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The Wagner Law Group Description 

The Wagner Law Group, A Professional Corporation, is a nationally recognized ERISA & employee benefits, estate planning, employment, labor & human resources practice. 


Established in 1996, The Wagner Law Group has 23 attorneys engaged exclusively in employee benefits, estate planning and employment law. Seven 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.



Contact Info

The Wagner Law Group


  Integrity | Excellence


Massachusetts Office 

Tel: (617) 357-5200 

Fax: (617) 357-5250 

99 Summer Street 

13th Floor

Boston, MA 02110

Florida Office 

Tel: (561) 293-3590
Fax: (561) 293-3591
7108 Fairway Drive
Suite 125
Palm Beach Gardens, FL 33418


San Francisco Office

Tel: (415) 625-0002

Fax: (415) 358-8300

315 Montgomery Street

Suite 904

San Francisco, CA 94104





September 19, 2013 

 State and Federal Law Alert


IRS Issues Proposed Reporting Regulations 


The IRS has issued two sets of proposed regulations on the reporting requirements under the Patient Protection and Affordable Care Act ("PPACA"). The first set of regulations covers the reporting of "minimum essential coverage" while the second deals with health insurance coverage offered by large employers.


The reporting requirements were originally supposed to take effect as of January 1, 2014. However, the effective date was delayed at the same time as the employer shared responsibility (or pay-or-play) provisions. (See the Alert of 7/3/13.) As a result, the first reports will be due in early 2016 for the 2015 calendar year.


The first proposed regulations are directed at entities that provide their employees with "minimum essential coverage" that individuals must obtain to avoid a tax penalty under PPACA. (For further information on minimum essential coverage and the individual penalty, see the Alert of 9/12/13.)


For insured group health plans, the insurer will be responsible for this reporting. However, self-insured plans must file their own information which includes:

  • the name, address and taxpayer identification number of each "responsible individual" (e.g., the insured employee) and other covered individuals (e.g., spouse and dependents);
  • whether the health insurance coverage is a qualified plan offered through an Exchange;
  • the months for which the individual was enrolled in coverage; and
  • the name, address and EIN of the employer maintaining the plan.

This information must also be sent to the responsible individual, but not to other covered individuals, along with the insurance policy number (if applicable) and the reporting entity's name, address and contact number.


The second set of reporting requirements applies to large employers (50 full-time employees or equivalents) and relates to the employer pay-or-play rules. To determine if an employer is considered a large employer, all members of a controlled or aggregated group will be treated as a single employer.


The regulations "require those employers to report to the IRS information about their compliance with the employer shared responsibility provisions...and about the health care coverage they have offered employees."


Along with some duplicative information, this regulation requires employers to report to IRS and to employees:

  • the length of any waiting period for the group health plan;
  • a certification as to whether the employer offers its full-time employees, and their dependents, the opportunity to enroll in minimum essential coverage under the plan;
  • the months of the year for which coverage was available under the plan; and
  • the monthly premium for the lowest cost option in each of the enrollment categories under the plan. 

The IRS has stated that it hopes to simplify these reporting rules before final regulations are issued. One proposal would allow certain information to be transmitted to employees via Form W-2, rather than through separate communication.  


This Newsletter is protected by copyright. Material appearing herein may be reproduced with appropriate credit.


Pursuant to Internal Revenue Service Circular 230, we hereby inform you that any advice set forth herein with respect to US federal tax issues is not intended or written by The Wagner Law Group to be used and cannot be used, by you or any taxpayer, for the purpose of avoiding penalties that may be imposed on you or any other person under the Internal Revenue Code.


This Newsletter is provided for information purposes by The Wagner Law Group to clients and others who may be interested in the subject matter, and may not be relied upon as specific legal advice.  This material is not to be construed as legal advice or legal opinions on specific facts. Under the Rules of the Supreme Judicial Court of Massachusetts, this material may be considered advertising.