Indikator bantuan transisi 4980h

Indikator bantuan transisi 4980h

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Untuk informasi terbaru tentang perkembangan yang berkaitan dengan Formulir 1094-C, Penawaran Bantuan Kesehatan Pemberian Bantuan Tenaga Kerja dan Pengembalian Informasi Cakupan, dan Formulir Penawaran dan Cakupan Asuransi Kesehatan 1095-C, yang diberikan oleh Pemberi Kerja, dan peraturan, seperti peraturan perundang-undangan yang diberlakukan setelah Diterbitkan, pergi ke irs.govform1094c dan irs.govform1095c. Apa revisi Formulir Baru? Pada Form 1094-C, baris 22, kotak B ditunjuk 8220 Reserved. 8221 Metode Penawaran Kualifikasi Transisi Kualifikasi tidak berlaku untuk tahun 2016. Pada Bagian III, kolom (b), 8220 Bagian 4980H 8221 disisipkan sebelum 8.220 Perhitungan Karyawan Penuh Waktu untuk Anggota ALE 8221 untuk mengingatkan para penyokong bahwa definisi 4980H bagian dari 8220 penuh Karyawan waktu 8221 berlaku untuk tujuan kolom ini, tidak ada definisi lain yang mungkin digunakan oleh Anggota ALE untuk tujuan lain. Pada Formulir 1095-C, bahasa 8220 Jangan melampirkan pengembalian pajak Anda. Simpan catatanmu 8221 dimasukkan dengan judul formulir untuk menginformasikan kepada penerima bahwa Formulir 1095-C tidak boleh diserahkan bersamaan dengan pengembalian. Pada baris ke 15 judul tersebut direvisi untuk dibaca 8220 Employee Required Contribution (lihat petunjuknya). 8221 Perubahan klarifikasi kecil lainnya dilakukan pada kedua bentuk. Perubahan kode. Kode 1I untuk Formulir 1095-C, baris 14, dan kode 2I untuk Formulir 1095-C, baris 16, tidak berlaku lagi dan telah dipesan. Kode baru 1J dan 1K telah ditambahkan untuk Formulir 1095-C, baris 14. Untuk informasi lebih lanjut, lihat instruksi untuk Formulir 1095-C, baris 14 dan baris 16. Bantuan transisi. Beberapa bentuk bantuan transisi tersedia bagi pengusaha untuk tahun 2015 di bawah bagian 4980H dan 6056, namun hanya peralihan transisi yang terbatas yang terus berlaku di tahun 2016. Referensi untuk bantuan transisi yang hanya diterapkan pada tahun kalender 2015 telah dihapus. Uraian tentang sisa bentuk bantuan transisi telah diubah untuk memperjelas selama bulan-bulan di tahun 2016, peralihan transisi berlaku. Untuk penjelasan tentang kelegaan dan kapan penerapannya, lihat Bagian 4980H Transition Relief for 2015 Plan Years. Informasi Tambahan Untuk informasi yang berkaitan dengan Undang-Undang Perawatan Terjangkau, kunjungi irs.govuacAffordable-Care-Act-Tax-Provisions-Home. Untuk peraturan akhir di bawah bagian 6056, Pelaporan Informasi oleh Pengusaha Besar yang Berlaku mengenai Cakupan Asuransi Kesehatan yang Ditawarkan berdasarkan Rencana Pemberian Pemberian Kerja, lihat T.D. 9661, 2014-13 I.R.B. 855, di irs.govirb2014-13IRBar09.html. Untuk peraturan akhir di bawah bagian 6055, Pelaporan Informasi Mengenai Cakupan Esensial Minimum, lihat T.D. 9660, 2014-13 I.R.B.842, di irs.govirb2014821113IRBar08.html. Untuk peraturan akhir di bawah bagian 4980H, Tanggung Jawab Bersama untuk Pengusaha Mengenai Cakupan Kesehatan, lihat T.D. 9655, 2014-9 I.R.B. 541, di irs.govirb2014-9IRBar05.html. Untuk jawaban atas pertanyaan yang sering diajukan mengenai atasan berbagi ketentuan tanggung jawab dan persyaratan pelaporan informasi terkait, kunjungi IRS.gov. Untuk informasi yang berkaitan dengan pengarsipan Formulir 1094-C dan 1095-C secara elektronik kunjungi irs.govfor-Tax-ProsSoftware-DevelopersInformation-ReturnsAffordable-Care-Act-Information-Return-AIR-Program. Untuk panduan tambahan dan perubahan peraturan yang diusulkan yang berkaitan dengan bagian 6055, termasuk klarifikasi mengenai persyaratan pelaporan untuk penyedia cakupan minimum yang minimum dan persyaratan untuk meminta NPWP setiap individu yang tercakup untuk tujuan pelaporan informasi cakupan kesehatan, lihat Bagian Peraturan yang Diusulkan 1.6055 -1 (h) dan bagian Regulasi 301.6724-1. Petunjuk Umum untuk Cacing 1094-C dan 1095-C Lihat Definisi. Kemudian, untuk istilah kunci yang digunakan dalam petunjuk ini. Tujuan Bentuk Pengusaha dengan 50 atau lebih karyawan tetap (termasuk pegawai setara penuh) pada tahun sebelumnya menggunakan Formulir 1094-C dan 1095-C untuk melaporkan informasi yang dibutuhkan berdasarkan bagian 6055 dan 6056 tentang penawaran cakupan kesehatan dan pendaftaran Dalam cakupan kesehatan untuk karyawan mereka. Formulir 1094-C harus digunakan untuk melapor ke informasi ringkasan IRS untuk setiap Anggota ALE dan mengirimkan Formulir 1095-C ke IRS. Formulir 1095-C digunakan untuk melaporkan informasi tentang masing-masing karyawan kepada IRS dan kepada karyawan tersebut. Formulir 1094-C dan 1095-C digunakan untuk menentukan apakah seorang Anggota ALE berhutang atas pembayaran di bawah ketentuan tanggung jawab bersama di bawah bagian 4980H. Formulir 1095-C juga digunakan dalam menentukan kelayakan karyawan untuk kredit pajak premium. Anggota ALE yang menawarkan cakupan pertanggungan sendiri yang disponsori perusahaan juga menggunakan Formulir 1095-C untuk melaporkan informasi kepada IRS dan kepada karyawan tentang individu yang memiliki cakupan penting minimal berdasarkan rencana perusahaan dan oleh karena itu tidak bertanggung jawab atas pembayaran tanggung jawab bersama individu untuk Bulan mereka ditutupi rencana. Siapa yang Harus Memberi Anggota ALE harus mengajukan satu atau lebih Formulir 1094-C (termasuk Formulir 1094-C yang ditunjuk sebagai Pengiriman Resmi, mengarsipkan beberapa Formulir 1094-C), dan harus mengajukan Formulir 1095-C untuk setiap karyawan Yang merupakan karyawan penuh waktu Anggota ALE untuk setiap bulan dari tahun kalender. Umumnya, Anggota ALE diminta untuk memberikan salinan Formulir 1095-C (atau formulir pengganti) kepada karyawan tersebut. Anggota ALE adalah, secara umum, satu orang atau entitas yang merupakan Pemberi Kerja Besar yang Berlaku, atau jika berlaku, setiap orang atau entitas yang merupakan anggota Grup ALE Agregat. Majikan Majikan yang Majikan, umumnya adalah majikan dengan 50 atau lebih karyawan tetap (termasuk karyawan setara penuh) pada tahun sebelumnya. Untuk tujuan menentukan apakah pemberi kerja atau kelompok pengusaha adalah Pemberi Kerja Berwaris yang Berlaku, semua Anggota ALE yang sepengendali (Grup ALE Agregat) digabungkan bersama. Jika Kelompok ALE Agregat, dengan mempertimbangkan karyawan semua Anggota ALE dalam kelompok tersebut, mempekerjakan rata-rata 50 atau lebih karyawan tetap (termasuk pegawai tetap penuh) pada hari kerja selama tahun kalender sebelumnya, maka ALE Gabungan Kelompok adalah Pemberi Kerja yang Berlaku dan masing-masing pemberi kerja terpisah dalam kelompok tersebut adalah Anggota ALE. Setiap Anggota ALE diminta untuk mengajukan Formulir penawaran pelaporan 1094-C dan 1095-C kepada karyawan penuh waktu (walaupun Anggota ALE memiliki kurang dari 50 karyawan tetap). Untuk informasi lebih lanjut tentang majikan mana yang tunduk pada atasan berbagi ketentuan tanggung jawab bagian 4980H, lihat Majikan di bagian Definisi dari petunjuk ini. Untuk informasi lebih lanjut tentang menentukan karyawan purna waktu, lihat Bagian Karyawan Purna Waktu di bagian Definisi dari petunjuk ini, yang mencakup informasi mengenai perlakuan terhadap karyawan baru dan karyawan dalam Periode Non-Asesmen Terbatas. Untuk tujuan pelaporan tentang Formulir 1094-C dan 1095-C, seorang karyawan dalam Periode Non-Penilaian Terbatas tidak dianggap sebagai karyawan tetap selama periode tersebut. Pelaporan oleh Penyedia Tenaga Sendiri yang Mempercepat Rencana Kesehatan Self-Insured Majikan yang menawarkan cakupan kesehatan melalui rencana kesehatan yang diasuransikan sendiri harus melaporkan informasi tentang setiap individu yang terdaftar dalam cakupan tersebut. Bagi majikan yang merupakan Anggota ALE, informasi ini harus dilaporkan pada Formulir 1095-C, Bagian III, untuk setiap karyawan yang terdaftar dalam cakupan (dan pasangan atau tergantung dari karyawan tersebut). Lihat di bawah untuk memberi opsi pada Formulir 1094-B dan Formulir 1095-B, daripada Formulir 1094-C dan Formulir 1095-C, untuk melaporkan cakupan non-karyawan tertentu. Anggota ALE yang menawarkan cakupan kesehatan melalui rencana kesehatan mandiri yang disponsori perusahaan harus melengkapi Formulir 1095-C, Bagian I, II, dan III, untuk setiap karyawan yang mendaftar dalam cakupan kesehatan, apakah karyawan tersebut adalah karyawan penuh atau tidak, Waktu karyawan untuk setiap bulan dari tahun kalender. Untuk karyawan penuh waktu yang terdaftar dalam cakupan pertanggungan ALE Member8217s, termasuk seorang karyawan yang merupakan karyawan penuh waktu paling sedikit satu bulan dalam satu tahun kalender, Anggota ALE harus melengkapi Formulir 1095-C, Bagian II, sesuai dengan Petunjuk yang berlaku umum, dan jangan memasukkan kode 1G pada baris 14 untuk bulan apa saja. Untuk karyawan yang terdaftar dalam cakupan pertanggungan ALE Member8217s yang bukan merupakan pegawai tetap untuk setiap bulan dari tahun kalender (artinya selama 12 bulan kalender karyawan tersebut bukan pegawai tetap), untuk Formulir 1095- C, Bagian II, Anggota ALE harus memasukkan kode 1G pada baris 14 di kolom 8220 Semua 12 Bulan 8221 atau dalam kotak bulanan terpisah untuk semua 12 bulan kalender, dan Anggota ALE tidak perlu melengkapi Bagian II, baris 15 dan 16. Majikan yang menawarkan cakupan kesehatan pertanggungjawaban yang disponsori oleh majikan namun bukan Anggota ALE yang seharusnya tidak mengajukan Formulir 1094-C dan 1095-C, namun sebaiknya mengajukan Formulir 1094-B dan 1095-B untuk melaporkan informasi bagi karyawan yang terdaftar di Cakupan kesehatan yang diasuransikan oleh perusahaan yang disponsori majikan. Jika Anggota ALE menawarkan pertanggungan kesehatan kepada karyawan selain di bawah rencana pertanggungjawaban sendiri, seperti melalui rencana kesehatan yang diasuransikan atau rencana kesehatan multiemployer, penerbit asuransi atau sponsor rencana yang memberikan pertanggungan tersebut diperlukan untuk memberikan Informasi tentang cakupan kesehatan mereka kepada setiap karyawan yang terdaftar, dan Anggota ALE tidak boleh melengkapi Formulir 1095-C, Bagian III, untuk karyawan tersebut. Pelaporan Informasi Pendaftaran untuk Bukan Pegawai: Opsi Untuk Menggunakan Formulir 1094-B dan 1095-B ALE Anggota yang menawarkan cakupan kesehatan yang dipertanggungkan kepada perusahaan yang disponsori oleh perusahaan kepada non-karyawan yang mendaftar dalam liputan dapat menggunakan Formulir 1094-B dan 1095-B, Daripada Formulir 1095-C, Bagian III, untuk melaporkan cakupan bagi individu-individu dan anggota keluarga lainnya. Untuk tujuan ini, seorang non-karyawan mencakup, misalnya, seorang direktur non-karyawan, seorang individu yang merupakan pegawai pensiunan selama satu tahun penuh, atau penerima manfaat COBRA non-karyawan, termasuk mantan karyawan yang menghentikan pekerjaan selama tahun sebelumnya . Untuk informasi tentang pelaporan untuk non-karyawan yang terdaftar dalam rencana kesehatan mandiri yang disponsori perusahaan dengan menggunakan Formulir 1094-B dan 1095-B, lihat petunjuk untuk formulir tersebut. Bagi Anggota ALE yang memilih untuk menggunakan Formulir 1095-C untuk melaporkan informasi cakupan untuk non-karyawan yang terdaftar dalam rencana kesehatan mandiri yang disponsori perusahaan, lihat petunjuk khusus untuk Formulir 1095-C, Bagian III8212Covered Individuals (Lines 17821122), kemudian . Formulir 1095-C hanya bisa digunakan jika individu yang diidentifikasi pada jalur 1 memiliki SSN. Pernyataan Pengganti kepada Penerima Jika Anda tidak menggunakan formulir IRS resmi untuk memberikan pernyataan kepada penerima, lihat Pub. 5223, Aturan Umum dan Spesifikasi untuk Formulir Undang-Undang Pengganti Perawatan Terjangkau 1095-A, 1094-B, 1095-B, 1094-C, dan 1095-C, yang menjelaskan persyaratan untuk format dan isi pernyataan pengganti kepada penerima. Anda bisa mengembangkannya sendiri atau membelinya dari printer pribadi. Pernyataan pengganti yang diberikan kepada penerima mungkin dalam format potret, namun pengembalian pengganti yang diajukan ke IRS dengan menggunakan kertas harus dicetak dalam format lansekap. Transmisi Resmi untuk ALEMembers Mengajukan Formulir Berganda 1094-C Formulir 1094-C harus diajukan saat Anggota ALE mengajukan satu atau lebih Formulir 1095-C. Anggota ALE dapat memilih untuk mengajukan beberapa Formulir 1094-C, masing-masing disertai dengan Formulir 1095-C untuk sebagian karyawannya, dengan ketentuan bahwa Formulir 1095-C diajukan untuk setiap karyawan yang diminta Anggota ALE untuk mengajukannya. Jika Anggota ALE mengarsipkan lebih dari satu Formulir 1094-C, satu (dan satu) Formulir 1094-C yang diajukan oleh Anggota ALE harus diidentifikasi pada baris 19, Bagian I sebagai Pengiriman Resmi, dan, pada Transmmit Resmi, Anggota ALE harus melaporkan data agregat tertentu untuk semua karyawan tetap dan semua karyawan, sebagaimana berlaku, dari Anggota ALE. Majikan A, Anggota ALE, mengajukan Formulir 1094-C tunggal, melampirkan Formulir 1095-C untuk masing-masing 100 karyawan tetapnya. Formulir 1094-C ini harus diidentifikasi sebagai Authoritative Transmittal on line 19, dan sisa formulir dilengkapi seperti yang ditunjukkan dalam petunjuk untuk baris 19, kemudian. Majikan B, Anggota ALE, mengajukan dua Formulir 1094-C, satu untuk masing-masing dari dua divisi operasi, Divisi X dan Divisi Y. (Divisi X dan Divisi Y adalah unit Anggota ALE yang sama, dan karenanya keduanya melaporkan hal yang sama EIN mereka bukan anggota Grup ALE Agregat.) Terlampir pada satu Formulir 1094-C adalah Formulir 1095-C untuk 200 pegawai tetap Divisi X, dan dilampirkan pada Formulir 1094-C lainnya adalah Formulir 1095-C untuk 1.000 karyawan penuh waktu dari Divisi Y. Salah satu dari Formulir 1094-C ini harus diidentifikasi sebagai Pengiriman Resmi pada jalur 19, dan harus mencakup data tingkat agregat untuk 1.200 karyawan tetap dari Majikan B dan juga Jumlah karyawan Majikan B, jika berlaku, sebagaimana dipersyaratkan dalam Bagian II, III, dan IV dari Formulir 1094-C. Formulir 1094-C yang lain tidak boleh diidentifikasi sebagai Transmisi Resmi pada baris 19, hanya melaporkan nomor 18 hanya sejumlah Formulir 1095-C yang dilekatkan pada Formulir 1094-C tersebut, dan harus meninggalkan bagian yang tersisa dari formulir Kosong seperti yang ditunjukkan dalam petunjuk untuk baris 19, nanti. Setiap Anggota ALE harus mengajukan Formulir 1094-C dan 1095-C sendiri di bawah EIN tersendiri, bahkan jika Anggota ALE adalah bagian dari Grup ALE Agregat. Tidak ada Kiriman Resmi yang harus diajukan ke Grup ALE Agregat. Asumsikan bahwa Majikan A dari Contoh 1 adalah anggota Kelompok ALE Agregat yang sama dengan Majikan B dari Contoh 2. Dengan demikian, Majikan A dan Majikan B adalah anggota ALE yang terpisah yang berada di bawah EIN yang terpisah. Formulir 1094-C harus diajukan dengan cara yang sama seperti yang ditunjukkan pada Contoh 1 dan 2. Majikan A harus hanya memasukkan informasi tentang karyawan Pemberi Kerja A dalam Pengiriman Resmi, dan Majikan B harus hanya memasukkan informasi tentang karyawan Pemberi Kerja B dalam Pengiriman Resmi . Tidak ada pengiriman resmi yang diajukan untuk Grup Gabungan ALE yang melaporkan data gabungan untuk karyawan Pemberi Kerja A dan Majikan B. Aturan serupa berlaku untuk Unit Pemerintah yang telah mendelegasikan tanggung jawab pelaporannya kepada beberapa karyawannya kepada Unit Pemerintah lainnya8212 Melihat Badan Pemerintah yang Ditunjuk ( DGE) di bagian Definisi petunjuk ini untuk informasi lebih lanjut. Dalam kasus Unit Pemerintah yang telah mendelegasikan tanggung jawab pelaporan untuk beberapa karyawannya, Unit Pemerintah harus memastikan bahwa di antara banyak Formulir 1094-C yang diajukan oleh atau atas nama Unit Pemancar Pemerintah yang Mengirimkan Formulir 1095-C untuk Unit Pemerintah8217s Karyawan, salah satu formulir yang diajukan 1094-C ditunjuk sebagai Authoritative Transmittal dan melaporkan data tingkat perusahaan agregat untuk Unit Pemerintah, sebagaimana dipersyaratkan dalam Bagian II, III, dan IV dari Formulir 1094-C. County adalah Kelompok ALE Agregat yang terdiri dari ALE Members School District, Police District, dan County General Office. Distrik Sekolah menunjuk negara untuk melapor atas nama guru dan laporan untuk dirinya sendiri bagi sisa pegawai tetapnya. Dalam hal ini, baik Distrik Sekolah atau negara harus mengajukan data tingkat pengapalan untuk pelaporan resmi oleh Pejabat Resmi untuk Distrik Sekolah. Satu Formulir 1095-C untuk Masing-masing Karyawan Anggota ALE Untuk setiap pegawai penuh waktu dari Anggota ALE, hanya boleh ada satu Formulir 1095-C yang mengajukan pekerjaan kepada Anggota ALE tersebut. Misalnya, jika Anggota ALE secara terpisah melaporkan masing-masing dua divisinya, Anggota ALE harus menggabungkan informasi penawaran dan liputan untuk setiap karyawan yang bekerja di kedua divisi selama tahun kalender sehingga Formulir 1095-C tunggal diajukan untuk Tahun kalender untuk karyawan yang melaporkan informasi untuk semua 12 bulan tahun kalender dari Anggota ALE tersebut. Sebaliknya, seorang karyawan penuh waktu yang bekerja untuk lebih dari satu anggota ALE yang merupakan anggota Kelompok ALE Agregat yang sama harus menerima Formulir 1095-C terpisah dari masing-masing Anggota ALE. Untuk setiap bulan kalender di mana karyawan penuh waktu bekerja untuk lebih dari satu anggota ALE dari Grup ALE Agregat, hanya satu anggota ALE yang diperlakukan sebagai pemberi kerja dari karyawan tersebut untuk tujuan pelaporan (umumnya, Anggota ALE untuk siapa karyawan tersebut bekerja Jumlah jam layanan paling banyak), dan hanya Anggota ALE yang melaporkan untuk karyawan tersebut pada bulan kalender itu. Anggota ALE lainnya tidak diharuskan melapor untuk karyawan tersebut pada bulan kalender tersebut, kecuali Anggota ALE lainnya diminta untuk mengajukan Formulir 1095-C untuk karyawan tersebut karena individu tersebut adalah pegawai tetap Anggota ALE untuk hal yang berbeda. Bulan dari tahun kalender yang sama Dalam kasus ini, individu dapat diperlakukan tidak dipekerjakan oleh Anggota ALE untuk bulan kalender itu. Jika berdasarkan peraturan ini, Anggota ALE tidak diharuskan melapor untuk karyawan pada bulan manapun dalam tahun kalender, Anggota ALE tidak diharuskan melapor untuk karyawan tetap tersebut pada tahun kalender tersebut. Untuk deskripsi peraturan yang terkait dengan penentuan Anggota ALE dalam Grup ALE Agregat diperlakukan sebagai pemberi kerja selama sebulan dalam situasi ini, lihat definisi Karyawan. Majikan A dan Majikan B adalah anggota ALE terpisah yang termasuk dalam Grup ALE Agregat yang sama. Baik cakupan penawaran Pemberi Kerja A dan Employer B melalui rencana kesehatan AB, yang merupakan rencana yang diasuransikan. Pada bulan Januari dan Februari, Karyawan memiliki 130 jam pelayanan untuk Majikan A dan tidak ada jam kerja untuk Majikan B. Pada bulan Maret, Karyawan memiliki 100 jam pelayanan untuk Majikan A dan 30 jam pelayanan untuk Majikan B. Pada bulan April sampai Desember, Karyawan Memiliki 130 jam pelayanan untuk Pemberi Kerja B dan tidak ada jam kerja untuk Majikan A. Majikan A adalah majikan Karyawan untuk tujuan pengarsipan untuk bulan Januari, Februari, dan Maret. Majikan A harus mengajukan Formulir 1095-C untuk Penawaran Pelaporan Karyawan yang menggunakan kode yang sesuai pada baris 14 untuk bulan Januari, Februari, dan Maret, harus melengkapi baris 15 dan 16 per instruksi, dan harus mencakup Karyawan dalam jumlah total karyawan dan Karyawan penuh waktu melaporkan untuk bulan-bulan tersebut pada Formulir 1094-C. Untuk bulan April sampai Desember, pada Formulir 1095-C, Majikan A harus memasukkan kode 1H (tidak ada penawaran pertanggungan) pada baris 14, biarkan baris 15 kosong, dan masukkan kode 2A (bukan pegawai) pada baris 16 (karena Karyawan adalah Diperlakukan sebagai karyawan Majikan B dan bukan sebagai karyawan Majikan A pada bulan-bulan tersebut), dan harus mengecualikan Karyawan dari jumlah total karyawan dan karyawan penuh waktu yang dilaporkan untuk bulan-bulan tersebut pada Formulir 1094-C. When To File Anda akan memenuhi persyaratan untuk mengajukan Formulir 1094-C dan 1095-C jika formulir ditangani dengan benar dan dikirim pada atau sebelum tanggal jatuh tempo. Jika tanggal jatuh tempo reguler jatuh pada hari Sabtu, Minggu, atau hari libur resmi, berkas pada hari kerja berikutnya. Hari kerja adalah hari yang bukan hari Sabtu, Minggu, atau libur resmi. Umumnya, Anda harus mengajukan Formulir 1094-C dan 1095-C pada 28 Februari jika mengajukan di atas kertas (atau 31 Maret jika mengajukan secara elektronik) tahun setelah tahun takwim yang kembali berhubungan. Untuk tahun kalender 2016, Formulir 1094-C dan 1095-C wajib diajukan pada tanggal 28 Februari 2017, atau 31 Maret 2017, jika mengajukan secara elektronik. Lihat Formulir Furnishing 1095-C ke Karyawan untuk informasi kapan Formulir 1095-C harus dilengkapi. Ekstensi Anda bisa mendapatkan perpanjangan waktu 30 hari otomatis untuk mengajukannya dengan mengisi Formulir 8809, Aplikasi untuk Perpanjangan Waktu Untuk Mengembalikan Informasi File. Formulir dapat diajukan di atas kertas, atau melalui Sistem FIRE baik sebagai formulir isi maupun file elektronik. Tidak ada tanda tangan atau penjelasan yang diperlukan untuk perpanjangan. Namun, Anda harus mengajukan Formulir 8809 pada atau sebelum tanggal jatuh tempo untuk mendapatkan perpanjangan 30 hari. Dalam kondisi sulit tertentu Anda mungkin mengajukan perpanjangan 30 hari tambahan. Lihat petunjuk untuk Formulir 8809 untuk informasi lebih lanjut. Bagaimana menerapkan. Segera setelah Anda mengetahui bahwa perpanjangan waktu 30 hari untuk file diperlukan, file Form 8809. Lihat petunjuk untuk Formulir 8809. Formulir Mail atau Fax 8809 menggunakan alamat dan nomor telepon yang tercantum dalam petunjuk. Anda bisa mengirimkan permintaan perpanjangan secara online melalui FIRE System. Anda dianjurkan untuk mengirimkan permintaan menggunakan formulir isi online. Lihat Pub. 1220, Bagian B, untuk informasi lebih lanjut tentang pengarsipan online atau elektronik. Dimana Untuk Mengarsipkan Jika Anda diminta untuk mengembalikan 250 informasi atau lebih, Anda harus mengajukan secara elektronik. Persyaratan 250-atau-lebih berlaku secara terpisah untuk setiap jenis formulir yang diajukan dan secara terpisah untuk pengembalian asli dan yang dikoreksi. Misalnya, jika Anda harus memasukkan 500 Formulir 1095-B dan 100 Formulir 1095-C, Anda harus mengajukan Formulir 1095-B secara elektronik, namun Anda tidak diminta untuk mengajukan Formulir 1095-C secara elektronik. Jika Anda memiliki 150 Formulir 1095-C untuk diperbaiki, Anda dapat mengajukan pengembalian yang dikoreksi di atas kertas karena harganya jatuh di bawah ambang batas 250. Namun, jika Anda memiliki 300 Formulir 1095-C untuk diperbaiki, mereka harus diajukan secara elektronik. Persyaratan pengarsipan elektronik tidak berlaku jika Anda mengajukan permohonan dan menerima pembebasan kesukaran. IRS mendorong Anda untuk mengajukan secara elektronik meskipun Anda mengajukan kurang dari 250 pengembalian. Pembebasan Untuk menerima pengabaian dari pengajuan informasi yang diminta secara elektronik, kirimkan Formulir 8508. Anda dianjurkan untuk mengajukan Formulir 8508 setidaknya 45 hari sebelum tanggal jatuh tempo, namun paling lambat tanggal jatuh tempo pengembalian. IRS tidak memproses permintaan pengabaian sampai tanggal 1 Januari tahun kalender akan kembali. Anda tidak dapat mengajukan pengabaian lebih dari satu tahun pajak dalam satu waktu. Jika Anda memerlukan pembebasan selama lebih dari satu tahun pajak, Anda harus mengajukan permohonan kembali pada waktu yang tepat setiap tahunnya. Jika pembebasan untuk pengembalian asli disetujui, koreksi untuk jenis pengembalian yang sama akan tercakup dalam pengabaian. Namun, jika Anda mengirimkan pengembalian asli secara elektronik namun Anda ingin mengirimkan koreksi di atas kertas, pembebasan harus disetujui untuk koreksi jika Anda harus mengajukan koreksi 250 atau lebih. Jika Anda menerima pengabaian yang disetujui, jangan kirim salinannya ke pusat layanan tempat Anda mengembalikan uang kertas Anda. Simpan pembebasan untuk catatan Anda saja. Jika Anda diminta untuk mengajukan secara elektronik namun gagal melakukannya, dan Anda tidak memiliki pengabaian yang disetujui, Anda mungkin dikenai hukuman sebesar 260 per pengembalian atas kegagalan untuk mengajukan secara elektronik kecuali jika Anda menetapkan alasan yang masuk akal. Namun, Anda dapat mengajukan hingga 250 pengembalian di atas kertas hasil pengembalian tersebut tidak akan dikenakan hukuman karena kegagalan untuk mengajukan secara elektronik. Hukuman berlaku secara terpisah untuk pengembalian asli dan pengembalian terkoreksi. Pub. 5165, Panduan Pengarsipan Informasi Perhatian Khusus untuk Perawatan yang Diambil secara Elektronik (ACA) untuk Pengembang Perangkat Lunak dan Pemancar (saat ini sedang dikembangkan untuk Pemrosesan Tahun 2017), menentukan prosedur komunikasi, format transmisi, peraturan bisnis, prosedur validasi, dan menjelaskan kapan pengembalian akan Diterima, diterima dengan kesalahan atau ditolak karena pengembalian diajukan secara elektronik untuk tahun kalender 2016 melalui sistem ACA Information Return (AIR). Untuk mengembangkan perangkat lunak untuk digunakan dengan sistem AIR, pengembang perangkat lunak, pemancar, dan emiten, termasuk Anggota ALE yang mengarsipkan Formulir 1094-C dan 1095-C mereka sendiri, sebaiknya menggunakan panduan yang diberikan di Pub. 5165 bersama Skema Extensible Markup Language (XML) yang diterbitkan di IRS.gov. Peringatan. Petunjuk pemformatan dalam petunjuk ini (misalnya, petunjuk untuk memasukkan EIN 9 digit termasuk tanda hubung pada baris 2 dari Formulir 1094-C) adalah untuk persiapan pengembalian kertas. Saat mengajukan formulir secara elektronik, format yang tercantum dalam Skema XML dan Aturan Bisnis yang dipublikasikan di IRS.gov harus diikuti daripada petunjuk format dalam petunjuk ini. Untuk informasi lebih lanjut mengenai pengarsipan elektronik, lihat Pub. 5164 dan 5165. Pengganti Pengganti yang Diarsipkan dengan IRS Anda akan memenuhi persyaratan untuk memberikan Formulir 1095-C kepada karyawan jika formulir tersebut ditangani dengan benar dan dikirimkan pada atau sebelum tanggal jatuh tempo. Jika tanggal jatuh tempo reguler jatuh pada hari Sabtu, Minggu, atau hari libur resmi, berkas pada hari kerja berikutnya. Hari kerja adalah hari yang bukan hari Sabtu, Minggu, atau libur resmi. Anggota ALE harus memberikan Formulir 1095-C kepada masing-masing pegawai tetapnya pada tanggal 31 Januari tahun setelah tahun yang bersangkutan dengan Formulir 1095-C. Formulir 1095-C untuk tahun kalender 2016 harus dilengkapi pada tanggal 31 Januari 2017. Untuk informasi lebih lanjut tentang metode pemberian alternatif untuk pengusaha, lihat A. Metode Penawaran Kualifikasi. Filers of Form 1095-C dapat memotong nomor jaminan sosial (SSN) seseorang (karyawan atau anggota keluarga dari karyawan yang menerima pertanggungan) pada formulir 1095-C yang diberikan kepada karyawan dengan hanya menampilkan empat digit terakhir SSN Dan mengganti lima digit pertama dengan tanda bintang () atau Xs. Potongan tidak diperbolehkan pada formulir yang diajukan ke IRS. Sebagai tambahan, nomor identifikasi pengusaha ALE member (EIN) mungkin tidak terpotong pada laporan yang diberikan kepada karyawan atau formulir yang diajukan ke IRS. Kecuali sebagaimana ditentukan di bawah, pernyataan harus diberikan di atas kertas melalui surat (atau dikirimkan dengan tangan), kecuali jika penerima secara sah setuju untuk menerima pernyataan tersebut dalam format elektronik. Jika dikirim, surat pernyataan tersebut harus dikirim ke alamat permanen yang diketahui terakhir, atau jika tidak ada alamat tetap yang diketahui, ke alamat sementara karyawan tersebut. Persetujuan untuk memberikan pernyataan secara elektronik. Anggota ALE diharuskan untuk mendapatkan persetujuan afirmatif untuk memberikan pernyataan secara elektronik. Persyaratan ini memastikan bahwa pernyataan diberikan secara elektronik hanya kepada individu yang dapat mengaksesnya. Persetujuan harus berhubungan secara khusus untuk menerima Formulir 1095-C secara elektronik. Seorang individu dapat memberikan persetujuan di atas kertas atau secara elektronik, seperti melalui email. Jika izin ada di atas kertas, orang tersebut harus mengkonfirmasi persetujuannya secara elektronik. Pernyataan dapat diberikan secara elektronik melalui email atau dengan menginformasikan individu bagaimana cara mengakses pernyataan di situs web ALE Member8217s. Pernyataan yang melaporkan liputan berdasarkan rencana kesehatan ekspatriat, bagaimanapun, dapat dilakukan secara elektronik kecuali penerima secara eksplisit menolak untuk menyetujui untuk menerima pernyataan tersebut dalam format elektronik. Informasi spesifik tentang persetujuan untuk memberikan pernyataan secara elektronik dapat ditemukan di bagian Regulasi 301.6056-2. Perpanjangan waktu untuk memberikan pernyataan kepada penerima. Anda dapat meminta perpanjangan waktu untuk memberikan pernyataan kepada penerima dengan mengirimkan surat ke Internal Revenue Service, Attn: Perpanjangan Koordinator Waktu, 240 Murall Drive, Mail Stop 4360, Kearneysville 25430. Surat tersebut harus mencakup (a) filer Nama, (b) filer TIN, (c) alamat filer, (d) jenis pengembalian, (e) pernyataan bahwa permintaan perpanjangan adalah untuk memberikan pernyataan kepada penerima, (f) alasan penundaan, dan (g) tanda tangan Filer atau agen resmi Permintaan Anda harus diberi cap pos pada tanggal laporan dibuat oleh penerima. Jika permintaan perpanjangan Anda disetujui, umumnya Anda akan diberi waktu maksimal 30 hari ekstra untuk memberikan laporan penerima. Untuk keperluan meminta perpanjangan waktu untuk memberikan pernyataan, istilah filer berarti Anggota ALE, atau Entitas Pemerintah yang ditunjuk, jika berlaku. Informasi melaporkan hukuman. Semua majikan yang tunduk pada majikan berbagi tanggung jawab dan atasan lainnya yang mensponsori rencana kesehatan kelompok yang diasuransikan sendiri yang tidak memenuhi persyaratan pelaporan informasi yang berlaku dapat dikenai ketentuan penalti pelaporan umum karena kegagalan untuk mengajukan pengembalian informasi yang benar dan kegagalan untuk memberikan Benar pembayaran laporan. Untuk pengembalian yang harus dilakukan dan pernyataan yang diminta untuk mendapatkan kembali tahun pajak 2016, berlaku berikut ini. Hukuman atas kegagalan untuk mengajukan pengembalian informasi yang benar adalah 260 untuk setiap pengembalian yang kegagalannya terjadi, dengan hukuman total untuk satu tahun tak melampaui 3.193.000. Hukuman atas kegagalan memberikan pernyataan pembayaran yang benar adalah 260 untuk setiap pernyataan dimana kegagalan tersebut terjadi, dengan total hukuman untuk satu tahun tak melampaui 3.193.000. Aturan khusus berlaku yang meningkatkan per-statement dan total penalty jika ada disengaja mengabaikan persyaratan untuk mengajukan pengembalian dan memberikan pernyataan yang diminta. Baris 1. Masukkan nama majikan. Majikannya adalah Anggota ALE. Baris 2. Masukkan Nomor Identifikasi Perusahaan ALE Member8217s (EIN). Jangan masukkan SSN. Masukkan EIN 9 digit termasuk tanda hubung. Jika Anda mengajukan Formulir 1094-C, EIN yang valid diperlukan pada saat formulir diajukan. Jika EIN yang valid tidak tersedia, Form 1094-C tidak akan diproses. Jika Anda tidak memiliki EIN, Anda dapat mengajukan permohonan secara online. Pergi ke IRS.gov dan masukkan 8220EIN8221 di kotak pencarian. Anda juga dapat mengajukan permohonan melalui fax atau pengiriman Formulir SS-4, Application for Employer Identification Number, ke IRS. Lihat Petunjuk untuk Formulir SS-4 dan Pub. 1635, Nomor Induk Pengusaha. Baris 382116. Masukkan alamat lengkap ALE Member8217s (termasuk kamar atau suite no jika ada). Alamat ini harus sesuai dengan alamat ALE Member8217 yang digunakan pada Formulir 1095-C. Baris 7 dan 8. Masukkan nama dan nomor telepon orang tersebut untuk menghubungi siapa yang bertanggung jawab untuk menjawab pertanyaan dari IRS mengenai pengajuan atau informasi yang dilaporkan pada Formulir 1094-C atau 1095-C. (Ini mungkin berbeda dari informasi kontak pada baris 10 dari Formulir 1095-C.) Jika Anda adalah pengurus Instansi Pemerintah Yang Ditunjuk (DGE) atas nama Anggota ALE, baris lengkap 9821116. Jika Anda bukan pengarsipan DGE atas nama Anggota ALE tidak melengkapi garis 9821116. Sebaliknya, lompat ke garis 18. Lihat Badan Pemerintah Tertentu (DGE) di bagian Definisi dari petunjuk ini. Baris 9. Jika DGE mengajukan nama anggota ALE, masukkan nama DGE. Baris 10. Masukkan EIN DGE8217s (termasuk tanda hubung). Jangan masukkan SSN. Jika Anda adalah DGE yang mengajukan Formulir 1094-C, EIN yang valid diperlukan pada saat pengembalian diajukan. Jika EIN yang valid tidak tersedia, pengembalian tidak akan diproses. Jika DGE tidak memiliki EIN saat mengajukan Formulir 1094-C, itu bisa mendapatkan EIN dengan mendaftar secara online di IRS.gov atau dengan mengirim faks atau mengirim Formulir SS-4 yang telah selesai. Lihat Petunjuk untuk Formulir SS-4 dan Pub. 1635. Lines 11821114. Masukkan alamat lengkap DGE8217 (termasuk kamar atau suite tidak), jika ada. Baris 15 dan 16. Masukkan nama dan nomor telepon orang tersebut untuk menghubungi siapa yang bertanggung jawab untuk menjawab pertanyaan dari IRS mengenai pengajuan atau informasi yang dilaporkan pada Formulir 1094-C. Baris 18. Masukkan jumlah total Formulir 1095-C (tidak termasuk lembar lanjutan) yang dikirim dengan pengiriman 1094-C Formulir ini. Baris 19. Jika pengiriman 1094-C formulir ini adalah Authoritative Transmittal yang melaporkan data tingkat pekerja gabungan untuk Anggota ALE, centang kotak di baris 19 dan lengkapi Bagian II, III, dan IV, sejauh berlaku. Jika tidak, lengkapi bagian tanda tangan dari Formulir 1094-C dan tinggalkan sisa Bagian II, III, dan IV kosong. Hanya ada satu Authoritative Transmittal yang diajukan untuk masing-masing anggota ALE. If this is the only Form 1094-C being filed for the ALE Member, this Form 1094-C must report aggregate employer-level data for the ALE Member and be identified on line 19 as the Authoritative Transmittal. If multiple Forms 1094-C are being filed for an ALE Member so that Forms 1095-C for all full-time employees of the ALE Member are not attached to a single Form 1094-C transmittal (because Forms 1095-C for some full-time employees of the ALE Member are being transmitted separately), one (and only one) of the Forms 1094-C must report aggregate employer-level data for the ALE Member and be identified on line 19 as the Authoritative Transmittal. For more information, see Authoritative Transmittal for ALE Members Filing Multiple Forms 1094-C . earlier. Part II8212ALE Member Information Reminder. Lines 20821122 should be completed only on the Authoritative Transmittal for the ALE Member. For more information, see Authoritative Transmittal for ALE Members Filing Multiple Forms 1094-C . earlier. Line 20. Enter the total number of Forms 1095-C (not counting continuation sheets) that will be filed by andor on behalf of the ALE Member. This includes all Forms 1095-C that are filed with this transmittal including those filed for individuals who enrolled in the employer-sponsored self-insured plan, if any, and for any Forms 1095-C filed with a separate transmittal filed by or on behalf of the ALE Member. Line 21. If during any month of the calendar year the ALE Member was a member of an Aggregated ALE Group, check 8220 Yes. 8221 If you check 8220 Yes, 8221 also complete the 8220Aggregated Group Indicator8221 in Part III, column (d), and then complete Part IV to list the other members of the Aggregated ALE Group. If, for all 12 months of the calendar year, the employer was not a member of an Aggregated ALE Group, check 8220 No, 8221 and do not complete Part III, column (d), or Part IV. Line 22. If the ALE Member meets the eligibility requirements and is using one of the Offer Methods andor one of the forms of Transition Relief indicated, it must check each applicable box. See the descriptions of Qualifying Offer Method, Section 4980H Transition Relief, and 98 Offer Method, below. A. Qualifying Offer Method. Check this box if the ALE Member is eligible to use and is using the Qualifying Offer Method to report the information on Form 1095-C for one or more full-time employees. Under the Qualifying Offer Method there is an alternative method of completing Form 1095-C and an alternative method for furnishing Form 1095-C to certain employees. If the ALE Member is using either of these alternative rules, check this box. To be eligible to use the Qualifying Offer Method, the ALE Member must certify that it made a Qualifying Offer to one or more of its full-time employees for all months during the year in which the employee was a full-time employee for whom an employer shared responsibility payment could apply. Additional requirements described below must be met to be eligible to use the alternative method for furnishing Form 1095-C to employees under the Qualifying Offer Method. Alternative Method of Completing Form 1095-C under the Qualifying Offer Method. If the ALE Member reports using this method, it must not complete Form 1095-C, Part II, line 15, for any month for which a Qualifying Offer is made. Instead it must enter the Qualifying Offer code 1A on Form 1095-C, line 14, for any month for which the employee received a Qualifying Offer (or in the all 12 months box if the employee received a Qualifying Offer for all 12 months), and must leave line 15 blank for any month for which code 1A is entered on line 14. The ALE Member may, but is not required, to enter an applicable code on line 16 for any month for which code 1A is entered on line 14 a Qualifying Offer is, by definition, treated as an offer that falls within an affordability safe harbor even if no code is entered on line 16. An ALE Member is not required to use the Qualifying Offer Method, even if it is eligible and instead may enter on line 14 the applicable offer code and then enter on line 15 the Employee Required Contribution. If the ALE Member is eligible to use the Qualifying Offer Method, it may report on Form 1095-C by entering the Qualifying Offer code 1A on Form 1095-C, line 14, for any month for which it made a Qualifying Offer to an employee, even if the employee did not receive a Qualifying Offer for all 12 calendar months. However, if an employee receives a Qualifying Offer for less than all 12 months, the ALE Member must furnish a copy of Form 1095-C to the employee (rather than using the alternative method of furnishing Form 1095-C described below). Employee8217s employment with Employer begins on January 1. Employee is in a health coverage waiting period (and an employer shared responsibility payment could not apply with respect to Employee, because Employee is in a Limited Non-Assessment Period) until April 1 and is a full-time employee for the remainder of the calendar year. Employer makes a Qualifying Offer to Employee for coverage beginning on April 1 and for the remainder of the calendar year. Employer is eligible to use the Qualifying Offer method because it has made a Qualifying Offer to at least one full-time employee for all months in which both (1) the employee was a full-time employee and (2) an employer shared responsibility payment could apply with respect to the employee. Employer may use the alternative method of completing Form 1095-C under the Qualifying Offer Method for this Employee. However, Employer may not use the alternative method of furnishing Form 1095-C to Employee under the Qualifying Offer Method because Employee did not receive a Qualifying Offer for all 12 months of the calendar year. Alternative Method of Furnishing Form 1095-C to Employees under the Qualifying Offer Method. An ALE Member that is eligible to use the Qualifying Offer Method may use the alternative method of furnishing Form 1095-C only for a full-time employee who: (1) received a Qualifying Offer for all 12 months of the calendar year, and (2) did not enroll in employer-sponsored self-insured coverage. For such an employee, an ALE Member meets its obligation to furnish a Form 1095-C to the employee if it furnishes the employee a statement containing the following information. EmployerALE Member name, address, and EIN. Contact name and telephone number at which the employee may receive information about the offer of coverage and the information on the Form 1095-C filed with the IRS for that employee. Notification that, for all 12 months of the calendar year, the employee and his or her spouse and dependents, if any, received a Qualifying Offer and therefore are not eligible for a premium tax credit. Information directing the employee to see Pub. 974, Premium Tax Credit (PTC), for more information on eligibility for the premium tax credit. An ALE Member is not required to use the alternative method of furnishing for an employee even if the alternative method would be allowed. Instead, the ALE Member may furnish a copy of Form 1095-C as filed with the IRS (with or without the statement described above). As stated above, an ALE Member may not use the alternative furnishing method for a full-time employee who enrolled in self-insured coverage. Rather, the ALE Member must furnish Form 1095-C, including the information reporting enrollment in the coverage on Form 1095-C, Part III. C. Section 4980H Transition Relief. For the 2016 calendar year, the transition relief described below is applicable only if an ALE Member (or any other member of the ALE Member8217s Aggregated ALE Group, if applicable) offers coverage under a health plan with a plan year beginning on a date other than January 1 (a non-calendar year plan year), and only for calendar months in 2016 that fall within that 2015 plan year. Check this box if the ALE Member is eligible for section 4980H Transition Relief for one or more months of the 2016 calendar year under either: 2015 Plan Year Section 4980H Transition Relief for ALEs with Fewer Than 100 Full-Time Employees, Including Full-Time Equivalent Employees (50-99 Transition Relief), or 2015 Plan Year Transition Relief for Calculation of Assessable Payments Under Section 4980H(a) for ALEs with 100 or More Full-Time Employees, Including Full-Time Equivalent Employees (100 or More Transition Relief). For a description of the relief, including which ALE Members are eligible for the relief, and to which months in 2016 the relief may apply, including if the ALE Member (or any member of the ALE Member8217s Aggregated ALE Group, if applicable) sponsors more than one plan, see Section 4980H Transition Relief for 2015 Plan Years . later. If an ALE Member checks this box, it must also indicate the type of section 4980H transition relief on Form 1094-C, Part III, column (e), Section 4980H Transition Relief Indicator, for each month to which the relief applies. D. 98 Offer Method. Check this box if the employer is eligible for and is using the 98 Offer Method. To be eligible to use the 98 Offer Method, an employer must certify that, taking into account all months during which the individuals were employees of the ALE Member and were not in a Limited Non-Assessment Period, the ALE Member offered, affordable health coverage providing minimum value to at least 98 of its employees for whom it is filing a Form 1095-C employee statement, and offered minimum essential coverage to those employees8217 dependents. The ALE member is not required to identify which of the employees for whom it is filing were full-time employees, but the ALE Member is still required, under the general reporting rules, to file Forms 1095-C on behalf of all its full-time employees who were full-time employees for one or more months of the calendar year. To ensure compliance with the general reporting rules, an ALE Member should confirm for any employee for whom it fails to file a Form 1095-C that the employee was not a full-time employee for any month of the calendar year. (For this purpose, the health coverage is affordable if the ALE Member meets one of the section 4980H affordability safe harbors.) Employer has 325 employees. Of those 325 employees, Employer identifies 25 employees as not possibly being full-time employees because they are scheduled to work 10 hours per week and are not eligible for additional hours. Of the remaining 300 employees, 295 are offered affordable minimum value coverage for all periods during which they are employed other than any applicable waiting period (which qualifies as a Limited Non-Assessment Period). Employer files a Form 1095-C for each of the 300 employees (excluding the 25 employees that it identified as not possibly being full-time employees). Employer may use the 98 Offer Method because it makes an affordable offer of coverage that provides minimum value to at least 98 of the employees for whom Employer files a Form 1095-C. Using this method, Employer does not identify whether each of the 300 employees is a full-time employee. However, Employer must still file a Form 1095-C for all of its full-time employees. Employer chooses to file a Form 1095-C on behalf of all 300 employees, including the five employees to whom it did not offer coverage, because if one or more of those employees was, in fact, a full-time employee for one or more months of the calendar year, Employer would be required to have filed a Form 1095-C on behalf of those employees. If an ALE member uses the 98 offer method, it is not required to complete the 8220 Section 4980H Full-Time Employee Count for ALE Member 8221 in Part III, column (b). Part III8212ALE Member Information8212Monthly (Lines 23821135) Column (a) Minimum Essential Coverage Offer Indicator. If the ALE Member offered minimum essential coverage to at least 95 of its full-time employees and their dependents for the entire calendar year, enter 8220X8221 in the 8220Yes8221 checkbox on line 23 for 8220 All 12 Months 8221 or for each of the 12 calendar months. If the ALE Member offered minimum essential coverage to at least 95 of its full-time employees and their dependents only for certain calendar months, enter 8220 X 8221 in the 8220 Yes 8221 checkbox for each applicable month. For the months, if any, for which the ALE Member did not offer minimum essential coverage to at least 95 of its full-time employees and their dependents, enter 8220 X 8221 in the 8220 No 8221 checkbox for each applicable month. If the ALE Member did not offer minimum essential coverage to at least 95 of its full-time employees and their dependents for any of the 12 months, enter 8220 X 8221 in the 8220 No 8221 checkbox for 8220 All 12 Months 8221 or for each of the 12 calendar months. However, for ALE Members with non-calendar year plans, an ALE Member that did not offer minimum essential coverage to at least 95 of its full-time employees and their dependents but is eligible for certain transition relief described in the instructions later under Section 4980H Transition Relief for 2015 Plan Years should enter an 8220X8221 in the 8220 Yes 8221 checkbox for Part III, column (a), for months to which the transition relief is applicable. This transition relief is available in 2016 only for ALE Members with plans with a non-calendar year plan year for such an ALE Member, the relief applies only to the calendar months in 2016 that fall within the 2015 plan year. See the instructions later under Section 4980H Transition Relief for 2015 Plan Years . For purposes of column (a), an employee in a Limited Non-Assessment Period is not counted in determining whether minimum essential coverage was offered to at least 95 (or 70) of an ALE Member8217s full-time employees and their dependents. For a description of the differences between the definition of the term Limited Non-Assessment Period used with respect to section 4980H(a) and the definition used with respect to section 4980H(b), relating to whether the ALE Member offers minimum value coverage at the end of the Limited Non-Assessment Period, see the Definitions section. An employee who is treated as having been offered health coverage for purposes of section 4980H (even though not actually offered) is treated as offered minimum essential coverage for this purpose. For example, for the months for which the ALE Member is eligible for dependent coverage transition relief or multiemployer arrangement interim guidance (if the ALE Member is contributing on behalf of an employee whether or not the employee is eligible for coverage under the multiemployer plan) with respect to an employee, that employee should be treated as having been offered minimum essential coverage for purposes of column (a). For more information on the dependent coverage transition relief, which is available in 2016 only for ALE Members with plans with a non-calendar year plan year and only for the calendar months in 2016 that fall within the 2015 plan year, see Section 4980H Transition Relief for 2015 Plan Years. For different rules for purposes of reporting offers of coverage on Form 1095-C, see the specific instructions for Form 1095-C, Part II, line 14. For purposes of column (a), if the ALE Member offered minimum essential coverage to all but five of its full-time employees and their dependents, and five is greater than 5 of the number of full-time employees of the ALE Member, the ALE Member may report in column (a) as if it offered health coverage to at least 95 of its full-time employees and their dependents (even if it offered health coverage to less than 95 of its full-time employees and their dependents, for example to 75 of its 80 full-time employees and their dependents). See Definitions . later, for more information on an offer of health coverage. Column (b) Section 4980H Full-Time Employee Count for ALE Member. Enter the number of full-time employees for each month, but do not count any employee in a Limited Non-Assessment Period. If the number of full-time employees (excluding employees in a Limited Non-Assessment Period) for a month is zero, enter 8220 0. 8221 An employee should be counted as a full-time employee for a month if the employee satisfied the definition of full-time employee under the monthly measurement method or the look-back measurement method (as applicable) on any day of the month. See Full-time employee and Limited Non-Assessment Period in the Definitions section. Be sure to use the section 4980H definition and not any other definition of the term full-time employee that you may use for other purposes. Employer uses the look-back measurement method to determine the full-time status of its employees. Employee, who is not in a Limited Non-Assessment Period, averaged over 130 hours of service per month during the measurement period that corresponds with the stability period starting January 1, 2016, and ending December 31, 2016. Employee terminates employment with Employer on February 15, 2016. Employer must include Employee in the number of full-time employees reported in column (b) for January and February. See the description of code 2B in the instructions for line 16 of Form 1095-C, later, for rules for reporting an offer of coverage in an employee8217s final month of employment. If the ALE Member certified that it was eligible for the 98 Offer Method by selecting box D, on line 22, it is not required to complete column (b). Column (c) Total Employee Count for ALE Member. Enter the total number of all of the ALE Member8217s employees, including full-time employees and non-full-time employees, and employees in a Limited Non-Assessment Period, for each calendar month. An ALE Member must choose to use one of the following days of the month to determine the number of employees per month and must use that day for all months of the year: (1) the first day of each month (2) the last day of each month (3) the 12th day of each month (4) the first day of the first payroll period that starts during each month or (5) the last day of the first payroll period that starts during each month (provided that for each month that last day falls within the calendar month in which the payroll period starts). If the total number of employees was the same for every month of the entire calendar year, enter that number in line 23, column (c) 8220All 12 Months8221 or in the boxes for each month of the calendar year. If the number of employees for any month is zero, enter 8220 0. 8221 Column (d) Aggregated Group Indicator. An ALE Member must complete this column if it checked 8220Yes8221 on line 21, indicating that, during any month of the calendar year, it was a member of an Aggregated ALE Group. If the ALE Member was a member of an Aggregated ALE Group during each month of the calendar year, enter 8220X8221 in the 8220 All 12 Months 8221 box or in the boxes for each of the 12 calendar months. If the ALE Member was not a member of an Aggregated ALE Group for all 12 months but was a member of an Aggregated ALE Group for one or more month(s), enter 8220X8221 in each month for which it was a member of an Aggregated ALE Group. If an ALE Member enters 8220X8221 in one or more months in this column, it must also complete Part IV. Column (e) Section 4980H Transition Relief Indicator. If the ALE Member certifies by selecting box C on line 22, that it is eligible for Section 4980H Transition Relief and is eligible for the 50 to 99 Relief, enter code A for each month to which the transition relief applies. If the ALE Member certifies by selecting box C on line 22, that it is eligible for Section 4980H Transition Relief and is eligible for the 100 or More Relief, enter code B for each month to which the transition relief applies. An ALE Member will not be eligible for both types of relief. This transition relief is available in 2016 only for ALE Members with plans with a non-calendar year plan year or for ALE Members that are members of an Aggregated ALE Group with at least one plan with a non-calendar year plan year. For such an ALE Member, the relief applies only to the calendar months in 2016 that fall within the 2015 plan year. If any ALE Member, or different members in an Aggregated ALE Group, offer coverage under more than one health plan with different plan years, the transition relief applies through the last day of the latest of those plan years. See 4980H Transition Relief for 2015 Plan Years . later. Part IV8212Other ALE Members of Aggregated ALE Group (Lines 36821165) An ALE Member must complete this section if it checks 8220Yes8221 on line 21. If the ALE Member was a member of an Aggregated ALE Group (with other ALE Members) for any month of the calendar year, enter the name(s) and EIN(s) of up to 30 of the other Aggregated ALE Group members (not including the reporting ALE Member). If there are more than 30 members of the Aggregated ALE Group (not including the reporting ALE Member), enter the 30 with the highest monthly average number of full-time employees (using the number reported in Part III, column (b), if a number was required to be reported) for the year or for the number of months during which the ALE Member was a member of the Aggregated ALE Group. If any member of the Aggregated ALE Group uses the 98 Offer Method and thus is not required to identify which employees are full-time employees, all ALE Members of the Aggregated ALE Group should use the monthly average number of total employees rather than the monthly average number of full-time employees for this purpose. Regardless of the number of members in the Aggregated ALE Group, list only the 30 members in descending order, listing first the member with the highest average monthly number of full-time employees (or highest average number of total employees, if any member of the Aggregated ALE Group uses the 98 Offer Method), but do not include the reporting ALE Member. The reporting ALE Member must also complete Part III, column (d), to indicate which months it was part of an Aggregated ALE Group. If you are filing Form 1094-C, a valid EIN is required at the time it is filed. If a valid EIN is not provided, Form 1094-C will not be processed. If you do not have an EIN, you may apply for one online. Go to IRS.gov and enter 8220 EIN 8221 in the search box. You may also apply by faxing or mailing Form SS-4 to the IRS. See the Instructions for Form SS-4 and Pub. 1635. Specific Instructions for Form 1095-C Line 7. Enter the name of the ALE Member. Line 8. Enter the ALE Member8217s EIN. Do not enter an SSN. Enter the 9-digit EIN including the dash. The ALE Member8217s name and EIN should match the name and EIN of the ALE Member reported on lines 1 and 2 of Form 1094-C. If you are filing Form 1095-C, a valid EIN is required at the time it is filed. If a valid EIN is not provided, Form 1095-C will not be processed. If you do not have an EIN, you may apply for one online. Go to IRS.gov and enter 8220 EIN 8221 in the search box. You may also apply by faxing or mailing Form SS-4 to the IRS. See the Instructions for Form SS-4 and Pub. 1635. Lines 9 and 11821113. Enter the ALE Member8217s complete address (including room or suite no. if applicable). This address should match the address reported on lines 382116 of the Form 1094-C. Line 10. Enter the telephone number of the person to contact whom the recipient may call about the information reported on the form. This may be different than the contact information entered on line 8 of Form 1094-C. Part II8212Employee Offer of Coverage Plan Start Month. This box is optional for the 2016 Form 1095-C and the ALE Member may leave it blank it is anticipated that this box will be mandatory for the 2017 Form 1095-C. To complete the box, enter the two-digit number (01 through 12) indicating the calendar month during which the plan year begins of the health plan in which the employee is offered coverage (or would be offered coverage if the employee were eligible to participate in the plan). If more than one plan year could apply (for instance, if the ALE Member changes the plan year during the year), enter the earliest applicable month. If there is no health plan under which coverage is offered to the employee, enter 8220 00. 8221 Line 14. For each calendar month, enter the applicable code from Code Series 1. If the same code applies for all 12 calendar months, you may enter the applicable code in the 8220 All 12 Months 8221 box and not complete the individual calendar month boxes, or you may enter the code in each of the boxes for the 12 calendar months. If an employee was not offered coverage for a month, enter code 1H. Do not leave line 14 blank for any month (including months when the individual was not an employee of the ALE Member). An ALE Member offers health coverage for a month only if it offers health coverage that would provide coverage for every day of that calendar month. Thus, if coverage terminates before the last day of the month (because, for instance, the employee terminates employment with the ALE Member, or otherwise loses eligibility for coverage under the plan), the employee does not actually have an offer of coverage for that month (and code 1H should therefore be entered on line 14). See line 16, code 2B, later, for how the ALE Member may complete line 16 in the event that coverage terminates before the last day of the month. A code must be entered for each calendar month January through December, even if the employee was not a full-time employee for one or more of the calendar months. Enter the code identifying the type of health coverage actually offered by the ALE Member (or on behalf of the ALE Member) to the employee, if any. Do not enter a code for any other type of health coverage the ALE Member is treated as having offered (but the employee was not actually offered coverage). For example, do not enter a code for health coverage the ALE Member is treated as having offered (but did not actually offer) under the dependent coverage transition relief, even if the employee is included in the count of full-time employees offered minimum essential coverage for purposes of Form 1094-C, Part III, column (a). See 4980H Transition Relief for 2015 Plan Years for a discussion of the application of the dependent coverage transition relief in 2016. If the employee was not actually offered coverage, enter code 1H (no offer of coverage) on line 14. For reporting offers of coverage for 2016, an ALE Member relying on the multiemployer arrangement interim guidance should enter code 1H on line 14 for any month for which the ALE Member enters code 2E on line 16 (indicating that the ALE Member was required to contribute to a multiemployer plan on behalf of the employee for that month and therefore is eligible for multiemployer interim rule relief). For a description of the multiemployer arrangement interim guidance, see Offer of health coverage in the Definitions section. For reporting for 2016, code 1H may be entered without regard to whether the employee was eligible to enroll or enrolled in coverage under the multiemployer plan. For reporting for 2017 and future years, ALE Members relying on the multiemployer arrangement interim guidance may be required to report offers of coverage made through a multiemployer plan in a different manner. Indicator Codes for Employee Offer of Coverage (Form 1095-C, Line 14) Code Series 18212 Offer of Coverage. The Code Series 1 indicator codes specify the type of coverage, if any, offered to an employee, the employee8217s spouse, and the employee8217s dependents. The term 8220dependent8221 has the specific meaning set forth in the Definitions section of these instructions. In addition, for this purpose an offer of coverage is treated as made to an employee8217s dependents only if the offer of coverage is made to an unlimited number of dependents regardless of the actual number of dependents, if any, an employee has during any particular calendar month. If the type of coverage, if any, offered to an employee was the same for all 12 months in the calendar year, enter the Code Series 1 indicator code corresponding to the type of coverage offered either in the 8220 All 12 Months 8221 box or in each of the 12 boxes for the calendar months. Conditional offer of spousal coverage. New codes 1J and 1K address conditional offers of spousal coverage (also referred to as coverage offered conditionally). A conditional offer is an offer of coverage that is subject to one or more reasonable, objective conditions (for example, an offer to cover an employee8217s spouse only if the spouse is not eligible for coverage under Medicare or a group health plan sponsored by another employer). Using new codes 1J and 1K, an ALE Member may report a conditional offer to a spouse as an offer of coverage, regardless of whether the spouse meets the reasonable, objective condition. A conditional offer generally would impact a spouse8217s eligibility for the premium tax credit under section 36B only if all conditions to the offer are satisfied (that is, the spouse was actually offered the coverage and eligible for it). To help employees (and spouses) who have received a conditional offer determine their eligibility for the premium tax credit, the ALE Member should be prepared to provide, upon request, a list of any and all conditions applicable to the spousal offer of coverage. As is noted in the definition of dependent in the Definitions section, a spouse is not a dependent for purposes of section 4980H. An ALE Member may not report a conditional offer of coverage to an employee8217s dependents as an offer to the dependents, unless the ALE Member knows that the dependents met the condition to be eligible for the ALE Member8217s coverage. Further, an offer of coverage is treated as made to an employee8217s dependents only if the offer of coverage is made to an unlimited number of dependents regardless of the actual number of dependents, if any, an employee has during any particular calendar month. COBRA continuation coverage. An offer of COBRA continuation coverage is reported differently depending on whether or not the offer is made due to an employee8217s termination of employment. For more information, see IRS.gov. An offer of COBRA continuation coverage that is made to a former employee (or to a former employee8217s spouse or dependents) due to termination of employment should not be reported as an offer of coverage on line 14. In this situation, code 1H (No offer of coverage) must be entered on line 14 for any month for which the offer of COBRA continuation coverage applies, and code 2A (Employee not employed during the month) must be entered on line 16 (see the instructions for line 16), without regard to whether the employee or spouse or dependents enrolled in the COBRA coverage. However, for the month in which the employee terminates employment with the ALE Member, see the instructions for line 16, code 2B. An offer of COBRA continuation coverage that is made to an employee who remains employed by the ALE Member (or to that employee8217s spouse and dependents) should be reported on line 14 as an offer of coverage, but only for any individual who receives an offer of COBRA continuation coverage (or an offer of similar coverage that is made at the same time as the offer of COBRA continuation coverage is made to enrolled individuals). Generally, an offer of COBRA continuation coverage is required to be made only to individuals who were enrolled in coverage and would lose eligibility for coverage due to the COBRA qualifying event, but an ALE Member may choose to extend a similar offer of coverage to a spouse or dependent even if the offer is not required by COBRA. During the applicable open enrollment period for its health plan, Employer makes an offer of minimum essential coverage providing minimum value to Employee and to Employee8217s spouse and dependents. Employee elects to enroll in employee-only coverage starting January 1. On June 1, Employee experiences a reduction in hours that results in loss of eligibility for coverage under the plan. As of June 1, Employer terminates Employee8217s existing coverage and makes an offer of COBRA continuation coverage to Employee, but does not make an offer to Employee8217s spouse and dependents. Employer should enter code 1E (Minimum essential coverage providing minimum value offered to employee and at least minimum essential coverage offered to dependent(s) and spouse) on line 14 for months January 8211 May, and should enter code 1B (Minimum essential coverage providing minimum value offered to employee only) on line 14 for months June 8211 December. Notwithstanding the preceding instructions for completing line 14 of Form 1095-C, for purposes of section 4980H, an ALE Member is treated as having made an offer to the employee8217s dependents for an entire plan year if the ALE Member provided the employee an effective opportunity to enroll the employee8217s dependents at least once for the plan year, even if the employee declined to enroll the dependents in the coverage and, as a result, the dependents later did not receive an offer of COBRA coverage. Post-employment (non-COBRA) coverage. An offer of post-employment coverage to a former employee (or to that former employee8217s spouse or dependent(s)) for coverage that would be effective after the employee has terminated employment (such as at retirement) should not be reported as an offer of coverage on line 14. If the ALE Member is otherwise required to file Form 1095-C for the former employee (because, for example, the individual was a full-time employee for one or more months in the calendar year in which the termination of employment occurred), the ALE Member should enter code 1H (no offer of coverage) on line 14 for any month to which an offer of post-employment coverage applies, and should also enter code 2A (not an employee) on line 16 (see the instructions for line 16). 1A. Qualifying Offer: Minimum essential coverage providing minimum value offered to full-time employee with Employee Required Contribution equal to or less than 9.5 (as adjusted) of mainland single federal poverty line and at least minimum essential coverage offered to spouse and dependent(s). This code may be used to report for specific months for which a Qualifying Offer was made, even if the employee did not receive a Qualifying Offer for all 12 months of the calendar year. However, an ALE Member may not use the Alternative Furnishing Method for an employee who did not receive a Qualifying Offer for all 12 calendar months. 1B. Minimum essential coverage providing minimum value offered to employee only. 1C. Minimum essential coverage providing minimum value offered to employee and at least minimum essential coverage offered to dependent(s) (not spouse). 1D. Minimum essential coverage providing minimum value offered to employee and at least minimum essential coverage offered to spouse (not dependent(s)). Do not use code 1D if the coverage for the spouse was offered conditionally. Instead use code 1J. 1E. Minimum essential coverage providing minimum value offered to employee and at least minimum essential coverage offered to dependent(s) and spouse. Do not use code 1E if the coverage for the spouse was offered conditionally. Instead use code 1K. 1F. Minimum essential coverage NOT providing minimum value offered to employee employee and spouse or dependent(s) or employee, spouse and dependents. 1G. Offer of coverage for at least one month of the calendar year to an individual who was not an employee for any month of the calendar year or to an employee who was not a full-time employee for any month of the calendar year (which may include one or more months in which the individual was not an employee) and who enrolled in self-insured coverage for one or more months of the calendar year. Code 1G applies for the entire year or not at all. Therefore, if code 1G applies, an ALE Member must enter code 1G on line 14 in the 8220 All 12 Months 8221 column or in each separate monthly box (for all 12 months). 1H. No offer of coverage (employee not offered any health coverage or employee offered coverage that is not minimum essential coverage, which may include one or more months in which the individual was not an employee). 1J. Minimum essential coverage providing minimum value offered to employee and at least minimum essential coverage conditionally offered to spouse minimum essential coverage not offered to dependent(s). (See Conditional offer of spousal coverage . above, for an additional description of conditional offers.) 1K. Minimum essential coverage providing minimum value offered to employee at least minimum essential coverage offered to dependents and at least minimum essential coverage conditionally offered to spouse. (See Conditional offer of spousal coverage . above, for an additional description of conditional offers.) Line 15. Complete line 15 only if code 1B, 1C, 1D, 1E, 1J, or 1K is entered on line 14 either in the 8220 All 12 Months 8221 box or in any of the monthly boxes. Enter the amount of the Employee Required Contribution, which is, generally, the employee share of the monthly cost for the lowest-cost self-only minimum essential coverage providing minimum value that is offered to the employee. For additional details on how to determine the Employee Required Contribution, see the Definitions section, later. Enter the amount including any cents. If the employee is offered coverage but the Employee Required Contribution is zero, enter 8220 0.00 8221 (do not leave blank). If the Employee Required Contribution was the same amount for all 12 calendar months, you may enter that monthly amount in the 8220 All 12 Months 8221 box and not complete the monthly boxes. If the Employee Required Contribution was not the same for all 12 months (for instance, if an ALE Member has a non-calendar year plan and the employee share of the premium changes with the new plan year that starts in 2016), enter the amount in each calendar month for which the employee was offered minimum value coverage. See the definition of Employee Required Contribution in the Definitions section, for more information, including on how to determine the monthly required contribution from annual data. For line 15, the amount entered might not be the amount the employee is paying for the coverage, for example, if the employee chose to enroll in more expensive coverage such as family coverage or if the employee is eligible for certain other healthcare arrangements. Line 16. For each calendar month, enter the applicable code, if any, from Code Series 2. Enter only one code from Code Series 2 per calendar month. The instructions below address which code to use for a month if more than one code from Series 2 could apply. If the same code applies for all 12 calendar months, you may enter the code in the 8220 All 12 Months 8221 box and not complete the monthly boxes. If none of the codes apply for a calendar month, leave the line blank for that month. Code Series 28212Section 4980H Safe Harbor Codes and Other Relief for ALE Members. An ALE Member enters the applicable Code Series 2 indicator code, if any, on line 16 to report for one or more months of the calendar year that one of the following situations applied to the employee. The employee was not employed or was not a full-time employee The employee enrolled in the minimum essential coverage offered The employee was in a Limited Non-Assessment Period with respect to section 4980H(b) The ALE Member met one of the section 4980H affordability safe harbors with respect to this employee or The ALE Member was eligible for multiemployer interim rule relief for this employee. If no indicator code applies, leave line 16 blank. In some circumstances more than one indicator code could apply to the same employee in the same month. For example, an employee could be enrolled in health coverage for a particular month during which he or she is not a full-time employee. However, only one code may be used for a particular calendar month. For any month in which an employee enrolled in minimum essential coverage, in general, indicator code 2C reporting enrollment is used instead of any other indicator code that could also apply (but see the exceptions to this rule below, regarding the multiemployer interim rule relief and enrollment in COBRA continuation coverage or other post-employment coverage). For an employee who did not enroll in health coverage, there are some specific ordering rules for which code to use. See the descriptions of the codes. 2A. Employee not employed during the month. Enter code 2A if the employee was not employed on any day of the calendar month. Do not use code 2A for a month if the individual was an employee of the ALE Member on any day of the calendar month. Do not use code 2A for the month during which an employee terminates employment with the ALE Member. 2B. Employee not a full-time employee. Enter code 2B if the employee is not a full-time employee for the month and did not enroll in minimum essential coverage, if offered for the month. Enter code 2B also if the employee is a full-time employee for the month and whose offer of coverage (or coverage if the employee was enrolled) ended before the last day of the month solely because the employee terminated employment during the month (so that the offer of coverage or coverage would have continued if the employee had not terminated employment during the month). 2C. Employee enrolled in health coverage offered. Enter code 2C for any month in which the employee enrolled for each day of the month in health coverage offered by the ALE Member, regardless of whether any other code in Code Series 2 might also apply (for example, the code for a section 4980H affordability safe harbor) except as provided below. Do not enter code 2C in line 16 for any month in which the multiemployer interim rule relief applies (enter code 2E). Do not enter code 2C in line 16 if code 1G is entered in line 14. Do not enter code 2C in line 16 for any month in which a terminated employee is enrolled in COBRA continuation coverage or other post-employment coverage (enter code 2A). Do not enter code 2C in line 16 for any month in which the employee enrolled in coverage that was not minimum essential coverage. 2D. Employee in a section 4980H(b) Limited Non-Assessment Period. Enter code 2D for any month during which an employee is in a section 4980H(b) Limited Non-Assessment Period. If an employee is in an initial measurement period, enter code 2D (employee in a section 4980H(b) Limited Non-Assessment Period) for the month, and not code 2B (employee not a full-time employee). For an employee in a section 4980H(b) Limited Non-Assessment Period for whom the ALE Member is also eligible for the multiemployer interim rule relief for the month, enter code 2E (multiemployer interim rule relief) and not code 2D (employee in a section 4980H(b) Limited Non-Assessment Period). 2E. Multiemployer interim rule relief. Enter code 2E for any month for which the multiemployer arrangement interim guidance applies for that employee, regardless of whether any other code in Code Series 2 (including code 2C) might also apply. This relief is described under Offer of Health Coverage in the Definitions section of these instructions. Note. Although ALE Members may use the section 4980H affordability safe harbors to determine affordability for purposes of the multiemployer arrangement interim guidance, an ALE Member eligible for the relief provided in the multiemployer arrangement interim guidance for a month for an employee should enter code 2E (multiemployer interim rule relief), and not codes 2F, 2G, or 2H (codes for section 4980H affordability safe harbors). 2F. Section 4980H affordability Form W-2 safe harbor. Enter code 2F if the ALE Member used the section 4980H Form W-2 safe harbor to determine affordability for purposes of section 4980H(b) for this employee for the year. If an ALE Member uses this safe harbor for an employee, it must be used for all months of the calendar year for which the employee is offered health coverage. 2G. Section 4980H affordability federal poverty line safe harbor. Enter code 2G if the ALE Member used the section 4980H federal poverty line safe harbor to determine affordability for purposes of section 4980H(b) for this employee for any month(s). 2H. Section 4980H affordability rate of pay safe harbor. Enter code 2H if the ALE Member used the section 4980H rate of pay safe harbor to determine affordability for purposes of section 4980H(b) for this employee for any month(s). An affordability safe harbor code should not be entered on line 16 for any month that the ALE member did not offer minimum essential coverage to at least 95 of its full-time employees and their dependents (that is, any month for which the ALE member checked the 8220 No 8221 box on Form 1094-C, Part III, column (a)). For more information, see the instructions for Form 1094-C, Part III, column (a). References to 9.5 in the section 4980H affordability safe harbors and Qualifying Offer Method are applied based on the percentage as indexed for purposes of applying the affordability thresholds under section 36B (the premium tax credit). The percentage, as adjusted, is 9.56 for plan years beginning in 2015, and 9.66 for plan years beginning in 2016. See Notice 2015-87, QampA 12, at irs.govirb2015-52IRB ar11.html. Part III8212Covered Individuals (Lines 17821122) Complete Part III ONLY if the ALE Member offers employer-sponsored self-insured health coverage in which the employee or other individual enrolled. For this purpose, employer-sponsored self-insured health coverage does not include coverage under a multiemployer plan. Do not complete Part III if the ALE Member offers coverage only under an insured group health plan. If an ALE Member offers both insured and self-insured coverage, complete Part III only for employees who enroll in the self-insured coverage. An ALE Member with a self-insured major medical plan and a health reimbursement arrangement (HRA) that has an individual who enrolls in both types of minimum essential coverage is required to report the individual8217s coverage under only one of the arrangements in Part III. An ALE Member with an insured major medical plan and an HRA that has an individual who enrolls in both types of minimum essential coverage is not required to report in Part III the HRA coverage of an individual if the individual is eligible for the HRA because the individual enrolled in the insured major medical plan. An ALE Member with an HRA must report coverage under the HRA in Part III for any individual who is not enrolled in a major medical plan of the ALE Member (for example, if the individual is enrolled in a group health plan of another employer (such as spousal coverage)). For additional information on the reporting of supplemental coverage, see Proposed Regulations section 1.6055-1(d)(2) and (3). If the ALE Member is completing Part III, enter 8220 X 8221 in the check box in Part III. If the ALE Member is not completing Part III, do not enter 8220 X 8221 in the check box in Part III. This part must be completed by an ALE Member offering self-insured health coverage for any individual who was an employee for one or more calendar months of the year, whether full-time or non-full-time, and who enrolled in the coverage. The employee (if enrolled in self-insured coverage) should be listed on line 17 any other family members who enrolled in coverage offered to the employee should be listed on subsequent lines. All employee family members that are covered individuals through the employee8217s enrollment (for example, because the employee elected family coverage) must be included on the same form as the employee (or any other individual to whom the offer was made). For example, if the employee is offered family coverage by his or her employer under a self-insured health plan and enrolls in the family coverage, the employee and the employee8217s family members that are covered under the plan must all be reported on the same Form 1095-C. If two or more employees employed by the same ALE Member are spouses or an employee and his or her dependent, and one employee enrolled in a coverage option under the plan that also covered the other employee(s) (for example, one employee spouse enrolled in family coverage that provided coverage to the other employee spouse and their employee dependent child), the enrollment information should be reflected only on Form 1095-C for the employee who enrolled in the coverage. (However, it would report the other employee family members as covered individuals). Coverage of Non-Employee. This part may be completed by an ALE Member offering self-insured health coverage for any other individual who enrolled in the coverage under the plan for one or more calendar months of the year but was not an employee for any calendar month of the year, such as a non-employee director, a retired employee who retired in a previous year, a terminated employee receiving COBRA continuation coverage (or any other form of post-employment coverage) who terminated employment during a previous year, and a non-employee COBRA beneficiary (but not including an individual who obtained coverage through the employee8217s enrollment, such as a spouse or dependent obtaining coverage when an employee elects COBRA continuation coverage that is family coverage). If Form 1095-C is used with respect to an individual who was not an employee for any month of the calendar year, Part II must be completed by using code 1G in the 8220 All 12 Months 8221 box or the separate monthly boxes for all 12 calendar months. The employer must report for these individuals using Form 1095-B, if it chooses not to use Form 1095-C. If a non-employee individual enrolls in the coverage under a self-insured health plan, all family members that are covered individuals because of the individual8217s enrollment must be included on the same Form 1095-B or Form 1095-C as the individual who is offered, and enrolls in, the coverage. Columns (a) through (e), as applicable, must be completed for each individual enrolled in the coverage, including the employee reported on line 1. Enter the nine-digit SSN or other TIN for each covered individual in column (b). Enter a date of birth in column (c) only if an SSN or other TIN is not entered in column (b). Column (d) will be checked if the individual was covered for at least one day in every month of the year. For individuals who were covered for some but not all months, information will be entered in column (e) indicating the months for which these individuals were covered. If there are more than 6 covered individuals, complete this information on the additional covered individuals on Part III Covered Individuals 8212 Continuation Sheet(s). Do not count the continuation sheet(s) as additional Forms 1095-C in the count of forms submitted with the accompanying Form 1094-C. Governmental Unit employers offering self-insured health coverage that have delegated another governmental unit (DGE) for purposes of reporting and furnishing enrollment information (meaning the information that otherwise would be reported on Form 1095-C, Part III), but have not designated a DGE for purposes of reporting and furnishing offer of coverage information (meaning the information that is reported on Form 1095-C, Part II), should file and furnish Forms 1095-C with a completed Part I and Part II, but not a completed Part III, and should not check the box indicating that the Governmental Unit offers self-insured health coverage . In this case, the DGE should file Forms 1094-B and 1095-B to report enrollment information for employees on behalf of the Governmental Unit. See FAQs on IRS.gov. A DGE that has been delegated by a Governmental Unit for purposes of reporting and furnishing both offer of coverage and enrollment information (meaning the information that would be reported on Parts II and III of Form 1095-C) should file Forms 1094-C and 1095-C to report the information for employees on behalf of the Governmental Unit. Column (a). Enter the name of each covered individual (including the employee, if the employee is enrolled in self-insured coverage). Column (b). Enter the 9-digit SSN for each covered individual, including the dashes. For covered individuals who are not the employee listed in Part I, a taxpayer identification number (TIN), rather than an SSN, may be entered if the covered individual does not have an SSN, or the field may be left blank if the covered individual does not have a TIN. Column (c). Enter a date of birth (YYYY-MM-DD) for the covered individual only if column (b) is blank. Column (d). Check this box if the individual was covered for at least one day per month for all 12 months of the calendar year. Column (e). If the individual was not covered for all 12 months of the calendar year, check the applicable box(es) for the month(s) in which the individual was covered for at least one day in the month. This section contains the definitions of key terms used in Forms 1094-C and 1095-C and these instructions. For definitions of terms not included in this section, see the final regulations under section 4980H, T.D. 9655, 2014-9 I.R.B. 541, at irs.govirb2014-9IRBar05.html and section 6056, T.D. 9661, 2014-13 I.R.B. 855, at irs.govirb2014-13IRBar09.html. Aggregated ALE Group. An Aggregated ALE Group refers to a group of ALE Members treated as a single employer under section 414(b), 414(c), 414(m), or 414(o). An ALE Member is a member of an Aggregated ALE Group for a month if it is treated as a single employer with the other members of the group on any day of the calendar month. If an ALE is made up of only one person or entity, that one ALE Member is not a part of an Aggregated ALE Group. Government entities and churches or conventions or associations of churches may apply a reasonable, good faith interpretation of the aggregation rules under section 414 in determining their status as an ALE or member of an Aggregated ALE Group. For more information on how the aggregation rules apply to government entity employers, see Notice 2015821187, QampA 18, at irs.govirb2015821152IRBar11.html. Applicable Large Employer (ALE). An ALE is, for a particular calendar year, any single employer, or group of employers treated as an Aggregated ALE Group, that employed an average of at least 50 full-time employees (including full-time equivalent employees) on business days during the preceding calendar year. For purposes of determining an employer8217s average number of employees, disregard an employee for any month in which the employee has coverage under a plan described in section 4980H(c)(2)(F) (generally, TRICARE or Veterans Administration coverage). A new employer (that is, an employer that was not in existence on any business day in the prior calendar year) is an ALE for the current calendar year if it reasonably expects to employ, and actually does employ, an average of at least 50 full-time employees (including full-time equivalent employees) on business days during the current calendar year. For information on a special rule for certain employers with seasonal workers, see the final regulations under section 4980H and FAQs on IRS.gov. Applicable Large Employer Member (ALE Member). An ALE Member is a single person or entity that is an ALE, or if applicable, each person or entity that is a member of an Aggregated ALE Group. A person or entity that does not have employees or only has employees with no hours of service (for example, only employees whose entire service consists of work outside of the United States that does not count as hours of service under section 4980H) is not an ALE Member. Bona fide volunteer. A bona fide volunteer is an employee of a government entity or tax-exempt organization whose only compensation from that entity or organization is (1) reimbursement for (or reasonable allowance for) reasonable expenses incurred in the performance of services by volunteers, or (2) reasonable benefits (including length of service awards), and nominal fees, customarily paid by similar entities in connection with the performance of services by volunteers. COBRA continuation coverage. COBRA continuation coverage is health coverage that is required to be offered under the Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA) in certain circumstances in which an employee or other individual covered under a health plan loses eligibility for coverage under that health plan (for example, because the employee terminates employment or has a reduction in hours). For purposes of these instructions, COBRA continuation coverage also includes coverage required under any other federal or state law that provides continuation coverage comparable to that provided under COBRA. For additional details, see section 4980B and Regulations sections 54.4980B-1 through 54.4980B-10. Dependent. A dependent is an employee8217s child, including a child who has been legally adopted or legally placed for adoption with the employee, who has not reached age 26. A child reaches age 26 on the 26th anniversary of the date the child was born and is treated as a dependent for the entire calendar month during which he or she reaches age 26. For this purpose, a dependent does not include stepchildren, foster children, or a child that does not reside in the United States (or a country contiguous to the United States) and who is not a United States citizen or national. For this purpose, a dependent does not include a spouse. Designated Governmental Entity (DGE). A DGE is a person or persons that are part of or related to the Governmental Unit that is the ALE Member and that is appropriately designated for purposes of these reporting requirements. For a Governmental Unit that has delegated some or all of its reporting responsibilities to a DGE for some or all of its employees, one Authoritative Transmittal must still be filed for that Governmental Unit reporting aggregate employer-level data for all employees of the Governmental Unit (including those for whom the Governmental Unit has delegated its reporting responsibilities). For more information, see Authoritative Transmittal for Employers Filing Multiple Forms 1094-C . Eligible Employer-Sponsored Plan. An eligible employer-sponsored plan refers to group health coverage for employees under (1) a governmental plan, such as the Federal Employees Health Benefits Program (FEHB), (2) an insured plan or coverage offered in the small or large group market within a state, (3) a grandfathered health plan offered in a group market, or (4) a self-insured group health plan for employees. Employee. An employee is an individual who is an employee under the common-law standard for determining employer-employee relationships. An employee does not include a sole proprietor, a partner in a partnership, an S corporation shareholder who owns at least 2-percent of the S corporation, a leased employee within the meaning of section 414(n), or a worker that is a qualified real estate agent or direct seller. If an employee is an employee of more than one ALE Member of the same Aggregated ALE Group during a calendar month, the employee is treated as an employee of the ALE Member for whom the employee has the greatest number of hours of service for that calendar month if the employee has an equal number of hours of service for two or more ALE Members of the same Aggregated ALE Group for the calendar month, those ALE Members must treat one of the ALE Members as the employer of that employee for that calendar month. See One Form 1095-C for Each Employee of Each Employer for a discussion of reporting in these circumstances. See Pub.15-A, Employer8217s Supplemental Tax Guide, for more information on determining who is an employee. In certain circumstances, an employee may have a break in service (including a break in service due to a termination of employment) during which the individual does not earn hours of service, but upon beginning to earn hours of service again the ALE Member must treat the individual as a continuing employee rather than a new hire for purposes of certain rules under the regulations under section 4980H. See Regulations sections 54.4980H-3(c)(4) and 54.4980H-3(d)(6). These rules do not impact whether the individual was an employee during the break in service, so the individual should only be treated as an employee during the break in service for purposes of reporting if the individual remained an employee during that period (and had not terminated employment with the ALE Member). For example, an employee on unpaid leave during the break in service would be treated as an employee for reporting purposes during the break in service, while a former employee whose employment had been terminated during the break in service would not be treated as an employee for reporting purposes. Employee Required Contribution. The Employee Required Contribution is the employee8217s share of the monthly cost for the lowest-cost self-only minimum essential coverage providing minimum value that is offered to the employee by the ALE Member. The employee share is the portion of the monthly cost that would be paid by the employee for self-only coverage, whether paid through salary reduction or otherwise. For purposes of determining the amount of the employee8217s share of the monthly cost, an ALE Member may divide the total cost to the employee for the plan year by the number of months in the plan year. This monthly amount of the employee8217s share of the cost would then be reported for any months of that plan year that fall within the 2016 calendar year. For example, if the plan year begins January 1, the ALE Member may determine the amount to report for each month by taking the total annual employee cost for all 12 months and dividing by 12. If the plan year begins April 1, the ALE Member may determine the amount to report for January through March, 2016, by taking the total annual employee cost for the plan year ending March 31, 2016, and dividing by 12 (and reporting that amount for January, February, and March 2016). Then the ALE Member may determine the monthly amount for April through December, 2016 by taking the total annual employee cost for the plan year ending March 31, 2017, and dividing by 12 (and reporting that amount for April through December 2016). The Employee Required Contribution may not be the amount the employee paid for coverage. For additional rules on determining the amount of the Employee Required Contribution, including for cases in which an ALE Member makes available certain HRA contributions, cafeteria plan contributions, wellness program incentives, and opt-out payments, see Regulations sections1.5000A-3(e)(3)(ii) and 1.36B-2(c)(3)(v)(A). Also see Notice 2015-87. Employer. For purposes of these instructions, an employer is the person that is the employer of an employee under the common-law standard for determining employer-employee relationships and that is subject to the employer shared responsibility provisions of section 4980H (these employers are referred to as ALE Members). For more information on which employers are ALE Members, see the definitions of Applicable Large Employer (ALE) and Applicable Large Employer Member (ALE Member). Full-time employee. For purposes of Forms 1094-C and 1095-C, the term 8220 full-time employee 8221 means a full-time employee as defined under section 4980H and the related regulations, rather than any other definition of that term that the ALE Member may use for other purposes. Accordingly, a full-time employee is an employee who, for a calendar month, is determined to be a full-time employee under either the monthly measurement method or the look-back measurement method (as applicable to that employee). The monthly measurement method and the look-back measurement method are the two methods provided under the section 4980H regulations for determining whether an employee has sufficient hours of service to be a full-time employee. Under the monthly measurement method, a full-time employee is an employee who was employed an average of at least 30 hours of service per week with the ALE Member during a calendar month. Under the look-back measurement method, an employee is a full-time employee for each month of the stability period selected by the ALE Member if the employee was employed an average of least 30 hours of service per week with the ALE Member during the measurement period preceding that stability period. (The look-back measurement method for identifying full-time employees is available only for purposes of determining and computing liability under section 4980H, and not for purposes of determining if the employer is an Applicable Large Employer.) For purposes of both methods, 130 hours of service in a calendar month is treated as the monthly equivalent of at least 30 hours of service per week. An ALE Member must report complete information for all 12 months of the calendar year for any of its employees who were full-time employees for one or more months of the calendar year. For more information on the identification of full-time employees, including discussion of the monthly measurement method and the look-back measurement method, and the rules for when an ALE Member may use one or both methods, see Regulations sections 54.4980H-1(a)(21) and 54.4980H-3 and Notice 2014-49, 2014-41 I.R.B. 66 (describing a proposed approach to the application of the look-back measurement method in situations in which the measurement period applicable to an employee changes). A former employee (for example, a retiree) is not a full-time employee for any month after termination of employment with the ALE Member. However, if the former employee was a full-time employee for any month of the calendar year (for example, before retiring mid-year), the ALE Member must complete information in Part II of Form 1095-C for all 12 months of the calendar year, using the appropriate codes. An ALE Member need not file a Form 1095-C for an individual who for each month of a calendar year is either not an employee of the ALE Member or is an employee in a Limited Non-Assessment Period with respect to section 4980H(b). However, for the months in which the employee was an employee of the ALE Member, such an employee would be included in the total employee count reported on Form 1094-C, Part III, column (c). Also, if during the Limited Non-Assessment Period the employee enrolled in coverage under a self-insured employer-sponsored plan, the ALE Member must file a Form 1095-C for the employee to report coverage information for the year. Full-time equivalent employees. A combination of employees, each of whom individually is not treated as a full-time employee because he or she is not employed on average at least 30 hours of service per week with an employer, but who, in combination, are counted as the equivalent of a full-time employee solely for purposes of determining whether the employer is an ALE. For rules on how to determine full-time equivalent employees, see Regulations section 54.4980H-2(c). Governmental Unit and Agency or Instrumentality of a Governmental Unit. A Governmental Unit is the government of the United States, any State or political subdivision thereof, or any Indian tribal government (as defined in section 7701(a)(40)) or subdivision of an Indian tribal government (as defined in section 7871(d)). For purposes of these instructions, references to a Governmental Unit include an Agency or Instrumentality of a Governmental Unit. Until guidance is issued that defines the term Agency or Instrumentality of a Governmental Unit for purposes of section 6056, an entity may determine whether it is an Agency or Instrumentality of a Governmental Unit based on a reasonable and good faith interpretation of existing rules relating to agency or instrumentality determinations for other federal tax purposes. Health coverage. As used in these instructions, health coverage refers to minimum essential coverage, unless otherwise indicated. Hours of service. An hour of service is each hour for which an employee is paid, or entitled to payment, for the performance of duties for the employer, and each hour for which an employee is paid, or entitled to payment, for a period of time during which no duties are performed due to vacation, holiday, illness, incapacity (including disability), layoff, jury duty, military duty, or leave of absence. An hour of service does not include any hour of service performed as a bona fide volunteer of a government entity or tax-exempt entity, as part of a Federal Work-Study Program (or a substantially similar program of a State or political subdivision thereof) or to the extent the compensation for services performed constitutes income from sources outside the United States. For additional rules for determining hours of service, see Regulations sections 54.4980H-1(a)(24), 54.4980H-3(b) and Notice 2015821187, QampA 14, at irs.govirb2015821152IRBar11.html. See section VI of the preamble to the section 4980H regulations for a discussion of determination of hours of service for categories of employees for whom the general rules for determining hours of service may present special difficulties (including adjunct faculty and commissioned salespeople) and certain categories of work hours associated with some positions of employment, including layover hours (for example, for certain airline employees), on-call hours, and work performed by an individual who is subject to a vow of poverty as a member of a religious order. Limited Non-Assessment Period. A Limited Non-Assessment Period generally refers to a period during which an ALE Member will not be subject to an assessable payment under section 4980H(a), and in certain cases section 4980H(b), for a full-time employee, regardless of whether that employee is offered health coverage during that period. The first five periods described below are Limited Non-Assessment Periods with respect to sections 4980H(a) and 4980H(b) only if the employee is offered health coverage by the first day of the first month following the end of the period. Also, the first five periods described below are Limited Non-Assessment Periods for section 4980H(b) only if the health coverage that is offered at the end of the period provides minimum value. For more information on Limited Non-Assessment Periods and the application of section 4980H, see Regulations section 54.4980H-1(a)(26). First Year as ALE Period. January through March of the first calendar year in which an employer is an ALE, but only for an employee who was not offered health coverage by the employer at any point during the prior calendar year. Waiting Period under the Monthly Measurement Method. If an ALE Member is using the monthly measurement method to determine whether an employee is a full-time employee, the period beginning with the first full calendar month in which the employee is first otherwise (but for completion of the waiting period) eligible for an offer of health coverage and ending no later than two full calendar months after the end of that first calendar month. Waiting Period under the Look-Back Measurement Method. If an ALE Member is using the look-back measurement method to determine whether an employee is a full-time employee and the employee is reasonably expected to be a full-time employee at his or her start date, the period beginning on the employee8217s start date and ending not later than the end of the employee8217s third full calendar month of employment. Initial Measurement Period and Associated Administrative Period under the Look-Back Measurement Method. If an ALE Member is using the look-back measurement method to determine whether a new employee is a full-time employee, and the employee is a variable hour employee, seasonal employee or part-time employee, the initial measurement period for that employee and the administrative period immediately following the end of that initial measurement period. Period Following Change in Status that Occurs During Initial Measurement Period Under the Look-Back Measurement Method. If an ALE Member is using the look-back measurement method to determine whether a new employee is a full-time employee, and, as of the employee8217s start date, the employee is a variable hour employee, seasonal employee or part-time employee, but, during the initial measurement period, the employee has a change in employment status such that, if the employee had begun employment in the new position or status, the employee would have reasonably been expected to be a full-time employee, the period beginning on the date of the employee8217s change in employment status and ending not later than the end of the third full calendar month following the change in employment status. If the employee is a full-time employee based on the initial measurement period and the associated stability period starts sooner than the end of the third full calendar month following the change in employment status, this Limited Non-Assessment Period ends on the day before the first day of that associated stability period. First Calendar Month of Employment. If the employee8217s first day of employment is a day other than the first day of the calendar month, then the employee8217s first calendar month of employment is a Limited Non-Assessment Period. Minimum essential coverage (MEC). Although various types of health coverage may qualify as minimum essential coverage, for purposes of these instructions, minimum essential coverage refers to health coverage under an eligible employer-sponsored plan. For more details on minimum essential coverage, see Minimum essential coverage in Pub. 974. Minimum value. A plan provides minimum value if the plan pays at least 60 of the costs of benefits for a standard population and provides substantial coverage of inpatient hospitalization services and physician services. An offer of coverage under a plan that fails to provide substantial coverage of inpatient hospitalization and physician services should be reported on Form 1095-C as not providing minimum value, even if an employer qualifies for the section 4980H transition rule under Notice 2014-69, 2014-48 I.R.B. 903 at irs.govirb2014-48IRBar07.html. Offer of health coverage. An ALE Member makes an offer of coverage to an employee if it provides the employee an effective opportunity to enroll in the health coverage (or to decline that coverage) at least once for each plan year. For this purpose, the plan year must be 12 consecutive months unless a short plan year of less than 12 consecutive months is permitted for a valid business purpose. An ALE Member makes an offer of health coverage to an employee for the plan year if it continues the employee8217s election of coverage from a prior year but provides the employee an effective opportunity to opt out of the health coverage. If an ALE Member provides health coverage to an employee but does not provide the employee an effective opportunity to decline the coverage, the ALE Member is treated as having made an offer of health coverage to the employee only if that health coverage provides minimum value and does not have an Employee Required Contribution for the coverage for any calendar month of more than 9.5 (as adjusted) of a monthly amount determined as the mainland federal poverty line for a single individual for the applicable calendar year, divided by 12. For purposes of reporting, an offer to a spouse includes an offer to a spouse that is subject to one or more reasonable, objective conditions, regardless of whether the reasonable, objective conditions are satisfied. For example, an offer of coverage that is available to a spouse only if the spouse certifies that the spouse does not have access to health coverage from another employer is treated as an offer of coverage to the spouse for reporting purposes. Note that this treatment is for reporting purposes only, and generally will not affect the spouse8217s eligibility for the premium tax credit if the spouse did not meet the condition and therefore did not have an actual offer of coverage. A conditional offer to a spouse is reported by entering code 1J or 1K (as applicable) on line 14 of Form 1095-C. See the instructions for line 14 for more information. An offer to a dependent does not include an offer to a dependent that is subject to one or more reasonable, objective conditions unless the dependent satisfies the conditions and the dependent actually had an offer of coverage. In addition, an offer of coverage is treated as made to an employee8217s dependents only if the offer of coverage is made to an unlimited number of dependents regardless of the actual number of dependents, if any, an employee has during any particular calendar month. An ALE Member offers health coverage for a month only if it offers health coverage that would provide coverage for every day of that calendar month. For reporting purposes, this means that an offer of coverage does not occur for a month if an employee8217s employment terminates before the last day of a calendar month and the health coverage also ends before the last day of that calendar month (or for an employee who did not enroll in coverage, the coverage would have ended if the employee had enrolled in coverage). However, see the description of Code Series 28212Section 4980H Safe Harbor Codes and Other Relief for Employers, code 2B which may be applicable in these circumstances to indicate that the ALE Member is treated as having offered coverage for the entire month for purposes of section 4980H. An ALE Member offers health coverage to an employee if it, or another employer in the Aggregated ALE Group, or a third party such as a multiemployer or single employer Taft-Hartley plan, a multiple employer welfare arrangement (MEWA), or, in certain cases, a staffing firm, offers health coverage on behalf of the employer. See Regulations sections 54.4980H-4(b)(2) and 54.4980H-5(b). Interim Guidance Regarding Multiemployer Arrangements. An ALE Member is treated as offering health coverage to an employee if the ALE Member is required by a collective bargaining agreement or related participation agreement to make contributions for that employee to a multiemployer plan that offers, to individuals who satisfy the plan8217s eligibility conditions, health coverage that is affordable and provides minimum value, and that also offers health coverage to those individuals8217 dependents (or is eligible for the section 4980H transition relief regarding offers of coverage to dependents, if applicable for certain calendar months in 2016. See Section 4980H Transition Relief for 2015 Plan Years). For more information, see section XV.E of the preamble to the final regulations under section 4980H. This relief is referred to as the multiemployer arrangement interim guidance and the multiemployer interim rule relief in these instructions. Qualifying Offer. A Qualifying Offer is an offer of MEC providing minimum value to one or more full-time employees for all calendar months during the calendar year for which the employee was a full-time employee for whom a section 4980H assessable payment could apply, with an Employee Required Contribution for each month not exceeding 9.5 (as adjusted) of the mainland single federal poverty line divided by 12, provided that the offer includes an offer of MEC to the employee8217s spouse and dependents (if any). Section 4980H TransitionRelief for 2015 Plan Years Several forms of transition relief under section 4980H were available to ALE Members for 2015. Only certain of these forms of transition relief continue to apply in 2016, and they apply only for certain ALE Members and only for certain calendar months in 2016. This section describes these types of section 4980H transition relief that continue to apply and how an ALE Member reports its eligibility for each type of relief. The transition relief described in this section is solely for the ALE Member for purposes of section 4980H and does not affect the employee8217s potential eligibility for the premium tax credit. Accordingly, regardless of whether the ALE Member is eligible for relief under section 4980H for an employee for one or more months, the Form 1095-C for that employee must accurately report the health coverage offered to that employee (if any) during that period, including, if applicable, the Employee Required Contribution. For more details regarding this section 4980H transition relief, see section XV of the preamble to the final regulations under section 4980H. 2015 Plan Year Section 4980H Transition Relief Based on Number of Full-Time Employees (Form 1094-C, Line 22, Box C, and Form 1094-C, Lines 23-35, Column (e)) An employer may be eligible for one of the two types of 2015 plan year transition relief under section 4980H based on the employer8217s number of full-time employees (and full-time equivalent employees) if certain conditions described below are met. One of these two types of 2015 transition relief under section 4980H is for employers with 50 to 99 full-time employees and the other type of relief is for employers with 100 or more full-time employees (in each case including full-time equivalent employees). Eligibility for this transition relief is reported on Form 1094-C, line 22, box C, and the specific form of relief for which the employer is eligible must be reported on Form 1094-C, lines 23821135, column (e), using either code A (50-99 Transition Relief) or code B (100 or more Transition Relief). An employer eligible for this relief for certain calendar months in 2016 is still subject to the Forms 1094-C and 1095-C reporting requirements for all months of 2016, including the calendar months in the 2015 plan year. For purposes of determining eligibility for either of these types of section 4980H transition relief, the number of full-time employees (including full-time equivalent employees) for 2015 is determined in the same way that an employer determines whether it is an ALE (including using employment and hours of service data from 2014) and is calculated for the Aggregated ALE Group (rather than for each ALE Member). For the 2016 calendar year, the transition relief described below (50-99 Transition Relief and 100 or more Transition Relief) is applicable only if the ALE Member, or any member of an ALE Member8217s Aggregated ALE Group, if applicable, offers coverage under a health plan with a plan year beginning on a date other than January 1 (a non-calendar year plan year), and only with respect to calendar months in 2016 that fall within the plan year that began in the 2015 calendar year (the 2015 plan year). If an ALE Member, or different members in an Aggregated ALE Group, offer coverage under more than one health plan with different plan years, the transition relief applies through the last day of the latest of those plan years, for all ALE Members in the Aggregated ALE Group, if applicable. Employer A and Employer B are ALE Members in the same Aggregated ALE Group. Employer A offers coverage through Health Plan A, with a plan year beginning January 1 and ending December 31. Employer B offers coverage through Health Plan B, with a plan year beginning July 1 and ending June 30. If otherwise eligible for either of the forms of the transition relief described below (50-99 Transition Relief and 100 or more Transition Relief), both Employer A and Employer B may rely on that transition relief for the months January through June 2016 (including with respect to employees who were offered coverage under Health Plan A but not Health Plan B). 1. 2015 Plan Year Section 4980H Transition Relief for ALEs with Fewer Than 100 Full-Time Employees, Including Full-Time Equivalent Employees (50-99 Transition Relief). For an ALE Member with at least one plan with a non-calendar year plan year or for an ALE Member that is a member of an Aggregated ALE Group with at least one plan with a non-calendar year plan year, if the ALE Member is eligible for this 2015 plan year transition relief, no assessable payment under section 4980H(a) or (b) will apply for any calendar month in 2016 that falls within the 2015 plan year. If any ALE Member, or different members in an Aggregated ALE Group, offer coverage under more than one health plan with different plan years, the transition relief applies through the last day of the latest of those plan years, for all ALE Members in the Aggregated ALE Group, if applicable. To certify that an employer is eligible for this transition relief it must have met the following conditions: The employer is an ALE or is part of an Aggregated ALE Group that had 50 to 99 full-time employees, including full-time equivalent employees, on business days in 2014 During the period of February 9, 2014, through December 31, 2014, the ALE or the Aggregated ALE Group of which the employer is a member did not reduce the size of its workforce or reduce the overall hours of service of its employees in order to qualify for the transition relief and During the period of February 9, 2014, through the last day of the 2015 plan year, the ALE or Aggregated ALE Group of which the employer is a member does not eliminate or materially reduce the health coverage, if any, it offered as of February 9, 2014. As of February 9, 2014, Employer A (which is an ALE with only one ALE Member) sponsors a group health plan with a plan year that begins April 1 under which 40 of its full-time employees a re offered health coverage that provides minimum value and with an employer contribution of 300 per month for employee-only coverage. The offer of health coverage is affordable for some, but not all, of Employer A8217s full-time employees. During the period from February 9, 2014, through December 31, 2014, two of Employer A8217s employees voluntarily terminate employment and Employer A terminates three employees because of the non-renewal of a customer contract but does not otherwise reduce the size of its workforce or reduce any employee8217s hours of service. If those five employees had continued in employment throughout 2014, the employer would have had an average of 100 full-time employees (including full-time equivalent employees) on business days in 2014. However, as a result of the terminations, it had an average of only 97 full-time employees (including full-time equivalent employees) for business days in 2014. During the period of February 9, 2014, through March 31, 2016, Employer A does not change the eligibility requirements for the group health plan (including not amending it to eliminate its existing health coverage for dependents) and continues to make an employer contribution of 300 per month toward the cost of employee-only coverage that provides minimum value. Employer A certifies in a timely manner as to its eligibility for the transition relief Employer A is eligible for the transition relief for January 2016 through March 2016. 2. 2015 Plan Year Transition Relief for Calculation of Assessable Payments Under Section 4980H(a) for ALEs with 100 or More Full-Time Employees, Including Full-Time Equivalent Employees (100 or More Transition Relief). This relief applies for an ALE Member with at least one plan with a non-calendar year plan year and for an ALE Member that is a member of an Aggregated ALE Group with at least one plan with a non-calendar year plan year. For such an ALE Member, for the calendar months in 2016 that fall within the 2015 plan year, if the employer is an ALE or is part of an Aggregated ALE Group that had 100 or more full-time employees (including full-time equivalent employees) on business days in 2014, and is subject to an assessable payment under section 4980H(a) for any month(s) in 2016 that fall within the 2015 plan year, the assessable payment under section 4980H(a) is calculated by reducing the ALE Member8217s number of full-time employees by the ALE Member8217s allocable share of 80 (rather than by the ALE Member8217s standard allocable share of 30). If an ALE Member, or different members in an Aggregated ALE Group, offer coverage under more than one health plan with different plan years, the transition relief applies through the last day of the latest of those plan years, for all ALE Members in the Aggregated ALE Group, if applicable. For the rules on how the 80 employee reduction is allocated among the employers in an Aggregated ALE Group, see Regulations section 54.4980H-4(e). 2015 Plan Year Section 4980H(a) Transition Relief if an Offer of Health Coverage is Made to at least 70 Percent of Full-Time Employees (Form 1094-C, Lines 23821135, Column (a)) For an ALE Member with at least one plan with a non-calendar year plan year, for the calendar months in 2016 that fall within the 2015 plan year, an employer that offers health coverage to at least 70 of its full-time employees (and their dependents) may, on Form 1094-C, lines 23821135, column (a), enter an 8220 X 8221 in the 8220 Yes 8221 checkbox for the month(s) during which it met that 70-percent threshold, as applicable. If the ALE Member offers coverage under more than one health plan with different plan years, the transition relief applies through the last day of the latest of those plan years. 2015 Plan Year Section 4980H(a) Transition Relief for Certain Arrangements that do not Offer Health Coverage for Dependents (Form 1094-C, Lines 23821135, Column (a)) Solely for purposes of section 4980H, an employer may treat an offer of health coverage to a full-time employee but not his or her dependents under a non-calendar year plan as an offer of health coverage to the full-time employee and his or her dependents for the calendar months in 2016 that fall within the 2015 plan year, if the employer takes steps during the 2015 plan year to extend coverage under the plan to dependents not offered coverage during the 2013 or 2014 plan years (or both) and if the employee was not offered dependent health coverage during the 2013 or 2014 plan year. An employer using this transition relief for any month in 2016 is not eligible to report using the Qualifying Offer Method for 2016. This relief does not apply for purposes of reporting offers of coverage to dependents on Form 1095-C. Interim guidance regarding multiemployer arrangements. For a description of multiemployer arrangement interim guidance which relates to the treatment of certain coverage provided through a multiemployer arrangement, see Offer of health coverage in the Definitions section. Privacy Act and Paperwork Reduction Act Notice. We ask for the information on these forms to carry out the Internal Revenue laws of the United States and the Patient Protection and Affordable Care Act. Our legal right to ask for the information on this form is Internal Revenue Code sections 6055, 6056, 4980H and their regulations. We request it to confirm that you are providing your employees offers of, and enrollment in, health coverage and to determine the employer shared responsibility payments and eligibility of your employees for premium tax credits. If you do not provide this information, we may be unable to determine whether your employees are entitled to premium tax credits. Providing false or fraudulent information may subject you to penalties. We may disclose this information to the Department of Justice for civil or criminal litigation and to cities, states, and the District of Columbia for use in administering their tax laws. We may also disclose this information to other countries under a tax treaty, to Federal and state agencies to enforce Federal nontax criminal laws, or to Federal law enforcement and intelligence agencies to combat terrorism. You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential, as required by section 6103. The time needed to complete and file this form will vary depending on individual circumstances. The estimated average time is:Employers with 50 to 99 Employees: Do You Qualify for One-Year Delay of Pay-or-Play Penalties Written by Lisa Klinger, J.D. amp Susan Grassli, J.D. Background Under the Affordable Care Act (ACA) Employer Shared Responsibility provisions (also known as the Employer Mandate), a large employer is exposed to possible penalties (under IRC section 4980H) if it does not offer affordable and adequate health coverage to substantially all full-time employees. A large employer is defined as one who employed on average at least 50 full-time employees or full-time employee equivalents on business days in the prior calendar year. However, one type of transition relief in the final regulations (issued in February 2014) is that smaller large employers who employ 50-99 full-time employees or full-time employee equivalents will qualify for a one-year delay to 2016 if they certify they meet specific requirements. Certification is provided by checking a box on Form 1094-C, but employers need to understand exactly what they are certifying to. This article explains the certification requirements and includes a worksheet to assist in determining whether an employer qualifies for the certification. Employers are not required to submit the worksheet with the Form 1094-C it is only to help an employer determine if it qualifies for the one-year delay for small employers. Form 1094-C is one of the forms large employers will use to comply with Large Employer Information Reporting requirements under IRC section 6056. Even though employers with 50-99 employees who qualify for the certification are not subject to penalties under IRC section 4980H (Employer Shared Responsibility penalties) for 2015, they are subject to the IRC section 6056 Large Employer Information reporting requirements as of January 1, 2015. Thus, smaller large employers will file Form 1094-C for purposes of both information reporting and certifying that they qualify for this transition rule. (For more information about Large Employer Reporting Provisions, see our March 7, 2014 article entitled: Final Regs Simplify 6056 Information Reporting for Large Employers, at news.leavitthealth-care-reformfinal-regs-simplify-irc-section-6056-information-reporting-large-employers our July 28, 2014 article entitled: IRS Issues Draft Forms for Health Coverage Information Reporting by Employers at news.leavitthealth-care-reformirs-issues-draft-forms-health-coverage-information-reporting-employers ) and our August 29, 2014 article entitled: Short Summary of IRC 6056 Information Reporting Requirements at news.leavitthealth-care-reformshort-summary-irc-6056-information-reporting-requirements ) Certification for Employers with 50 to 99 Full-Time Employees To certify that it qualifies for Section 4980H Transition Relief (Employer Shared Responsibility penalties), an employer with 50-99 full-time employees will check Box C on Form 1094-C in Part II, line 22, and will use indicator code A (50- 99 Transition Relief) in Part III, Line 23, column (e). A summary of the requirements below is on page 11 of the draft 2014 Instructions for Forms 1094-C and 1095-C, which can be found at irs.govpubirs-dfti109495c8211dft.pdf. The employer itself may be an applicable large employer (ALE) or may be part of an Aggregated ALE Group. Employers only qualify for the transition rule if they can certify to the following: Workforce size Employer had on average 50-99 full-time employees (and full-time equivalents) on business days in 2014. No reduction in workforce or overall hours The employer did not reduce its workforce size or reduce employees overall hours between February 9, 2014 and December 31, 2014, in order to qualify for the transition relief. A workforce reduction due to bona fide business reasons is allowed however. For example, changes due to a sale of a division, economic changes in the industry or geographic area, termination for poor performance, or other similar changes unrelated to eligibility for the transition relief. No reduction or elimination of health coverage Employer maintained the health coverage it offered, if any, as of February 9, 2014. For calendar-year plans, the employer must maintain the coverage through December 31, 2015 and for non-calendar year plans, the period is February 9, 2014 through the last day of the 2015 plan year. An employer with the following will be deemed not to have eliminated or materially reduced health coverage: The employer contribution for employee-only coverage continues to be at least 95 of the dollar amount the employer paid on February 9th, or at least the same percentage of the total cost if the cost increases after February 9th If the employer changes the benefits offered for employee-only coverage, the new coverage must provide at least minimum value after the change The employer did not reduce or narrow the class of employees (and dependents) who are eligible Example: On February 9, 2014, an employer was contributing 300 per month for employee-only coverage that cost 400 per month. The new plan year began July 1, 2014 and the cost of employee-only coverage increased to 425 per month. The employer continues to offer to contribute 300 per month for the plan year beginning on July 1, 2014. The 25.00 increase in cost to the employee will not be treated for this purpose as an elimination or material reduction of health coverage offered because the employer contribution continues to be at least 95 of the dollar amount paid on February 9, 2014 (in fact the employer continues to pay 100 of what it previously paid.) Certification by Employers Who have Not Been Providing Coverage It appears that employers with 50-99 employees who have not been offering coverage can still certify and therefore wait until 2016 before exposure to Employer Shared Responsibility penalties. The Preamble to the final regulations (in section XV.D.6 ) states: The Treasury Department and the IRS understand that application of section 4980H will involve changes for applicable large employers that did not previously offer coverage, or that did not offer affordable, minimum value coverage. A large percentage of those employers are in the smaller size range, such as those with fewer than 100 fulltime employees (including FTEs). To assist these employers in transitioning into compliance with section 4980H, the transition relief described below is provided for all of 2015 plus, in the case of any non-calendar plan year that begins in 2015 (2015 plan year), the portion of that 2015 plan year that falls in 2016. Note: An IRS regulator informally indicated at a conference that an employer who has not been offering coverage cannot qualify for the one-year delay. However, the specific language in the preamble seems to say that employers with 50-99 employees who have not been offering coverage can still certify. Compliance Deadlines The certification is due at the same time as Large Employer Reporting. Large employer reporting is due the first quarter of 2016, but the reporting is for the period January 1 December 31, 2015. This means that even though employers with 50- 99 full-time employees do NOT have to comply with Employer Shared Responsibility until 2016, they must still comply with Large Employer Reporting provisions as of January 1, 2015. The specific due dates for employer reporting and certification in the first quarter of 2016 are February 28, 2016 for the 2015 calendar year, and March 31 if the form 1094-C is filed electronically. Here is a link to the PDF of this article which also contains the Worksheet: 50-99 Delay ER Worksheet amp Article 9-30-14 Get the full white paper of this article, including the employee worksheet.
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