News & Updates
Under the Affordable Care Act (ACA or health care reform law), U.S. citizens and legal residents must have basic health insurance or face a penalty. This basic insurance is called minimum essential coverage (MEC). Many people already get coverage that counts as MEC through their employers. Those who don’t have it may have to pay a penalty to the Internal Revenue Service (IRS). It’s called the individual shared responsibility payment.
Reporting for individual and fully insured (FI) group business
Employers, insurance companies and others who provide MEC will be required to report who’s covered with them to the IRS. This is called Minimum Essential Coverage Reporting, or IRS Code Section 6055 Reporting, and it will take place each year. This is how the federal government will make sure people have MEC. It’s also how the IRS will determine who may owe a penalty for not having coverage.
Self-funded or Administrative Services Only (ASO) groups are also responsible for filing their own reports, using form 1095-C.
Collecting Social Security numbers
As required by law, Anthem now files the 1095-B form for their fully insured groups and send a copy to the plan members. When Anthem sends the IRS reports, they’ll list all individuals covered under a group’s plan by their Social Security numbers (SSNs). For some of Anthem's members and dependents, they are missing their SSNs. In these cases, the IRS requires carriers to collect them for reporting purposes. In June, a staggered mailing began and will continue through the summer and early fall to gather this data.
As a reminder, ASO groups are responsible for getting the SSNs from workers and their dependents. They can hire a third party to do the reporting for them, but the employer is responsible for the report being complete and correct. Anthem will not act as the third party for ASO groups and will not file the report for a fee.
For more details about MEC and IRS reporting, read this fact sheet.
For additional questions, please contact a member of your b&p Sales Team - 888.722.3373.