Podcast Episode 49: Digging Deeper into the Challenges of a Single-Payer System — Part II
Reminder: Upcoming IRC 6055 and 6056 Reporting Deadlines
Reminder: Medicare Part D Disclosure to CMS
Benefits Compliance Bytes: Forms 1094-C and 1095-C Instructional Videos
IRS Releases Final Form 8955-SSA and Instructions
IRS Updates 2018 Publication 560 – Retirement Plans for Small Business
IRS Provides 401(k) Fix-It-Guides for Hardship Distribution and Participant Loan Failures
Chase Cannon and Suzanne Spradley focus on the parts of the US system that are working well, focusing on the employer-sponsored group health insurance market. Chase orates a brief history of the employer-based insurance model, including why employer groups were originally (and still today) the ideal group market target for insurance companies. Chase explains that between 180 and 185 million people (or 55 to 60 percent of the US population) are currently covered through an employer group health plan; the vast majority of whom are happy with their plan and benefits. Chase and Suzanne outline the importance of employer engagement in employee’s health care benefit coverage, and how the employer market has seen lower cost increases than the individual market. Chase describes the built-in incentives for employers and carriers to develop innovative plan design and cost-saving strategies, and how the private market (as compared to the government) is better suited to stoke the embers of further innovation. The two conclude that the employer model is working well: It’s a stable system that has lower premium rate increases, less adverse selection, more incentives for innovation, and that already covers the majority of US citizens. The better approach is to develop fixes for the more problematic individual market.
Every other week, NFP's legal experts make the subject of compliance personal for a wide audience. By breaking down the daunting details of emerging policies and bridging the gap between legislation and what it means for the listener, Chase Cannon and Suzanne Spradley make compliance issues relatable and relevant. Visit our Soundcloud page every two weeks for the most up-to-date episode.
Applicable large employers (ALEs: those with 50 or more full-time employees including full-time equivalents, or FTEs) in 2017 must comply with IRC Section 6056 reporting in early 2019. Specifically, ALEs must complete and distribute a Form 1095-C to FTEs by March 4, 2019 (changed from Jan. 31, 2019). The form should detail whether the employee was offered minimum value, affordable coverage during 2018. The forms may be mailed, delivered electronically or delivered by hand (although proof of delivery in some manner is recommended).
If an employer sponsored a self-insured plan during 2018, it must comply with Section 6055 reporting in 2019. Self-insured employers with 50 or more FTEs must complete Section III of Form 1095-C detailing which months the employee (and any applicable spouse and dependents) had coverage under the employer’s plan. If the self-insured employer has fewer than 50 FTEs, it must complete and distribute a Form 1095-B with such information. Again, the forms must be delivered to employees by March 4, 2019.
Employers must also file the forms with the IRS by Feb. 28, 2019, if filing by paper and April 1, 2019, if filing electronically. Those filing 250 or more forms are required to file electronically. Lastly, the employer is required to a file the transmittal Form 1094-C (if filing Forms 1095-C) or Form 1094-B (if filing Forms 1095-B).
As a reminder, employers who sponsor a group health plan that provides prescription drug coverage to Medicare Part D eligible individuals must disclose to CMS, on an annual basis, whether the coverage qualifies as creditable or non-creditable. The disclosure is due no later than 60 days after the beginning of each plan year. Thus, for calendar year plans, the disclosure is due March 1, 2019.
NFP’s Benefits Compliance team has recorded two instructional videos to assist applicable large employers in completing the Forms 1094-C and 1095-C as required under IRC Sections 6055 and 6056. The videos provide a walk-through of each form, an explanation of codes and discussions of common employer mistakes.
The Form 1095-C must be distributed to full-time employees by March 4, 2019 (an extension from the previous due date of Jan. 31, 2019). The forms 1094-C and 1095-C must be filed with the IRS by Feb. 28, 2019, if filing by paper and April 1, 2019, if filing electronically. Those filing 250 or more forms are required to file electronically.