ACA Forms Overview of ACA 1095-B and 1095-C Reporting Obligations

Image of Form 1095-B Header Section
Image of Form 1095-C Header Section

Under the Affordable Care Act (ACA), all U.S. citizens employed domestically must acquire healthcare coverage. The IRS enforces this by overseeing Sections 6055 and 6056 of the ACA.

Explore further to understand the implications of Sections 6055 and 6056.

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
Form 1095-B
1 per Responsible Individual

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)
Form 1095-C
1 per Eligible Employee

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

What is Form 1095-B?

Form 1095-B is an information return filed by health insurance providers or employers offering 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 2023 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.

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 2023 Form 1095-C, click here

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

2022 Affordable Care Act Reporting Changes

In the 2022 tax year, there were no modifications to the ACA Forms. Fundamentally, ACA reporting can be accomplished using two forms. Health coverage providers to individuals and employers with less than 50 employees should utilize 1095-B and 1094-B. ALEs who extend healthcare coverage to their employees and dependents should use 1095-C and 1094-C.

Changes to Form 1095-C for the 2021 Tax Year

Last year, the IRS introduced two new ACA codes to Form 1095-C for the purpose of reporting individual coverage HRAs and other related information.

Discover more about all Form 1095-C Code Instructions for the 2022 Tax Year.

What is Required to E-File ACA Form 1095-C?

At a minimum, you need the following information to complete a 1095-C:

  1. Part I - Employee: Basic census data, including the employee's name, SSN, and address

    Image of Form 1095-C Part I Employee Section

    Employer or Applicable Large Employer (ALE): Company name, EIN, and address

    Image of Form 1095-C Part I Employer or Applicable Large Employer (ALE) Section

  2. Part II - Employee Offer of Coverage: ACA Codes Box 14 - 17, premium amounts, and optional data for ICHRA plans.

    Image of Form 1095-C Part II Employee Offer of Coverage

    • Employee Age on January 1st
      • This should only be completed if certain ICHRA codes (1L, 1M, 1N, 1O, 1P, 1Q, 1T, or 1U) are entered on Line 14.
    • Plan Start Month
      • This should be completed with the month the employer's plan year begins. This must be completed with the two-digit number corresponding to the month (00-12). If there is no plan in which the employee was offered coverage, 00 should be entered.
    • Employee Required Contribution
      • This should be completed with the employee's share of the lowest-cost self-only plan offered to the employee. This line should only be completed when specific codes (1B, 1C, 1D, 1E, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1T, or 1U) are entered in Line 14.
    • ZIP Code
      • This should only be completed if certain ICHRA codes (1L, 1M, 1N, 1O, 1P, 1Q, 1T, or 1U) are entered on Line 14.
  3. Part III - Covered Individuals: Name, TIN, Date of Birth (optional if TIN entered), and checks for the covered months

    Image of Form 1095-C Part III Covered Individuals

    This section should only be completed if you offered employer-sponsored, self-insured health coverage, including an individual coverage HRA.

    ALL individuals covered under the offered plan should be listed here, including the employee.

    Please note: each line should list a different covered individual. Either (d) or (e) should be completed for each covered individual.

What Data is Necessary to File ACA Form 1095-B Electronically?

  1. Personal Details: Name, EIN, and Address

    Image of Form 1095-B Part I Employee Section

  2. Employer/Coverage Provider Information: Name, EIN, and Address

    Image of Form 1095-B Part II Employer Section

  3. Details of Issuer: Name, EIN, and Address

    Image of Form 1095-B Part III Employer Section

Consult our 1095-B guide to understand how to complete your Form 1095-B.

Submission Deadlines for Form 1095-B and Form 1095-C in Tax Year 2023

Here are the critical dates for filing and distributing Form 1095-B & 1095-C deadlines.

February 28th, 2024

Paper File Deadline

March 1st, 2024

Employee Copy Deadline

April 1st, 2024

E-File Deadline

What are the 1095-C State Reporting Deadlines?

Besides e-filing with the IRS, certain states require employers to report health coverage information to their respective state departments. Below are the states that require Individual Mandates and their respective deadlines:

State Deadline

California

Furnish Forms January 31st
File With State March 31st

District of Columbia

30 days after the federal ACA e-file deadline

Massachusetts

December 15th of the reporting year

New Jersey

Furnish Forms March 2nd
File With State March 31st

Rhode Island

File With State March 31st

Vermont

No additional requirements for employers

With BoomTax, you also have the option to e-file your ACA Form 1095 with the IRS and the applicable states ahead of the deadline.

Import Your ACA Forms Data

You can import your data as Excel, XML, or use files from popular payroll providers like QuickBooks, UKG, ADP, and many more.

Step-By-Step Wizard

We walk you through the process with no complicated jargon. You can also live chat with a real person as you work on your filing for hands-on help.

E-File & Mail Employee Copies

Once your data is loaded, you can e-file and distribute employee copies in minutes.

BoomTax is an IRS-authorized e-file provider for various IRS tax forms, including 1095 forms, 1095-B, 1095-C, 1094-B, and 1094-C.

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