Self-Insured Employers Must File Health Coverage Information Returns

InsightsClient Alert

Regardless of size, all employers that provide self-insured health coverage to their employees must file an annual return reporting certain information for each employee they cover. In accordance with the Affordable Care Act, these forms are used to report certain information to taxpayers as well as the IRS about individuals who are covered by minimum essential coverage and therefore not liable for the individual shared responsibility payment.

These employers must:

  • For those self-insured employers with fewer than 50 full-time or full-time equivalent employees in the preceding calendar year, file Form 1095-B, Health Coverage, with the IRS, accompanied by a Form 1094-B transmittal. Large employers should use Forms 1095-C and 1094-C instead. Filers of more than 250 Forms 1095-B must e-file. All others are encouraged to e-file.
  • Furnish a copy of the 1095-B to the responsible individual – generally the primary insured.

The information reporting requirements are first effective for coverage provided in 2015. Thus, these employers will file information returns with the IRS in 2016, and will furnish statements to individuals in 2016, to report coverage information in calendar year 2015.

Required reporting includes:

  • Name, address and employer identification number of provider.
  • Responsible individual’s name, address, and taxpayer identification number (or date of birth if TIN unavailable).
  • Name and TIN (or date of birth if TIN unavailable) of each individual covered under the program and months for which the individual was enrolled in coverage and entitled to receive benefits.

For more information review IRS Publication 5215 at Or, if you have questions, please contact our Albany office at (229) 883-7878 or our Atlanta office at (404) 220-8494.