The IRS has issued final versions of Forms 1095-C and 1094-C as well as updated final instructions on completing these forms. While the instructions and forms remain similar to those used last year, there are a few key changes worth noting.
In general, the Forms 1094-C and 1095-C are used by “applicable large employers,” or “ALEs,” to report offers of coverage to their full-time employees (those working 30 or more hours per week) as required under the Affordable Care Act, as well as by self-insured plan sponsors to report individuals covered under their plans.
The key changes to the forms and instructions include the following:
Conditional offers to spouses. New codes 1J and 1K were added to Form 1095‑C, line 14 to facilitate reporting of conditional offers to spouses. A “conditional offer” is an offer that is subject to one or more reasonable, objective conditions – such as an offer to cover an employee’s spouse only if the spouse is not eligible for coverage under Medicare or a group health plan sponsored by another employer. The instructions allow an employer to report a conditional offer to a spouse as an offer of coverage regardless of whether the spouse meets the condition, but the employer should be prepared to provide, upon request, a list of any and all applicable conditions.
Code 1J applies if minimum essential coverage (MEC) providing minimum value is offered to the employee, and MEC is conditionally offered to the spouse, but no MEC is offered to dependents. Code 1K applies if MEC providing minimum value is offered to the employee, and MEC is offered to dependents and conditionally offered to the spouse.
COBRA reporting. The 2016 instructions offer additional detail and examples for reporting offers of COBRA coverage to former employees, continuing employees and their dependents, as well as reporting offers of post-employment coverage that is not COBRA coverage.
Penalties. The penalties for failure to file or furnish the forms have increased from $250 to $260 per statement. In addition, the language permitting “good faith” compliance has been removed, although penalties can still be waived if the failure is due to reasonable cause and not willful neglect.
Other changes include the following:
ALE Aggregated Groups. The new instructions clarify reporting for members of an ALE Aggregated Group (each referred to as an “ALE Member”), including the following:
- Clarification that the reporting obligation is with each ALE Member if the ALE Aggregated Group has more than 50 full time equivalent employees, even if that particular ALE Member has fewer than 50 full time equivalent employees.
- Guidance for determining which ALE Member has the reporting obligation if an employee was employed by more than one ALE Member.
- Examples regarding ALE Members that file multiple Forms 1094-C, for assistance in identifying the authoritative transmittal.
Expanded definitions. The new instructions include expanded definitions of “full time employee” and “employee required contribution” which provide additional clarity.
Transition relief/interim guidance. The instructions note that qualifying offer transition relief is no longer available, and the applicable box on Form 1094-C is now marked “reserved.” Certain other transition relief is only available for non-calendar year plans, and only for those months that fall within the 2015 plan year. However, multiemployer plan interim guidance continues to apply for 2016.
Affordability safe harbor. The new instructions clarify that an affordability safe harbor code should not be used on line 16 of Form 1095-C for any month that the ALE member did not offer MEC to at least 95% of its full time employees and dependents.
Clarifications on forms. There are a few minor clarifying changes on the forms and in the instructions – including updating references to full-time employee counts to make clear that it refers to the definition of “full-time” in the employer mandate regulations, and clarification that Part III of Form 1095-C should only be completed for employees who enroll in self-insured coverage.
The new forms and instructions can be found on the IRS website using the following links:
While not addressed in this blog post, note that the IRS also issued updated forms 1094-B and 1095-B, and instructions for those forms, which can also be found on the IRS website using the links below. Forms 1094-B and 1095-B are generally used by health insurers, and may also be used by self-insured plan sponsors to report offers of coverage to certain non-employees such as retirees.
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- Pandemic Unemployment Assistance
- Parental Leave
- Patent
- Patient Protection and Affordable Care Act
- Patricia Shiu
- Pattern and Practice
- Paulsen v. Renaissance Equity Holdings
- Pay
- Pay and Promotions
- Pay Data
- pay disclosure
- Pay Discrimination
- Pay Equity
- Pay Reporting
- pay scale
- Pay Secrecy
- Pay Transparency
- Pay/Compensation
- Paycheck Deductions
- Paycheck Fairness Act
- Paycheck Protection Program
- Payroll Audit Independent Determination Program
- Payroll Debit Cards
- Payroll Taxes
- PBGC
- PCA
- PCC Structurals
- PCORI
- PDLL
- Penalties
- Penalty
- Pennsylvania
- Pennsylvania Minimum Wage Act
- Pension Plans
- Peoplemark
- PeopleSmart
- Perfectly Clear Doctrine
- Perfectly Clear Successor
- Performance and Accountability Report
- Period of Restoration
- Personal Jurisdiction
- Personal Jurisdiction; FLSA; Class Actions; Collective Action; General Jurisdiction; Specific Jurisdiction; Rule 23
- Personnel Policies
- Personnel Records
- Persuader Activity
- Persuader Agreements
- Persuader Rule
- Peter B. Robb
- Peter Schaumber
- Peter Sung Ohr
- Petition
- PEUC
- Phaladelphia Fair Practices Ordinance
- Philadelphia
- Pier 1 Imports
- Pitts v. Terrible Herbst
- Pizza Hut
- PLA
- plan sponsors
- Policies
- Portal-to-Portal Act
- Position Statement
- Post-Accident
- Poster Rule
- POWADA
- Poway Academy
- PPACA
- PPACA Checklist
- PPACA Timeline
- Practical Training
- Pre-Adverse Action Notice
- Pre-Adverse Action Requirements
- Precedent
- Predictable Scheduling
- Preemption
- Pregnancy Disability Leave
- Pregnancy Discrimination
- Pregnancy Discrimination Act
- Pregnancy Leave
- Pregnant Workers Fairness Act
- Preliminary Injunction
- Premium Pay
- Prenatal Leave
- Prescription Drug
- Prescription Drugs
- Prescription Medication
- Prevailing Wage
- Primary Beneficiary Test
- Prior Salary
- Privacy
- Private Equity Fund
- Privilege
- PRO Act
- Procedure
- Profanity
- Professional Responsibility
- Profiles in Diversity
- Progressive Discipline
- prohibition
- project labor agreement
- Property Rights
- Proposed Rule
- Proposed Rulemaking
- Proposed Rules
- Proposition 22
- Protected Activities
- Protected Activity
- Protected Concerted Activity
- Protecting Older Workers Against Discrimination Act
- Protective Order
- Protest
- provision
- PTO
- Public Accommodation
- Public Accommodations
- Public Bargaining
- Public Charge
- Public Entity
- Public Policy
- PUMP Act
- Punitive Damages
- Purchase Agreements
- Purple Communications
- PWFA
- Qualified Plans
- Quarantine
- Questioning
- Quickie Election
- Quickie Elections
- Race Discrimination
- Racial Equity
- Range
- Raytheon
- Reasonable Accommodation
- Reasonable Accommodations
- Recess Appointments
- Recordkeeping
- recruiting
- Reduction-in-Force
- Register Guard
- Regular Rate
- Regular Rate of Pay
- Regulation
- Regulations
- Regulatory Compliance
- Rehabilitation Act
- Reilly Moore
- Reimbursement
- Reimbursements
- release
- Religion
- Religious Accommodation
- Religious accommodation; Title VII; SCOTUS; Supreme Court; Third Circuit
- Religious Accommodations
- Religious Beliefs
- Religious Discrimination
- Religious Freedom Restoration Act
- Religious Institutions
- remedies
- Remote Work
- remote workforce
- Reopen Workplace
- Reopening Business
- Reopening Workplace
- Repeal
- report
- Reporting
- Reporting of Group Health Plans
- Reporting Pay
- Representation Election
- Representation Elections
- Representation Fairness Restoration Act
- Reprisal
- Reproductive Loss Event
- Reproductive Loss Leave
- Reproductive Rights
- Rescind
- RESPECT Act
- rest breaks
- Restaurant
- Restaurant Industry
- Restaurants
- Restoring Balance and Fairness to the National Labor Relations Board
- restriction
- Restrictive Covenants
- Restrictive Covenants Act
- Retail
- Retail Litigation Center
- Retaliation
- Retirement Plans
- Retirement Savings
- Return to Work
- Revenue Procedure 2013-12
- Revenue Ruling 2014-9
- Ricci v. DeStefano
- Richard Griffin
- RICO
- RIF
- RIFs
- right of first refusal
- Right to Disconnect
- Right to Know
- Right to Work
- Right-To-Sue
- Rising Star
- Rite Aid and Lamons Gasket
- Robert Quackenboss
- Roland Juarez
- Roland Juarez; Los Angeles Business Journal
- Roland M. Juarez
- Rollovers
- Roth
- Rounding Policy
- Rounding Time
- Rule 23
- Rule 68 Offer
- Rule-Making
- Rulemaking
- Ryan A. Glasgow
- Ryan Bates
- Ryan Glasgow
- Sabbath
- Safety
- Safety Incentives
- Salary
- Salary Basis Test
- Salary History
- Salary History Bans
- Salary History Inquiries
- Salary Inquiry
- Salary Reduction
- Sales Commissions
- Same-Sex
- Same-sex couples
- San Francisco
- San Francisco Fair Chance Ordinance
- Sanjee Weliwitigoda
- Sara Harlow
- Sarbanes-Oxley
- SB 459
- SB 553
- SB 95
- SB-973
- SBA
- SBC
- SCA
- Scabby
- Scale
- Scheduling Letter
- Schneiderman
- School Closings
- Scope Of Coverage
- Scott Brown
- Scott H. Kimpel
- Scott Nelson
- SCOTUS
- Sealed Records
- SEC
- Second Circuit
- Secondary Boycotts
- Section 125
- Section 1557
- Section 1983
- Section 203
- Section 2802
- Section 302
- Section 7
- Section 7 Rights
- Secure Scheduling
- Security
- Security Screenings
- Seff v. Broward County
- SEIU
- Self-Insured Health Plans
- Senate Bill 1162
- Separation Agreements
- Settlement
- Settlement Agreement
- Settlement Agreements
- Settlement Disclosure
- Seventh Circuit
- severance
- Severance Agreements
- Severance Payments
- Severe Injury Report
- Sex Discrimination
- Sexual Harassment
- Sexual Orientation
- SFFA
- Shaena Rowland
- Shannon S. Broome
- Sharon Block
- Sharon Goodwyn
- Shelter in Place
- Short-Time Compensation Program
- Shutdowns
- Sick Leave
- Sick Pay
- Silica Standards
- Single employer
- SIR Dashboard
- Sixth Circuit
- Slow the Spread
- Social Distancing
- Social Media
- Social Media Evidence
- Social Media Policy
- Solicitation Policy
- Solicitation/Distribution Policy
- Southern California Pizza Co.
- Speak Out Act
- Specialty Healthcare
- Specific Jurisdiction
- Spirituality Programs
- Spokeo
- Spoliation
- Spousal Rights
- Standard of Review
- Standing
- Staples
- Starbucks
- state court
- state legislation
- Statistical Audits
- Statute of Limitations
- Statute of Repose
- Statutes of Limitations
- Staub v. Proctor Hospital
- Stay Violations
- Steering Claims
- STEM
- Stengart v. Loving Care Agency
- Stephen Pattison
- Stewart Acuff
- Stillborn
- Strategic Objectives
- Strategic Plan
- Stray Markings
- Stray Remarks
- Strike
- Strike Plans
- Strike Tactics
- Students for Fair Admissions
- SUB Payments
- Subcommittee on Health
- Subject-Matter Jurisdiction
- Subpoena
- Subpoena Duces Tecum
- Substantial Compliance
- Successor Bargaining Duty
- Successor Company
- Successor Employer
- Successor Employer Duty to Bargain
- Successor Liability
- Suitable Seating
- Summary of Benefits and Coverage
- Super Lawyers
- Supervisor
- Supplemental Paid Sick Leave
- Supply Chain
- Supreme Court
- Susan Wiltsie
- Suspension
- Suzan Kern
- Systemic Discrimination
- Systemic Enforcement
- Taxpayer Responsibility Accountability and Consistency Act
- TCPA
- Technatomy Corporation
- Telecommuting
- Telephone Consumer Protection Act
- Telework
- Temporary Employees
- Temporary Reinsurance Program
- Temporary Workers
- Tenth Circuit
- Terence Connor
- Terrence Flynn
- Tesla
- Test Factor
- Testing
- Texas
- Texas Constitution
- Texas Lawyer
- Texas Legal Awards
- Texas Mutual v. Ruttiger
- Texas Regulatory Consistency Act
- Texting
- The Board
- The Boeing Company
- The Opportunity to Work Ordinance
- Third Circuit
- Third-party Liability
- Thompson v. North American Stainless
- Thriving in Their 40s
- Time Rounding
- Timekeeping
- Tip
- Tip Credit
- Tip Pooling
- Tip Sharing
- Tipped Employees
- Tipped Workers
- Tipping Policies
- Tips
- Title III
- Title IX
- Title VII
- Title VII of the Civil Rights Act of 1964
- Tolling
- Top Insurance Cases
- TRAC
- Trade Secrets
- Trade Secrets & Non-Competes
- Trademark
- Traditional labor
- Trailblazer
- Training
- Training Programs
- Transgender
- Transgender Rights
- Transparency
- TransUnion
- Tratree
- Traxler v. Multnomah County
- Trial Management
- TRICARE
- Trucking Industry
- Trump Administration
- Trump Rule
- Tyler S. Laughinghouse
- Typicality Requirement
- U.S. Senate
- U.S. Senate Finance Committee
- UAW
- Uber
- Uber Drivers
- ULP
- ULP Charge
- UNC
- Unconscionability Doctrine
- Undocumented Workers
- undue hardship
- Unemployment
- Unemployment Benefits
- Unemployment Compensation
- Unemployment Discrimination
- Unemployment Insurance
- Unfair Labor Charge
- Unfair Labor Practice
- Unfair Labor Practices
- Uniform Glossary
- Unilateral Change
- Union
- Union Apparel
- Union Button
- Union Dues
- Union Election
- Union Elections
- Union Information Request
- Union Insignia
- Union Logo
- Union Organizing
- Union Organizing and the NLRB
- Union Rat
- Union Representation
- Union Representation Elections
- Union Sticker
- Unions
- United States v. Windsor
- University of North Carolina
- Unlawful Insistence
- Unlimited Vacation
- Unsuccessful Assisted Reproduction
- UPMC Braddock
- US Chamber of Commerce
- US Supreme Court
- USAction
- USCIS
- USDA
- Use or Lose Rule
- USERRA
- Vacation
- Vacation Pay
- Vacation Scheduling
- Vaccination
- Vaccine
- Vaccine Incentives
- Vaccines
- Valley Hospital Medical Center
- Variant
- VBA
- VCP
- Venue
- Veterans Preference Act
- VETS-100A
- VETS-4212
- VEVRAA
- Victoria Lipnic
- Video
- Viking River
- Virginia
- Virginia Business Magazine
- Virginia Center for Inclusive Communities
- Virginia Employment Legislation
- Virginia Human Rights Act
- Virginia Labor Law
- Virginia Law
- Virginia Lawyers Weekly
- Virginia Marijuana Laws
- Virginia Overtime Wage Act
- Virginia Wage Payment Act
- Virginial Lawyers Weekly
- Virus
- Visa Waiver
- Vital Industry
- Volks Rule
- Voluntary Incentive
- Voter List
- VW
- Wage & Hour
- Wage and Hour
- Wage and Hour Exclusion
- Wage Equality Act
- Wage Fixing
- Wage Inquiries
- Wage Investigation
- Wage Payment
- Wage Penalties
- Wage Reduction
- Wage Statement
- Wage Theft
- Wage Theft Prevention Act
- Wage Transparency
- Waiter
- Waiting Period Rules
- Waiver
- Waivers
- walk around
- Walling v. Portland Terminal
- Wang v. Chinese Daily News
- WARN
- WARN Act
- Washington DC
- We Can Help
- Weapons
- Web Accessibility
- Web Designer
- Webinar
- Website
- Website Accessibility
- Weight Restrictions
- Weingarten
- Wellness Programs
- Wesson
- West Virginia Workplace Freedom Act
- WHD
- Whistleblower
- Whistleblowers
- White Collar Exemption
- William Emanuel
- William J. Emanuel
- Wilma Liebman
- Windsor Decision
- Withdrawal of Recognition
- withholding requirements
- Witness Statements
- Women
- Women In Leadership
- Women of Influence
- Women’s Equality Act
- Work Schedule
- Work Transfers
- Work-Sharing
- Worker Misclassification
- Worker Protection
- Worker Safety
- Workers Bill of Rights
- Workers Compensation
- Workers' Compensation Insurance
- Workplace AI
- Workplace Diversity
- Workplace Investigations
- Workplace Monitoring
- Workplace Policies
- Workplace Privacy
- Workplace Rules
- Workplace Safety
- Workplace Technology
- Workplace Violence
- Workplace Violence Prevention
- WR Reserve
- Wrongful Discharge
- Year In Review
Authors
- Jessica N. Agostinho
- Walter J. Andrews
- Ian P. Band
- Ryan M. Bates
- Christy E. Bergstresser
- Theanna Bezney
- Jesse D. Borja
- Brian J. Bosworth
- Jason P. Brown
- M. Brett Burns
- Daniel J. Butler
- Christopher J. Cunio
- Jacqueline Del Villar
- Kimberlee W. DeWitt
- Steven J. DiBeneditto Jr.
- Robert T. Dumbacher
- Raychelle L. Eddings
- Elizabeth England
- Juan C. Enjamio
- Karen Jennings Evans
- Geoffrey B. Fehling
- Jason Feingertz
- Katherine Gallagher
- Ryan A. Glasgow
- Sharon S. Goodwyn
- Meredith Gregston
- Eileen Henderson
- Kirk A. Hornbeck
- J. Marshall Horton
- Roland M. Juarez
- Keenan Judge
- Suzan Kern
- Elizabeth King
- Stephen P. Kopstein
- Torsten M. Kracht
- James J. La Rocca
- Kurt G. Larkin
- Jordan Latham
- Tyler S. Laughinghouse
- Crawford C. LeBouef
- Michael S. Levine
- Michelle S. Lewis
- Brandon Marvisi
- Lorelie S. Masters
- Reilly C. Moore
- Michael J. Mueller
- J. Drei Munar
- Alyce Ogunsola
- Christopher M. Pardo
- Michael A. Pearlson
- Adriana A. Perez
- Kurt A. Powell
- Robert T. Quackenboss
- D. Andrew Quigley
- Michael Reed
- Jennifer A. Reith
- Amber M. Rogers
- Alexis Zavala Romero
- Zachary Roop
- Adam J. Rosser
- Katherine P. Sandberg
- Elizabeth L. Sherwood
- Cary D. Steklof
- C. Randolph Sullivan
- Veronica A. Torrejón
- Debra Urteaga
- Emily Burkhardt Vicente
- Kevin J. White
- Holly H. Williamson
- Susan F. Wiltsie