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The IRS 1094-C form plays a crucial role in the realm of employer healthcare reporting, particularly in relation to the Affordable Care Act (ACA). Designed for applicable large employers, this form serves as a transmittal document for summarizing the information provided in individual employee forms, specifically the 1095-C forms. Employers utilize these forms to report on the health insurance coverage they offer to their employees. By compiling data about coverage, employee count, and related details, the 1094-C assists the IRS in assessing compliance with the ACA’s employer mandate. Its completion requires careful attention, as accuracy is vital. Notably, the form encompasses key sections that request essential information about employer status, the number of full-time employees, and the months during which healthcare coverage was offered. As the deadline for submission approaches each year, understanding the components and requirements of the 1094-C becomes increasingly important for businesses navigating the complexities of healthcare legislation.

Form Sample

Form1094-C

 

Transmittal of Employer-Provided Health Insurance Offer and

 

Department of the Treasury

 

Coverage Information Returns

 

Go to www.irs.gov/Form1094C for instructions and the latest information.

Internal Revenue Service

 

 

 

 

 

Part I

Applicable Large Employer Member (ALE Member)

CORRECTED

120118

OMB No. 1545-2251

2020

1 Name of ALE Member (Employer)

2 Employer identification number (EIN)

 

 

3Street address (including room or suite no.)

4

City or town

5 State or province

6

Country and ZIP or foreign postal code

 

 

 

 

 

7

Name of person to contact

 

8

Contact telephone number

 

 

 

 

 

9

Name of Designated Government Entity (only if applicable)

 

10

Employer identification number (EIN)

 

 

 

 

 

11Street address (including room or suite no.)

12 City or town

13 State or province

14 Country and ZIP or foreign postal code

 

 

 

For Official Use Only

15Name of person to contact

16 Contact telephone number

17

Reserved

 

 

 

 

 

 

 

 

 

18

Total number of Forms 1095-C submitted with this transmittal . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

19

 

 

Is this the authoritative transmittal for this ALE Member? If “Yes,” check the box and continue. If “No,” see instructions

 

 

Part II ALE Member Information

20

Total number of Forms 1095-C filed by and/or on behalf of ALE Member

. . .

.

.

. . . . . . .

 

21

Is ALE Member a member of an Aggregated ALE Group?

. . .

.

.

. . . . . . .

.

Yes

 

If “No,” do not complete Part IV.

 

 

 

 

 

 

 

 

 

 

22

Certifications of Eligibility (select all that apply):

 

 

 

 

 

 

 

 

 

A. Qualifying Offer Method

 

B. Reserved

 

C. Reserved

 

 

 

D. 98% Offer Method

 

 

 

 

 

 

 

 

 

 

Under penalties of perjury, I declare that I have examined this return and accompanying documents, and to the best of my knowledge and belief, they are true, correct, and complete.

 

 

Date

Signature

Title

No

For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.

Cat. No. 61571A

Form 1094-C (2020)

 

 

 

 

 

 

 

 

120218

Form 1094-C (2020)

 

 

 

 

Page 2

Part III

ALE Member Information—Monthly

 

 

 

 

 

 

 

(a) Minimum Essential Coverage

(b) Section 4980H Full-Time

(c) Total Employee Count

(d) Aggregated

(e) Reserved

 

 

Offer Indicator

 

 

 

 

Employee Count for ALE Member

for ALE Member

Group Indicator

 

 

 

 

 

 

 

 

 

Yes

 

No

 

 

 

 

23

All 12 Months

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Jan

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Feb

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Mar

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Apr

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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May

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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June

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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July

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Aug

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Sept

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Oct

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Nov

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Dec

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Form 1094-C (2020)

 

 

120316

Form 1094-C (2020)

Page 3

Part IV

Other ALE Members of Aggregated ALE Group

 

Enter the names and EINs of Other ALE Members of the Aggregated ALE Group (who were members at any time during the calendar year).

Name

EIN

Name

36

 

51

 

37

 

52

38

 

53

39

 

54

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41

 

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50

 

65

 

 

 

EIN

Form 1094-C (2020)

Document Specifications

Fact Name Description
Purpose The IRS 1094-C form is used to report health coverage information to the IRS under the Affordable Care Act (ACA).
Filing Requirement Applicable to employers with 50 or more full-time employees, including full-time equivalent employees.
Due Date The form must be filed by February 28 if submitted on paper, and by March 31 if filed electronically.
Information Included The form collects data about the employer, the number of full-time employees, and the health coverage offered.
Relation to 1095-C Form 1094-C serves as a cover sheet for the 1095-C forms submitted for each employee.
State-Specific Requirements Some states, like California and Massachusetts, have additional filing requirements and laws related to health coverage reporting.
Punitive Measures Failure to file may result in penalties imposed by the IRS, potentially up to $250 per form.
Record Keeping Employers must keep copies of the 1094-C and 1095-C forms for at least three years.

Steps to Filling Out IRS 1094-C

Completing the IRS 1094-C form can seem a bit daunting, but breaking it down into manageable steps can make the process smoother. Once you gather the necessary information and follow the steps outlined below, you'll be well on your way to submitting this form accurately.

  1. Begin by downloading the IRS 1094-C form from the IRS website to ensure you have the most up-to-date version.
  2. Gather all necessary information, including your organization’s name, Employer Identification Number (EIN), and contact details.
  3. Fill in the top section of the form with your company details, including the legal name and mailing address.
  4. In Part I, provide information about your Applicable Large Employer (ALE) status. Check the appropriate boxes that apply to your organization.
  5. Move to Part II of the form. Here, you will report information about your employees, including the number of full-time employees and the months they were covered by health insurance.
  6. Complete Part III by detailing the health coverage offered to employees, indicating the types of plans available and who was covered.
  7. If applicable, check any relevant boxes about multiemployer arrangements or other considerations that may affect your reporting requirements.
  8. Review the form for accuracy. Check all calculations and ensure all necessary information is complete.
  9. Sign and date the form at the bottom. This is necessary to certify the information you've provided is accurate.
  10. Submit the completed IRS 1094-C form along with any required 1095-C forms to the IRS by the specified deadline.

More About IRS 1094-C

What is the IRS 1094-C form?

The IRS 1094-C form serves as a transmittal form for the 1095-C forms that large employers must provide to the IRS. This is part of the Affordable Care Act (ACA) reporting requirements. Employers with 50 or more full-time employees, including full-time equivalent employees, utilize this form to demonstrate compliance with the employer mandates concerning health insurance coverage.

Who needs to file the 1094-C form?

Large employers, defined as those with 50 or more full-time employees, are required to file the 1094-C form. Additionally, employers that are part of a controlled group or affiliated service group must file a single 1094-C for the entire group. If you qualify as an applicable large employer (ALE), submitting this form is crucial to report the health insurance coverage you offer to your employees.

What information is needed to complete the 1094-C form?

To complete the 1094-C form, employers must provide detailed information about their organization, including the name, address, and Employer Identification Number (EIN). They must indicate the number of employees during the calendar year, the months that health coverage was available, and other relevant details regarding their health plans. This data ensures the IRS understands the coverage offered to employees and whether it meets ACA standards.

When is the deadline for filing the 1094-C form?

The deadline for filing the 1094-C form with the IRS is generally February 28 of the year following the calendar year being reported. However, if you file electronically, this deadline extends to March 31. It’s essential to adhere to these deadlines to avoid potential penalties for late or incomplete filings.

What happens if I fail to file the 1094-C form?

Failing to file the 1094-C form may lead to penalties from the IRS. Employers may incur a penalty for each form not filed by the deadline. Additionally, not submitting this form can affect your standing with the IRS regarding compliance with the ACA, which may have implications for your health plan offerings and tax status. It’s advisable to ensure timely and accurate filing to prevent these issues.

Common mistakes

  1. Incorrect Employer Identification Number (EIN): Many individuals fail to double-check their EIN, resulting in errors. This number is crucial for proper tax identification, and a mistake can lead to significant delays.

  2. Missing Parts III Details: Not providing enough detail in Part III regarding the covered individuals can cause complications. It's essential to ensure all required employee information is accurately reported.

  3. Confusing Offer of Coverage Codes: Selecting the wrong codes in Part II can lead to misunderstandings about health coverage offerings. Familiarize yourself with the various codes to ensure accurate reporting.

  4. Incorrect Reporting of Aggregated Groups: Businesses with multiple entities under common control might overlook accurate reporting of aggregated groups. This oversight can misrepresent the health care coverage provided.

  5. Failure to Provide Signature: Forgetting to sign the form is a common error. A signed form is critical for validation and compliance, so make checking this step a priority.

  6. Not Keeping Copies: Many forget to retain copies of submitted forms for their records. Keeping copies is important for future reference and in case of audits.

Documents used along the form

The IRS 1094-C form is a crucial document for applicable large employers as it helps report coverage under the Affordable Care Act (ACA). In addition to the 1094-C form, several other forms and documents often accompany it to ensure compliance with tax regulations related to health care coverage. Understanding these forms is essential for proper reporting and compliance.

  • IRS Form 1095-C: This form provides detailed information about the health coverage offered to employees. It serves as a proof of coverage for employees and must be furnished to them as well as filed with the IRS.
  • IRS Form 1095-B: Intended for small employers, this form is used to report minimum essential coverage. It provides similar details about health coverage as the 1095-C but applies to different scenarios.
  • Form W-2: Although primarily a wage and tax statement, the W-2 includes information about the health insurance coverage an employee has received. It often indicates whether health insurance was provided and what amount was withheld.
  • Employer Shared Responsibility Payment Worksheet: This worksheet helps employers determine if they owe a payment for failing to meet ACA requirements. It aids in calculating potential penalties based on employee coverage.
  • Summary of Benefits and Coverage (SBC): This document outlines the essential health benefits and coverage details. Employers provide the SBC to employees to help them understand their health plans.
  • Plan Documents: These include insurance plans and summary plan descriptions. They outline the specific details of health coverage offered by the employer and are important references for compliance with ACA mandates.
  • Health Coverage Reporting and Recordkeeping Guidelines: Provided by the IRS, these guidelines assist employers in understanding necessary reporting and recordkeeping requirements specific to the ACA.
  • State Health Insurance Exchange Notices: Some states require employers to provide information about health insurance options available through state exchanges. These notices ensure employees are informed about their coverage options.

Each of these forms and documents plays a specific role in the broader context of health care compliance and reporting. Familiarity with them not only safeguards against potential financial penalties but also supports a harmonious relationship between employers and employees regarding health coverage understanding.

Similar forms

The IRS 1095-A form is related to health coverage offered through the Health Insurance Marketplace. It provides information about the coverage, including who is covered and what the premium costs are. Like the 1094-C, it helps the IRS track compliance with the Affordable Care Act. Individuals use the 1095-A when filing their taxes to reconcile premium tax credits received during the year.

The IRS 1095-B form serves as proof of minimum essential coverage. Issued by health insurers or government programs, it details who is covered under the health plan. Similar to the 1094-C, it confirms compliance with health coverage requirements mandated by the Affordable Care Act, assisting taxpayers in demonstrating that they had coverage throughout the year.

The IRS 1095-C form is closely related to 1094-C, as both are used by applicable large employers (ALEs). The 1095-C provides information about the health insurance offered to employees. It informs the IRS and employees about the coverage's affordability and minimum value. Together with the 1094-C, these forms help ensure that employers meet their obligations under the Affordable Care Act.

The IRS W-2 form reports wages and tax withheld from employees’ paychecks. While it does not focus on health coverage specifically, it is similar in that it communicates vital employment and income information to both the IRS and the employee. The W-2 assists in determining eligibility for certain tax benefits that may relate to health insurance costs, just as the 1094-C aids in reporting insurance information.

The IRS 941 form is the Employer's Quarterly Federal Tax Return. It documents employment taxes withheld from employee paychecks. Similarly to the 1094-C, the 941 highlights employer responsibilities regarding employee compensation and tax obligations. Both forms are crucial in ensuring compliance with federal regulations, although they focus on different aspects of employment and associated benefits.

The Form 990 is a public document that tax-exempt organizations, including charities and non-profits, file with the IRS. It includes financial information about the organization’s operations, including employee benefits. While the significance of 990 does not lie directly in health insurance, the reporting requirements draw parallels in terms of transparency and accountability in providing benefits, as does the 1094-C for employers.

The Schedule C form is for sole proprietors to report income and expenses. Though it focuses on individual income, it also requires reporting of health insurance deductions. This connection to health coverage is similar to that of the 1094-C which outlines employer-offered coverage. Both forms allow taxpayers to account for health expenses related to their financial responsibilities.

The IRS 1040 form is the standard individual income tax return form. Taxpayers use it to report their annual income and claim deductions, such as those for health insurance premiums. While 1094-C focuses on employer-provided health coverage, both documents play essential roles in helping taxpayers report compliance with healthcare regulations and assess their tax situations.

Dos and Don'ts

When filling out the IRS 1094-C form, it's essential to be meticulous. This document is crucial for reporting information about your employer-sponsored health coverage. Here are six important things to consider while completing it:

  • Do: Double-check all employee information for accuracy. Incorrect names or Social Security numbers can lead to issues down the line.
  • Do: Maintain thorough records of your health coverage offerings. Documentation can streamline the process immensely and provide backup if needed.
  • Do: Ensure you select the right reporting method. Understanding whether you're using the “Pay or Play” or Transition Relief method is critical for compliance.
  • Do: Submit your form on time. Missing the deadline can result in penalties and complications.
  • Don't: Overlook the importance of the form's signature. Missing signatures can invalidate your submission.
  • Don't: Rush through the form. Take your time to ensure all fields are completed thoroughly to avoid costly mistakes.

Completing the IRS 1094-C form accurately is vital. By following these guidelines, you can help ensure compliance and avoid unnecessary complications.

Misconceptions

The IRS 1094-C form is important for large employers in relation to the Affordable Care Act (ACA). However, several misconceptions surround this form. Here are seven common misunderstandings:

  • Only large employers need to file - While the form is primarily for applicable large employers (those with 50 or more full-time employees), small employers may also need to be aware of it if they offer health insurance to their employees.
  • The 1094-C is the same as the 1095-C - The 1094-C is a transmittal form that summarizes information contained in the 1095-C, which provides details about the health coverage offered to employees.
  • Filing the 1094-C guarantees you won't face penalties - Submitting the form does not prevent penalties. Compliance with the ACA requirements is necessary to avoid potential fines.
  • Only full-time employees are reported - All employees, regardless of their work status (full-time or part-time), must be considered in the count for determining if the employer is an applicable large employer.
  • Filing deadlines are the same every year - Submission deadlines may change. Employers should check the IRS guidelines each year for the most current information on when to file.
  • You can file the 1094-C and 1095-C after the deadline without penalty - Late filing may result in penalties. It’s essential for employers to file on time to avoid these fees.
  • The information is only reviewed by the IRS - Other agencies and interested parties may also review the provided information. Accurate and timely reporting is crucial for compliance.

Understanding these misconceptions can help employers navigate their responsibilities related to the IRS 1094-C form more effectively.

Key takeaways

Here are ten key takeaways to keep in mind when filling out and using the IRS 1094-C form:

  1. The 1094-C form serves as a transmittal form for the 1095-C forms that report health coverage offered to employees.
  2. You must file the 1094-C if you are an Applicable Large Employer (ALE) with 50 or more full-time employees.
  3. Collect the necessary employee information, including names, Social Security numbers, and address details.
  4. Ensure that the information in the 1094-C aligns with the details on the related 1095-C forms.
  5. Check for any filing deadlines. Typically, if filing by paper, the deadline is February 28, and for electronic filing, it is March 31.
  6. A signature is not required on the 1094-C. However, the form must be completed accurately.
  7. Keep copies of your submitted forms. You may need these for audits or if any issues arise.
  8. Use the IRS instructions for the 1094-C form for guidance on filling it out correctly.
  9. If you are filing electronically, use IRS-approved software or services to ensure compliance.
  10. Understand that penalties may apply for late submissions or inaccuracies, so review the form carefully before submission.

Staying informed and cautious can help you navigate the process more effectively.