Seven Questions Employees Will Ask About the ACA 1095s

You did it! The 1095 forms are ready and going out to employees. Now what?

You guessed it: Rampant employee confusion. You’re going to get some questions. If you’re the one in charge of providing the answers, remember a great offense is the best defense. You’ll want to answer the most common questions before they’re even asked.

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We’ve put together a list of some basic things employees will want to know, along with sample answers. Tweak these Q&As as needed for your organization. Once you’ve assembled them, push them out to employees using every channel you can (mail, e-mail, employee meetings, company website, social media, posters). Tell employees how to get more detailed information if they need it.

[Related: Certificate in Health Plan Navigation provides the information you need to support your plan participants in making the best health care choices.]

Employee questions about the 1095s:

  1. What is this form I’m receiving?
    A 1095 form is a little bit like a W-2 form. Your employer or insurer sends one copy to the Internal Revenue Service (IRS) and one copy to you. A W-2 form reports your annual earnings. A 1095 form reports your health care coverage throughout the year.
  1. Who is sending it to me, when, and how?blog-marketbox_CHPN
    Your employer or health insurance company should send one to you either by mail or in person. They may send the form to you electronically if you gave them permission to do so. You should receive it by March 31, 2016. (Starting in 2017, you should receive it each year by January 31, just like your W-2.)
  1. Why are you sending it to me?
    The 1095 forms will show that you and your family members either did or did not have health coverage during each month of the past year. Because of the Affordable Care Act, every person must obtain health insurance or pay a penalty to the IRS.
  1. What am I supposed to do with this form?
    Keep it for your tax records. You don’t actually need this form in order to file your taxes, but when you do file, you’ll have to tell the IRS whether or not you had health insurance for each month of 2015. The Form 1095-B or 1095-C shows if you had health insurance through your employer. Since you don’t actually need this form to file your taxes, you don’t have to wait to receive it if you already know what months you did or didn’t have health insurance in 2015. When you do get the form, keep it with your other 2015 tax information in case you should need it in the future to help prove you had health insurance.
  1. What if I get more than one 1095 form?
    Someone who had health insurance through more than one employer during the year may receive a 1095-B or 1095-C from each employer. Some employees may receive a Form 1095-A and/or 1095-B reporting specific health coverage details. Just keep these—you do not need to send them in with your 2015 taxes.
  1. What if I did not get a Form 1095-B or a 1095-C?
    If you believe you should have received one but did not, contact the Benefits Department by phone or e-mail at this number or address.
  1. I have more questions—who do I contact?
    Please contact _____  at ____. You can also go to our website and find more detailed questions and answers. An IRS website called Questions and Answers about Health Care Information Forms for Individuals (Forms 1095-A, 1095-B, and 1095-C) covers most of what you need to know.


Still working on your ACA reporting? Watch Final Preparation for Filing the 1094/1095 on demand in ACA University and check out these previous Word on Benefits Posts:

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Lois Gleason, CEBS
Lois Mathis-Gleason, CEBS
Manager, Reference/Research Services at the International Foundation

 

 

 

 

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