Which ACA Form Do I Need to File with the IRS?

The ACA guidelines have 2 different types of forms (1095-B and 1095-C) to cover different reporting scenarios:

B Series

Filed by:

  • Insurance companies
  • Employers that offer coverage on a self-funded plan with less than 50 full time + full time equivalent employees

Consists of:

Form 1094-B
1 per Issuer

Includes issuer's information like address, city, state, zip and FEIN.

Form 1095-B
1 per Responsible Individual

Includes responsible individual and all covered individuals information.

A 1094-B and its 1095-Bs MUST be filed together

C Series

Filed by:

  • Employers that offer coverage to at least 50 full time + full time equivalent employees
  • Includes employers with self-funded, fully-funded, ICHRA and union based plans

Consists of:

Form 1094-C
1 per Applicable Large Employer (ALE)

Includes ALE member's information, monthly head counts, and other EINs that share common ownership.

Form 1095-C
1 per Eligible Employee

Includes eligible employee's information including coverage info and other covered individuals (if applicable).

A 1094-C and its 1095-Cs MUST be filed together

Not sure if you need to file?

Check out our ACA Survey   to see if you may need to file ACA forms.

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This includes:

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Frequently Asked Questions About ACA Forms

What is Form 1095-B?

Form 1095-B is an information return that is filed by health insurance providers or employers who offer self-funded coverage with fewer than 50 full time + full time equivalent employees.

Insurance Providers
OR
Self-Funded Small Employers

less than 50 full time + full time equivalent employees

For more info on Tax Year 2022 Form 1095-B, click here

What is Form 1095-C?

Form 1095-C is an information return filed by employers with at least 50 full time + full time equivalent employees. These employers are known as 'Applicable Large Employers' or ALEs by the IRS. This form tells the IRS if the employer met ACA guidelines for the healthcare coverage they offer, and it requires that employees receive a recipient copy as well.

Applicable Large Employers

at least 50 full time + full time equivalent employees for all EINs added together that share a common owner

For more info on Tax Year 2022 Form 1095-C, click here

We also recommend checking out the IRS.gov ACA FAQ as this contains many common 1095-C questions in an easy to understand format.

How Do You File 1095-C Online?

Generally, ACA filing is handled by self-filing or by using an ACA Software provider:

small boomtax logo

  • Simple format for data import (like Excel)
  • Can often use your payroll files directly
  • No testing, TCC, or IRS account required
  • Can help with questions/coding

Self-Filing

  • Format requires custom software development
  • Filing system can be slow and unreliable
  • Requires testing, TCC, and personal info
  • Errors and issues reported can be cryptic

Learn more about filing 1095-C online.

What Information is Required to File ACA Forms?

Depending on the type of form, most ACA forms will consist of:

  • The recipient's info like name, address, city, state, zip.
  • The employer or issuer's info like company name, contact, EIN, etc.
  • The coverage and plan details with codes to indicate if the coverage was affordable and met ACA guidelines.
  • The covered individuals' info like name, SSN, date of birth and covered months.

What are the 1095 Codes?

On the IRS Form 1095-C, there are two sets of codes used for Lines 14 and 16.

Series 1 Codes (Line 14)

These codes provide information about the health coverage offered by the employer, including whether it was a qualifying offer and whether coverage was offered to the employee's spouse and dependents.

Includes codes: (1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1I, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1R, 1S, 1T, 1U)

Read more about 1095-C Codes
Series 2 Codes (Line 16)

Provide additional details about the employee's employment status, such as whether the employee was not employed or was not full-time during certain months, whether the employee was enrolled in coverage, or whether the employer is eligible for transition relief.

Includes codes: (2A, 2B, 2C, 2D, 2E, 2F, 2G, 2H, 2I)

Read more about ACA Codes

How can I Request an Extension for Filing ACA Form 1095-C?

If you can't file ACA Form 1095-C on time, you can request an automatic, 30-day extension by filing Form 8809 OR by requesting a time extension directly from BoomTax.

Learn more about how to request an ACA Form 1095-C extension.

What are the Form 1095 Penalties?

ACA penalties are typically split into 2 categories:

  1. Employer Shared Responsibility Payment (ESRP): This penalty applies to large employers who do not offer minimum essential coverage to at least 95% of their full-time employees (and their dependents), and at least one of their full-time employees receives a premium tax credit for purchasing individual coverage on one of the health insurance marketplaces. The ESRP is also known as the "employer mandate" or "play or pay" penalty.

  2. Reporting and Disclosure Penalties: These penalties are assessed for failing to file required information returns with the IRS, or for failing to provide required statements to individuals. These information returns include Form 1094-C and Form 1095-C, which large employers are required to file under the ACA's reporting requirements.
To learn more about the various types of IRS ACA penalties and their corresponding fines, please click here.
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