On December 23, 2024, President Biden signed two laws intended to reduce the reporting burden under the Affordable Care Act (“ACA”) for employers and group health plans—the Paperwork Burden Reduction Act (“PBRA”) and the Employer Reporting Improvement Act (“ERIA”). Under the ACA, applicable large employers (ALEs)—generally those with 50 or more full-time employees—and self-insured group health plans must provide the IRS and covered individuals with information regarding whether the health coverage they provide is considered minimum essential coverage. ALEs using the 1095-C form and self-insured plans using the 1095-B form generally must submit the required information to the IRS on or before March 31 of the year following the calendar year of coverage. ALEs and self-insured plans must provide covered individuals with the 1095-B and 1095-C, respectively, by March 2 (or the next business day).
PBRA
Under the PBRA, ALEs and self-insured plans are no longer required to send the applicable form to covered individuals unless requested. If the covered individual requests the 1095-B or 1095-C form, the ALE or self-insured plan must provide that form by the later of January 31 or 30 days after the date of the request. To take advantage of this flexibility, ALEs and self-insured plans must provide the covered individual with a clear, conspicuous, and accessible notice informing them that they may request a copy of the 1095-B or 1095-C form. Previous guidance from the IRS allowed plans to avoid automatically sending the Form 1095-B if they posted notice of its availability on the plan website. The PBRA extends this treatment to employers and also appears to permit the notice to be provided in another format, including for plans that do not maintain websites.
ERIA
The ERIA permits greater flexibility to plans and employers by providing for the following:
Tax Identification Number (TIN) Flexibility: Under IRS guidance, an individual’s date of birth may be substituted for the individual’s TIN if the TIN is not available. The ERIA codifies that option.
Electronic Forms: The ERIA codifies existing IRS guidance that 1095-B or 1095-C forms may be sent to a covered individual electronically if the covered individual previously consented to receiving the form electronically.
Extended Time to Respond to Penalty Notification: Under the ERIA, ALEs will have 90 days (previously ALEs had 30 days unless an extension was granted) to respond to the first letter from the IRS notifying the ALE of the proposed employer shared responsibility assessment.
Statute of Limitation of Penalty Assessment: The ERIA establishes a six-year statute of limitations for imposing a penalty on ALEs for failure to offer affordable coverage. This provision applies to returns that are due after December 31, 2024.
Please contact Slevin & Hart for more information about how this legislation may affect your plan.
This publication is intended to provide general information only, and is not intended to provide legal advice. The distribution of our publications is not intended to create, and receipt of them does not constitute, an attorney-client relationship. Permission is granted to make and redistribute, without charge, copies of this entire document provided that such copies are complete and unaltered and identify Slevin & Hart, P.C. as the author. All other rights reserved.