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Proposed Regulations Issued To Simplify Information Reporting Process

The Patient Protection and Affordable Care Act (PPACA) provides for information reporting by insurers, self-insuring employers and other parties that provide health coverage.  It also provides for information reporting by employers that are large enough to be subject to the employer shared responsibility provisions regarding health coverage they offer their full-time employees.

On September 5, 2013 the Departments of Treasury and the Internal Revenue Service (IRS) issued proposed regulations on the information reporting requirements related to the individual mandate and the employer mandate provisions of the PPACA.  They describe a variety of options to potentially reduce or streamline information reporting.  There is a 60 day comment period to allow employers and insurers to provide feedback to the IRS on these proposals with the goal of further simplifying the reporting requirements.

Some of the proposed simplifications include:

  • Allowing employers to report employer-sponsored coverage to employees on the Form W-2 issued at the end of each year rather than on separate Section 6056 employee statements
  • Eliminating the need to determine whether particular employees are full-time if adequate coverage is offered to all potentially full-time employees
  • Not requiring insurers and employers to report the specific dates of coverage, but instead to report only the month of coverage
  • Allowing employers to report the specific cost of employer-sponsored coverage to an employee only if the cost is above a specified dollar amount
  • Allowing self-insured employers to provide a single statement to employees that meets both the individual mandate and employer mandate reporting requirements
  • Not requiring health insurers to provide reporting for individual coverage offered through the Marketplace because that information will be provided by the Marketplace

The statute calls for employers, insurers and other reporting entities to report, among other things:

For Section 6055:

  • Information about the entity providing coverage, including contact information
  • A list of individuals with identifying information and the months they were covered

For Section 6056:

  • Information about the applicable large employer offering coverage (including contact information for the employer and the number of full-time employees)
  • A list of full-time employees and information about the coverage offered to each, by month, including the cost of self-only coverage

The Treasury and IRS are inviting stakeholders to submit comments on the proposed rules through early November.  They said public comments will be taken into account in developing final reporting rules.  Once the final rules have been published, reporting will be optional in 2014 for reporting entities in preparation for the full application of the reporting provisions in 2015.

The proposed regulations for employers under Section 6056 can be viewed here.

The proposed regulations for insurance providers under Section 6055 can be viewed here.

We'll continue to keep you informed as more information is released and the final rules have been published, so check back often.