Effective for the 2024 reporting year, employers are no longer required to automatically send a 1095-B or 1095-C to a covered individual/employee. The employer must only provide the form 1095-B or 1095-C upon request. While the relief is considerable, a multi-state employer should review state reporting requirements relative to the ACA, as the employee and employer may have additional state reporting requirements.
To use this relief, an employer must provide a “conspicuous, timely, and accessible” notice to individuals and honor requests by January 31 of the year following the calendar year to which the term relates or 30 days after the request, whichever is later. The employer must still file the 1094/1095-B and 1094/1095-C with the IRS by March 31, 2025.
1094/1095-B Guidance
Recently passed legislation only requires reporting entities to provide 1095-B forms upon request. Therefore, any employer filing for a self-insured, level-funded, or balance-funded plan and is NOT an ALE can use that change in the law.
Attached is a model notice for self-funded employers. If you have employees in other states, additional reporting may be required. Since many self-funded groups are relatively small, they must e-file the 1094/1095-B forms directly to the IRS. This applies if the employer was self-funded for any month in the 2024 calendar year.
Click here for a model notice for the 1095-B form.
1094/1095-C Guidance
The same relief applies to distributing the 1095-C forms. If an ALE is self-insured, the ALE lists “covered individuals” under Part III of the 1095-C for any month the plan was self-insured.
ALEs subject to the ACA’s Pay or Play Rules now have 90 days (extended from 30 days) to respond to a potential penalty assessment. Additionally, potential penalty risk assessments are subject to a six-year statute of limitations, starting six years from filing the 1095-C (or the due date for filing, if later). This applies to the 2024 forms 1094/1095 due in 2025.
Click here for a model notice for the 1095-C form.
Please always consult your legal or tax professional to review the information prior to e-filing.