IRS Publishes Final ACA Forms and Instructions for 2023

The IRS has published final forms and instructions for insurance companies and employers to use for calendar year 2023 Affordable Care Act (ACA) reporting due in early 2024.  These include the following:

• Form 1095-B, Form 1094-B transmittal cover sheet, and instructions
  • These are mostly used by insurance companies to report who was enrolled in their fully insured plans at any point in 2023
  • These are also used by employers who were too small during calendar year 2022 to be deemed an applicable large employer (non-ALE) for calendar year 2023 and sponsored health plans that were not fully insured for some or all of 2023 (level funded, self-funded, etc.)
• Form 1095-C, Form 1094-C transmittal cover sheet, and instructions
  • These are solely used by applicable large employers (ALEs) to report who was full-time in 2023
  • When the plan is not fully insured for some or all of 2023 (level funded, self-funded, etc.), then information on everyone enrolled at any point in 2023 is provided in Part III of the 1095-C

Note there are no material changes to these forms or instructions from last year, other than the previously announced change that virtually every employer must file electronically going forward.  The formatting instructions for sending to the IRS should be ignored, as paper filings are no longer available and electronic filing is mandatory.

The 1095 forms are required to be provided to individuals 30 days after January 31.  Since 2024 is a leap year, that makes the deadline March 1, 2024.  However, there is a special rule that doesn’t require mailing 1095-B forms to individuals as long as proper notice is publicly posted to explain how individuals may obtain their 1095-B.

E-filings are due to the IRS by Monday, April 1, 2024 (as March 31 is a Sunday).

It is more important than ever employers not only audit the forms being generated on their behalf for submission to the IRS, but also audit the XML files for accuracy and completeness, too.  Employers are strongly encouraged to keep copies of all forms, XML files, and proof of e-filing in their records.  There is currently no statute of limitations on investigating and penalizing employers for incorrect or incomplete filings, so it would appear necessary to keep these records indefinitely along with the supporting documentation relied upon to generate accurate and complete forms.

IMA will continue to monitor regulator guidance and offer meaningful, practical, timely information. This material should not be considered as a substitute for legal, tax and/or actuarial advice. Contact the appropriate professional counsel for such matters. These materials are not exhaustive and are subject to possible changes in applicable laws, rules, and regulations and their interpretations.