Form 1095-C Penalties: What Employers Need to Know

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Form 1095-C is an important Affordable Care Act (ACA) reporting document used by certain employers to report information about health coverage offered to their employees. Employers that meet the definition of an Applicable Large Employer (ALE) generally have reporting responsibilities under the ACA. Understanding Form 1095-C requirements can help businesses maintain accurate records, meet filing deadlines, and reduce the risk of reporting errors.

What Is Form 1095-C?

Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, is used to report information about health coverage offered by an employer to eligible employees. The form provides details about whether an employer offered coverage, the type of offer made, and information about the employee's coverage when applicable.

Employees may use the information on Form 1095-C when reviewing their health insurance coverage and completing their federal tax-related records. Employers also use the information to satisfy ACA reporting requirements.

Who Needs to File Form 1095-C?

Form 1095-C reporting generally applies to Applicable Large Employers. An ALE is generally an employer that had an average of at least 50 full-time employees, including full-time equivalent employees, during the preceding calendar year.

The ACA rules can be complex because employee status, hours of service, and controlled-group relationships may affect whether an organization qualifies as an ALE. Employers should review their workforce information carefully when determining their reporting obligations.

ALEs generally must complete Form 1095-C for each full-time employee for whom reporting is required. Depending on the employer's circumstances, reporting may also involve information about self-insured health coverage.

Information Reported on Form 1095-C

Form 1095-C contains several sections that employers need to complete accurately.

Part I – Employee and Employer Information:
This section generally includes identifying information for the employee and employer, such as names, addresses, and taxpayer identification information.

Part II – Employer Offer and Coverage:
This section provides information about the health coverage offered to the employee. It includes codes that identify the type of offer and other applicable information. Employers need to select the appropriate codes based on the coverage offered and the employee's circumstances.

Part III – Covered Individuals:
For employers with self-insured plans, this section may include information about individuals covered by the plan. Depending on the arrangement, this can include the employee and covered dependents.

Because the codes and reporting requirements can vary according to the employer's circumstances, businesses should maintain detailed records to support the information reported.

Form 1095-C Filing Deadlines

Employers must meet both employee furnishing requirements and IRS filing requirements. The applicable deadlines can vary depending on whether forms are provided electronically or on paper and whether an extension applies.

For the most current filing year, employers should verify the applicable deadlines directly with the IRS before preparing their annual reporting. Businesses should also monitor IRS updates because reporting procedures and deadlines can change.

Employers filing many information returns may be required to file electronically. The IRS has expanded electronic filing requirements for information returns, making it important for businesses to determine whether they meet the applicable electronic filing threshold.

Electronic Filing Requirements

Electronic filing is an important consideration for employers preparing Form 1095-C. The IRS requires certain employers and other filers to submit information returns electronically when they meet the applicable filing threshold.

Employers should review the current IRS electronic filing requirements before submitting their forms. Businesses that are required to file electronically may need to register with the IRS filing system and ensure that their payroll or tax software supports the required filing process.

Planning ahead can help employers avoid last-minute technical or administrative issues.

Common Form 1095-C Mistakes

Errors on Form 1095-C can result from incomplete employee records, incorrect codes, or inaccurate coverage information. Some common mistakes include:

  • Reporting incorrect employee identification information
  • Using the wrong offer and coverage code
  • Failing to report an eligible full-time employee
  • Entering incorrect coverage information
  • Missing the applicable filing deadline
  • Failing to meet electronic filing requirements
  • Not keeping adequate records to support reported information
  • Submitting duplicate or inconsistent information

Employers should review forms carefully before furnishing them to employees and submitting them to the IRS.

How Employers Can Prepare for 1095-C Reporting

A structured process can make annual ACA reporting easier. Employers can begin by reviewing employee and payroll records well before the filing deadline.

Businesses should identify employees who may require Form 1095-C reporting and verify their full-time status based on applicable ACA rules. They should then collect accurate information about health coverage offers, employee contributions, coverage periods, and applicable codes.

Employers should also reconcile information from payroll, benefits administration, and human resources systems. Differences between these systems can lead to reporting errors.

Before filing, businesses should conduct a final review of employee names, identification numbers, addresses, coverage information, and applicable codes. Keeping supporting documentation is also important in case the employer needs to respond to an IRS inquiry.

What If Form 1095-C Contains an Error?

If an employer discovers an error after filing or furnishing Form 1095-C, it may need to submit a corrected form or take another corrective action depending on the type of error.

Employers should identify the specific issue, determine the appropriate correction procedure, and follow current IRS instructions. Corrections should generally be handled promptly rather than waiting until the next reporting cycle.

Maintaining organized records makes it easier to identify the source of an error and prepare an accurate correction.

Recordkeeping for Form 1095-C

Good recordkeeping is an important part of ACA compliance. Employers should retain documentation supporting the information reported on Form 1095-C, including employee status records, hours worked, coverage offers, enrollment information, and applicable contribution details.

Payroll and benefits records should be organized so that information can be retrieved when needed. Consistent recordkeeping can also help businesses prepare future forms more efficiently.

Why Accurate 1095-C Reporting Matters

Accurate Form 1095-C reporting helps employers meet their ACA information-reporting responsibilities and provides employees with important information about employer-provided health coverage.

For businesses, the reporting process involves more than simply completing a form. Employers need to determine which employees require reporting, collect accurate coverage information, apply the correct reporting codes, meet filing requirements, and retain appropriate documentation.

Conclusion

Form 1095-C is an important part of ACA employer reporting. Applicable Large Employers should understand their reporting responsibilities, identify employees who require forms, maintain accurate health coverage records, and follow current IRS filing procedures.

Starting the preparation process early can give employers time to identify discrepancies, correct employee information, review reporting codes, and address electronic filing requirements. Because ACA reporting rules can change, employers should always consult the latest IRS instructions and requirements when preparing Form 1095-C.

For businesses managing large workforces or complex benefits arrangements, professional tax and accounting support can also help organize reporting information and reduce administrative challenges.

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