What’s a 1095 Form, And What’s It Good For?

March 13, 2019|

By now, most large employers are aware (or should be aware) or their annual reporting obligations concerning the type of health care benefits they have (or have not) offered their full-time employees during the prior year. While the deadline for furnishing these forms to employees has been extended until March 4 this year, some of these forms have already been sent, creating a storm of questions from employees.

Whether you are on the sending or receiving end of these forms, here are some quick answers to questions you might be asking:

Why am I getting this form? The Affordable Care Act (ACA) created responsibilities for employers as well as individuals. These forms are designed to help establish whether those responsibilities are being met — for individuals, they report which months they and their dependents maintained qualifying health coverage; for employers, they report which months qualifying coverage was offered to full-time employees, and if not, why.

I thought these forms were no longer needed. In December 2017, President Donald Trump signed a tax reform bill into law, which eliminated the individual mandate penalty beginning in 2019. Now that this mandate is no longer in effect, individuals will not be penalized for failing to obtain health insurance.

However, the employer mandate for large employers to offer qualifying coverage to their full-time employees remains, along with the requirement to report on that coverage.

Since 2019 is the first year the individual mandate penalty has been eliminated, it remains to be seen whether all of the forms will be required going forward. However, all reporting requirements remain in place for this reporting season.

Do I need this form to file my individual taxes? No. The IRS has repeatedly said that the forms are not needed for filing individual taxes. Once received, they can be kept with other supporting tax documents as proof of coverage, or offer of coverage, for the year.

I received two of these forms – one from my insurance company and one from my employer. Is this a mistake? The 1095 series forms can come from several sources with varying reporting responsibilities, so it is very possible for an individual to receive more than one form. Large employers, health coverage providers and the Federal Exchange all have reporting requirements which may result in multiple forms being issued to the same person. Changing jobs and/or insurance coverage can trigger multiple forms as well.

Remember that the forms are designed to report proof of health care coverage (from a health coverage provider or the health insurance marketplace) and/or offers of health care coverage (from an employer), so the forms may not be reporting the same information.

I did not receive a form, but I had health care coverage. Is this a mistake? Depending on the size of your employer and the type of health care it offers, the company might not be required to send you a form. (For example, employers with fewer than 50 full-time-equivalent employees are exempt from reporting if they are fully insured.) Also, since the forms are not due until March 4, they may be received at a later time.

My spouse and children were covered on my employer’s plan. Will they receive a form, too? Generally, only one form will be issued to each employee. Copies might need to be made for adult dependents who are filing their taxes separately from you.

My employer or health coverage provider has suggested that I opt to receive these forms electronically rather than on paper. Are they allowed to ask me that?  Yes. Employers and health coverage providers may ask for your consent to receive the forms electronically. This is entirely acceptable and might be more convenient for you.

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