Penalties Increase for Individuals and for Employers under Obamacare (Affordable Care Act)

As promised, Obamacare taxes and penalties for not having health insurance are on the rise.  The following is a summary of  what to know:

Individual Health Care Penalties

The penalty for not having minimum essential coverage [MEC, ACA defined] in 2016 will increase to the following:

· The greater of (a) 2.5% of taxpayer’s household income over the filing threshold or (b) $695 per person ($347.50 per child under age 18) ($2,085 per family whichever is higher) OR the cost of the national average premium for a Bronze level health plan.
· Remember to save your 1095-A if you are a part of the Exchange. You should receive in January 2016 and will need it for your tax return.

Note : Open enrollment for 2016 coverage begins on November 1, 2015.

Employer Health Care Penalties

The Trade Preferences Extension Act of 2015 significantly increases penalties for companies failing to file correct information, returns, or provide correct payee statements. Penalties increased from $100 to $250 per return or statement with a cap increase up to $3 million.
Beginning in 2016, all companies with 50 or more Full Time Equivalent employees [FTE, defined by ACA] are required to report to the IRS whether they offer their FTE and their qualified dependents the opportunity to enroll in MEC under an employer-sponsored plan. Companies are required to file a transmittal report (Form 1094-C) which summarizes the Forms 1095-C which must be provided for each FTE employee who was employed for one or more months during 2015.

Employers who have fewer than 50 FTE but who sponsor a self-insured group plan must also file reports 1094-B for transmittal and a 1095-B to each employee.

Information that must reported to the IRS includes:
· The name, address, and employer identification number of the provider.
· The statement recipient’s name, address, and taxpayer identification number, or date of birth if a TIN is not available. If the statement recipient is not enrolled in the coverage, providers may, but are not required to, report the TIN.
· The name and TIN, or date of birth if a TIN is not available, of each individual covered under the policy or program and the months for which the individual was enrolled in coverage and entitled to receive benefits.

Employers should have steps and infrastructure in place to gather information reflecting coverage offered in plan year 2015, which can include monthly tracking.

Information you need to track:
· Date coverage is offered
· Proof of offering
· Employee Share of the Lowest Cost Monthly Premium for Self-only Coverage

Important Dates to Note:
· February 1, 2016 – Employee Statements are due
· February 29, 2016 – IRS Statements due if filing by paper
· March 31, 2016 – IRS Statements due if filing electronically (must file electronically if filing 250 or more forms)

Note: Employers who have fewer than 50 FTE and are not offering a self-insured group plan have no filing requirements.