Employer reporting requirements and information on Forms 1095 and 1094
6055 Overview – Minimum Essential Coverage Reporting
Section 6055 requires health insurers and sponsors of self-insured plans to report on Minimum Essential Coverage (MEC) to the IRS annually. The reporting to both individuals and the IRS for 2015 is due in early 2016. It also requires insurers and self-insured plans to report to their MEC recipients, so the individuals can report that coverage when filing their federal taxes.
The 6055 reporting requirement has two goals:
- It helps individuals verify that they have MEC for purposes of satisfying the Individual Shared Responsibility requirement and
- It enables the IRS to crosscheck that information with insurers or self-insured plans.
Entities subject to 6055 reporting are health insurance issuers, sponsors of self-insured plans, government sponsored programs, such as Medicaid, and providers of other arrangements designated as MEC, such as high-risk pools.
The final rule states that self-insured employers are responsible for reporting this information to the IRS. Health insurers will provide reporting to the IRS for fully insured groups. If a self-funded employer needs information on covered members and their coverage dates for a calendar year to meet their part of their reporting obligation, a report of covered individuals may be available from the Third Party Administrator.
Information required to be reported to the IRS by health insurers and sponsors of self-insured plans who provide minimum essential coverage: