Form 1095-B Case Study
With the advent of the ACA (Affordable Care Act) reporting requirements, many companies are unclear as to what forms they need to complete and submit. Form 1095-B is one of the forms causing confusion. However, by understanding how your company handles health insurance coverage for its employees, you can determine if you are responsible for filing Form 1095-B every year.
What is Form 1095-B?
The ACA requires that all individuals have health insurance or face tax penalties. A person needs to have basic insurance, known as minimal essential coverage. Form 1095-B provides detailed information about the type of health coverage offered, who receives the coverage (such as dependents) and the time period of the coverage. Whoever provides the individual with basic insurance has to submit Form 1095-B to the IRS and also send a copy of the form to the individual receiving the insurance coverage.
In its
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Your company is self-insured.
For any large company with 50 or more full-time employers, it is also required to file Form 1095-C with the IRS and to send a copy to its insured employees. Form 1095-C also details the type of health insurance coverage offered to employees. If large employers are also self-insured or self-funded, the company has to submit both 1095-B and 1095-C. In these situations, the IRS rules allow the employer to combine the information for both forms onto a single form, the 1095-C.
What Does Self-Insured Mean?
A company is self-insured if it pays for all its employees' medical costs rather than using an insurance company to pay the medial bills. If your company doesn't meet both conditions, you are not required to file Form 1095-B.
A self-insured or self-funded company is both the sponsor and the provider of the health insurance. An employer is the sponsor because it offers individuals health insurance through their jobs. As the organization that actually pays the medical bills, the company is also the provider.
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