Final Ruling for ACA Reporting

How Complex Will it Be?

ACA Reporting for Employers and Providers

On March 5, the U.S. Department of the Treasury and the Internal Revenue Service released final regulations for information reporting provisions required by certain employers and insurers for Affordable Care Act compliance starting 2015. Employers with more than 50 employees will be required to provide affordable, quality health care coverage, and must prove they are in compliance through mandatory reporting. While employers and insurers anticipated burdensome and costly reporting requirements, the newly released rules were designed to streamline and simplify information reporting for ACA coverage requirements with a consolidated form.

Reporting Rules Summary

The new rules require covered employers to certify minimum essential coverage offerings for full-time employees on a form titled Section 6056. Another form, Section 6055, is required of insurers and self-insured employers to file health care coverage data. Section 6056 is required of employers with 50 or more full-time employees and Section 6055 is required of any entity offering a health plan. Tracking must begin in 2015 for returns in 2016 filed with employees and the IRS. The Section 6055 and 6056 forms will be combined into a single form with completion only pertaining to specific entities so that self-insured employers will fill out both sections but employers who do not self-insure will only have to complete Section 6056.

What Information Must Be Reported

The information required by the new rules includes information about the entity providing coverage, identifying information about individuals enrolled in coverage and when they were covered.  Some employers will also need to provide data regarding coverage offered to full-time employees (by employee and month) and the lowest cost of employee-only coverage that was offered. No information about ACA waiting periods, employers’ share of plan benefits, or advance payments is required as of yet. Treasury spokesperson Mark J. Mazur said the final rules are an effort to provide early guidance so employers and insurers can begin preparing for 2015, and that they were developed to make the information reporting process easier and faster.

Reactions to New Rules

The NRA (National Retirement Association) has been advocating for flexibility for employers under ACA implementation to get a less costly reporting process. It has sought to limit the kind of data required, such as only reporting on the number of full-time employees and not every employee and dependent. The Employers for Flexibility in Health Care Coalition, a group of service industry businesses including restaurant, retail, temporary staffing, and other service businesses, also filed comments with the IRS urging them to provide more flexibility in the process.

Although the Treasury and IRS have reported a streamlined reporting process, some employers and groups are not happy with the new rules. NRA President Dawn Sweeney calls the newly released rules an “overwhelming and extensive set of requirements.” She warns that the new rules represent a burden to track, provide and protect massive amounts of data requiring new administrative and technology resources.

Alongside Reporting Rules

In addition to the final reporting requirements released in March, an Insurance Standards Bulletin was published, extending a transition relief policy for canceled health plans for two more years.  This bulletin gives individuals and small businesses the possibility of keeping non-ACA compliant coverage into 2017 in some instances. The 2015 Notice of Benefit and Payment Parameters Final Rule also issued final rules on payment parameters, open enrollment periods and patient safety standards for qualified health plans in the exchanges. 

If the announcement of these final rulings has created even more confusion, talk to PAYDAY’s sister company, Beneforce Insurance Solutions.  Together, we are keeping our clients in compliance with ACA requirements and we can help you, too. 

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About the Author:

As Director of Operations, Jessica oversees the day-to-day operations for payroll, human resources, tax, finance and client affairs. She also plays an active role in formulating corporate strategy and developing client programs. Jessica believes a company’s success begins with its people. She strives to build a team encompassing excellence and professionalism, and to play a large role in developing the staff on an ongoing basis. Her passion for strong client relationships drives her in ensuring that clients receive the highest level of personal service and the best products in the industry. Jessica joined PAYDAY in 2004, and quickly advanced to Development Coordinator in 2006, when she took charge of Human Resources. She was promoted to Director of Operations in September, 2011.

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