What are ACA reporting requirements?
Asked by: Leilani Reilly | Last update: January 14, 2026Score: 4.7/5 (57 votes)
What is required for ACA reporting?
To satisfy the reporting requirements, fully insured and self-insured applicable large employers must complete Form 1095-C (and the 1094-C transmittal form). If you offer health insurance, you'll complete Parts I and II of the 1095-C. Self-insured employers will complete Parts I, II and III.
What are the ACA reporting requirements for 2024?
Employers must report employee insurance information with the California Franchise Tax Board (FTB) once per year. Information should be submitted to the state using federal Forms 1094-C, 1095-C, and 1095-B. Organizations must also distribute copies to employees.
What are the ACA minimum requirements?
Under the Affordable Care Act, major medical health insurance plans and qualified health plans (QHPs) must meet Minimum Essential Coverage Standards, which generally means they must: Have an “Actuarial Value” of 60% or more. Cover 10 Essential Health Benefits.
Who is exempt from ACA reporting?
Businesses with fewer than 50 workers are exempt from the employer mandate, but if they chose to offer health coverage it must meet certain ACA specifications.
ACA Reporting Requirements
Who is the ACA mandatory for?
Residents of California, Massachusetts, New Jersey, Rhode Island, and Washington, D.C. are required to buy health insurance or face a penalty, unless they have an exemption. Maryland and Vermont require residents to report their health insurance status but do not have a financial penalty for being uninsured.
Who completes ACA reporting?
All applicable large employers (ALE) must file Forms 1094-C and 1095-C with the IRS and furnish a copy of the 1095-C to all full-time employees. The insurance carrier for a fully insured plan must complete Forms 1094-B and 1095-B.
How many employees before ACA is required?
An applicable large employer, generally those with 50 or more full-time employees, including full-time equivalents. If you have no employees, the information in the section below does not apply to you.
What disqualifies you from ACA?
Can you be denied Obamacare? As long as you are eligible for Obamacare, you can't be denied. That means that as long as you are living in the U.S. lawfully and are not incarcerated or covered by Medicare, you can enroll in an ACA insurance plan.
What determines ACA eligibility?
Under the Affordable Care Act (ACA), Medicaid coverage is extended to nearly all nonelderly adults with incomes at or below 138% of the federal poverty level (FPL) (about $23,556 for a family of three in 2022) in the 42 states (including DC) that opted to expand as of March 2023.
Are 1095-C required for 2024?
ACA reporting season for the 2024 tax year is upon us and the first deadline is approaching. Applicable Large Employers (ALEs) in California must furnish 1095-C forms to employees by Jan. 31, 2025 to comply with the state's individual mandate.
Which states require a state filing ACA?
Rhode Island, New Jersey, California, Massachusetts, Vermont and the District of Columbia have enacted state-level ACA reporting, with more on the way. This development leaves employers needing to monitor state-level ACA developments as they do for state and local tax withholding regulations today.
What is considered an applicable large employer?
An applicable large employer (ALE) is an employer with an average of at least 50 full-time employees.
What data is needed for ACA reporting?
Reporting data: IRS and applicable states
This document includes information about the type of health coverage offered, the lowest premium available to each employee, the months of the year when coverage was available, and the months the employee and dependents enrolled in that coverage.
How much does ACA reporting cost?
eFile Only
This chart shows pricing for 1095-B and 1095-C ACA (Affordable Care Act) forms. ACA Direct state filing is available for $1.49 per form for the following states only: California, Massachusetts (MA 1099-HC), New Jersey, Rhode Island and the District of Columbia.
What is the 30 hour rule for ACA?
If an employee is credited with an average of 30 hours per week or more during the Standard Measurement Period, the employee would be eligible for benefits for the upcoming plan year. The Stability Period is the period of time that the employee cannot lose eligibility regardless of the hours he works.
What is the income limit for ACA subsidies in 2024?
In 2024, an individual in a one-person household is eligible for some degree of Covered California subsidies if they earn up to $33,975 Meanwhile, that limit rises to $69,375 for a household size of 4. These numbers refer to your Adjusted Gross Income (AGI) as found on line 11 of your Form 1040.
Who is exempt from ACA?
Hardship exemptions are available for those who cannot afford to pay for health insurance or for whom health insurance would exceed 8.16 percent of their gross household income.
What is the controversial ACA insurance requirement?
Individual mandate. The most legally and politically controversial aspect of the ACA, the individual mandate requires Americans to purchase health insurance or face a government penalty, with some exceptions—particularly for low-income individuals who cannot afford to buy insurance [3].
What is the 50 employee rule for ACA?
Under the Affordable Care Act (ACA), businesses with 50 or more full-time equivalent (FTE) employees that do not offer health coverage, or that offer health coverage that does not meet certain minimum standards, may be subject to a financial penalty, referred to as the Employer Shared Responsibility payment.
How to determine if an employee is ACA eligible?
The predefined period is known as the "measurement period" or ACA lookback period. If the employee's average hours per week are 30 or higher, that employee is considered full-time for purposes of the ACA (regardless of HR full- or part-time status).
What are the FTE requirements for ACA?
Any employee who works an average of at least 30 hours per week for more than 120 days in a year. Part-time employees work an average of less than 30 hours per week.
What does the ACA require?
The law requires you and your dependents to have health care coverage. If you purchased coverage from the Health Insurance Marketplace, you may be eligible for the Premium Tax Credit.
What employers are subject to ACA reporting?
Employers must determine their ALE status each calendar year based on the average size of your workforce during the prior year. Employers that had at least 50 full-time employees, including full-time equivalent employees, on average last year, are most likely an ALE for the current year.
What is the penalty for not filing ACA reporting?
The state may be assessed IRPs for any corrected 1095-Cs beginning when SCO submits the 2021 corrected 1095-Cs to the IRS. 2021 IRP Amounts for each corrected 1095-C: $280: Failure to file a correct 1095-C with the IRS. $280: Failure to provide a correct 1095-C to the employee.