GBS Health & Benefits Compliance
Does My Company Need to File ACA 1094/1095 Forms This Year?
Under the Affordable Care Act (ACA), certain employers must file and furnish the ACA 1094/1095 forms. The term “filing” refers to submitting the forms to the IRS and “furnishing” refers to providing individualized 1095 forms to employees. The deadline to furnish the 1095 forms to employees is February 28 and the deadline to file 1094/1095 forms with the IRS is generally March 31, although the specific dates vary each year depending on the day of the week upon which the deadline lands.
The reporting requirements are different for large employers compared to small employers. All large employers must file and furnish using the 1094/1095-C forms. Only certain small employers must file and furnish. If a small employer sponsors an insured plan, there is no obligation*. If a small employer sponsors a level-funded plan, it must file but sometimes the TPA will file and furnish on behalf of the employer, so the employer should confirm that in advance. If the small employer sponsors a self-funded plan, filing is required using the 1094/1095-B forms.
To confirm reporting obligations, small employers must be careful to ensure size calculation is accurate. A small employer employs less than 50 full-time employees plus full-time equivalents, calculated using data based on the full PRIOR calendar year. Make sure to use our GBS ACA Step 1 toolkit to navigate size calculation correctly. Remember this calculation means an employer does not immediately become large in the first month it exceeds the 50 threshold. For example,
- Calculate monthly average size using data from 1/1/2023 to 12/31/2023 to determine whether the company is large for 2024. If average is 50+, then 2024 1094/1095-C forms must be filed and furnished by February/March 2025 deadlines.
- Calculate monthly average size using data from 1/1/2024 to 12/31/2024 to determine whether the company is large for 2025. If average is 50+, then 2025 1094/1095-C forms must be filed and furnished by February/March 2026 deadlines.
2023
If employer employs on average at least 50 FT + FTEE employees between January 1 2023 through December 31, 2023, then . . .
2024
The employer is considered an applicable large employer (ALE) for 2024.
2025
Because considered large for 2024, must file and furnish the 2024 1094/1095-C forms in March/April of 2025.
Use this four-year chart (Page 2) to better understand the connection between employer size determination and when to file and furnish. For additional resources, contact your GBS team.
Footnote: There is one exception to the rule that a small employer sponsoring an insured group health plan need NOT report. It must in fact report if an employee is covered by an HRA sponsored by one employer and a group health plan sponsored by another employer (such as spousal coverage). This means each employer (or the health insurance carrier if the plan is insured) must report but only for those particular employees, not for all enrolled employees.
November 2024
This document is not intended to be exhaustive, nor should any information be construed as tax or legal advice. Readers should contact a tax professional or attorney if legal advice is needed. Although we have made every effort to provide complete, up-to-date, and accurate information in this document, such information is meant to be used for reference only. If there is any inconsistency between the information contained in this document and any applicable law, then such law will control.
