Under the ACA there are two types of reporting requirements for Minimum Essential Coverage (MEC) provided by insurance carriers, employer groups, and individuals beginning with the 2015 calendar
tax year:
6055/6056 Reporting - The two sections of the Internal Revenue Code that implement new requirements
- Section 6055 requires that every provider of MEC will report coverage information by filing an "information return" with the IRS and furnishing a statement to individuals.
- Section 6056 requires "applicable large employers" to report information to the IRS about coverage that they provide employees, and provide statements to full-time employees about the employer-sponsored coverage offered.
1095 Reporting - The series of IRS forms used to satisfy reporting requirements
The table below indicates the 6055 and 6056 reporting obligations by funding type/group size:
|
Individual/Group Type
|
Required Form 6055 Reporting (Coverage Provider)
|
Required Form 6056 Reporting (Employer)
|
| Individual Marketplace |
1095-A (from Marketplace) |
N/A |
| Individual Off-Marketplace |
1095-B |
N/A |
| Small Group FI |
1095-B |
N/A |
| Small Group ASO |
1095-B (from Employer) |
N/A |
| Applicable Large Employer (ALE) FI |
1095-B |
1095-C Parts I, II |
| Applicable Large Employer (ALE) ASO |
N/A |
1095-C (6055 + 6056) |
For fully insured groups, the 1095-B forms will be distributed by UPMC Health Plan's third party vendor to the member household. All 1095 forms must be distributed to current and former member households by January 31. Form submissions to the IRS from issuers and employers are due by February 28 (March 31, if filing electronically).
For more information about the reporting requirements, the IRS has released comprehensive FAQ documents:
Employer Reporting FAQ
UPMC Health Plan will provide enrollment information for calendar year 2015 to support self-insured employer reporting requirements. Click here for a sample Minimum Essential Coverage Enrollment Report. The report will be available on Employer OnLine (secure employer portal) during the first week of January.
The enrollment data provided in the MEC Enrollment Report is provided as a courtesy and reflects UPMC Health Plan's enrollment records only at the time the report is generated. This report is not intended to be used for tax reporting purposes, and UPMC Health Plan strongly recommends that plan sponsors base their 6055/6056 reporting on their own group health plan eligibility and enrollment records.
