Employer Reporting - From the desk of Shelly Sheppard
(Posted on 10/19/22)
There are a few different types of employer reporting that may affect some of your groups. The following reviews employer reporting for applicable large employers (ALEs) and self-funded groups, the NJ state reporting requirements, and also a Massachusetts reporting requirement.

Employer Reporting (1094/1095 B&C)
This reporting is still in force and our applicable employers should continue to comply with this ACA requirement. Groups should take this time and make sure that they are aligned with the proper vendor to help them issue the 1094 and 1095 forms if they are required to do so. Generally, the 1094-C & 1095-C forms will be issued by the same vendor that files the company’s W-2s. Or, the employer can vet out another TPA to assist them with the filing. ALE’s must furnish 1095-C forms to all full-time employees no later than March 2nd, 2023 while they must report all files to the IRS no later than February 28th, 2023 (if by paper) or no later than March 31st, 2023 (if filing electronically).

As a reminder for self-funded groups under 50 - if a group is a part of a level or self-funded arrangement, the employer may be responsible to file/send proof of enrolled coverage (forms 1094/1095-B) to the IRS and employees. This is indicated on forms 1094-B and 1095-B. This form is used for individuals on the group plan to prove that they had coverage. Some self-funded carriers may provide reports or assistance with the filing, so please be sure to check with them. If a group is an ALE (over 50 full time equivalents) AND on a self-funded plan they are required to show both the proof of coverage to insured employees and the offer of coverage. In essence they are acting as the provider and the employer. For groups that fall into this category, the IRS has made it a little easier for groups to only fill out the 1094-C and 1095-C forms. This is the form that all ALEs must complete and also has a section for them to complete if they are self-funded.

NJ State Reporting
In addition to the federal filings, to enforce the NJ Health Insurance Mandate, NJ requires third party reporting to verify health coverage information for NJ residents. We are waiting on the 2023 deadlines however last year the filers had to submit coverage information electronically by March 31st. Employers need to make sure that they submit any required reporting to NJ, if applicable, as this state requirement is in addition to the federal reporting requirements. In some circumstances, employers may not need to file information directly to the state as their health insurance carrier may be sending on their behalf.

Massachusetts Reporting
Employers that have six or more employees in Massachusetts within the past 12 months are required to complete the Health Insurance Responsibility Disclosure (HIRD) form. This form is used to collect information about the employer sponsored insurance offerings. The HIRD form is available starting November 15 and must be completed by December 15 of the reporting year. This must be done electronically.

Below you’ll find links to copies of the new draft forms/instructions for 2022 and resources on the information above.
Copies of the 1094/1095 B&C forms are available on the IRS website and linked below.

-NJ Shared Responsibility Requirement - NJ Health Insurance Mandate - Employers and Coverage Providers
-MA Health Insurance Responsibility Disclosure (HIRD) FAQs - Health Insurance Responsibility Disclosure (HIRD) FAQs | Mass.gov