthly FTE counts are then
totaled and divided by 12. If the resulting number is 50 or
more, the employer is subject to the mandate.
file Forms 1094-C with the IRS to transmit and summarize information
provided on Forms 1095-C. ALEs file Forms 1095-C for each
employee who was full-time during one or more months in the calendar
year. Forms 1095-C report information (on a monthly basis)
about the health care coverage offered to the employee.
to the 2016 versions.
Some of the changes contained in the 2016 versions (of the forms and
- The end
of certain transition relief. Certain transition
relief no longer applies for calendar year plans beyond 2015,
including the transition penalty relief available for
ALEs. For 2015, the transition relief exempted ALEs with
50 to 99 full-time equivalent employees from the ACA's employer
mandate penalties and reduced the required offer of coverage
threshold for full-time employees from 95% to 70% for other
This relief remains available in 2016, however, for non-calendar year
plans through the end of their 2015 plan year.
- The end
of "good faith" relief. In 2015,
non-compliance penalties could be waived if an ALE could show it
made "good faith" efforts towards complying with the
regulations and deadlines. For 2016, an ALE must now show
"reasonable cause" for why it failed to comply in
order to receive penalty relief.
COBRA offers of coverage. Offers of COBRA coverage to
former employees (and their dependents) should not be reported
as offers of coverage (on line 14 of Form 1095-C).
However, an offer of COBRA coverage to an employee who remains
employed with the ALE should be entered as an offer of coverage.
Member" replaces "Employer". The 2015
ACA reporting forms referred to the entity required to file the
form as "employer." In the 2016 versions, the
IRS has replaced the term "employer" with "ALE
Member" to highlight the fact that each ALE member must
file its own forms.
Spousal Coverage. The IRS has created new codes (for
Part II, Line 14 of Form 1095-C) to indicate when an ALE has
offered coverage to employees' spouses.
deadlines no longer extended. For offers of coverage
made during 2016, Forms 1095-C must be furnished to employees by
January 31, 2017 (the date was extended until March 31, 2016 for
the 2015 forms), and to the IRS by February 28, 2017 (previously
May 31, 2016), if filed by paper, and March 31, 2017 (previously
June 30, 2016), if filed electronically.
Entities filing 250 or more Forms 1095-C must file them
penalties. An ALE's failure to timely provide correct
forms to either the IRS or employees can result in a penalty of
$260 per delinquent or incorrect return (up from $250 in 2015),
with an annual maximum of approximately $3.2 million.
Takeaway For Employers. With 2017 less than three months away,
employers should begin preparing to meet their 2016 ACA reporting
obligations by reviewing the final versions of the instructions and