During Affordable Care Act (ACA) reporting season, some employers wonder whether reporting on 1095-C forms is required for retirees receiving employer-provided health coverage.

8-18_retirees-receiving-health-coverage

Internal Revenue Code Section 6055 requires every provider of minimum essential coverage to report coverage information to the Internal Revenue Service (IRS) and to furnish a statement to individuals receiving coverage. This includes all retirees receiving coverage. The information is used by the IRS to administer, and by individuals to show compliance with, the ACA individual shared responsibility provision. The coverage information is usually reported on Form 1095-C, Section III.

The IRS instructions provide specific details on reporting coverage for retirees that worked at least one month during the past year on page 11, and for retirees that have not worked in the past year on page 13. Retirees that did not work in the past year are categorized as non-employees.

Note:

The Tax Cuts and Jobs Act enacted in 2017 keeps the individual mandate in place for 2017 and 2018 before reducing the individual penalty dollar amount to zero in 2019.

Resources:

IRS Questions and Answers on Information Reporting by Health Coverage Providers (Section 6055)
(See Questions 5, 6, and 7)

IRS 2018 Instructions for Forms 1094-C and 1095-C
(See Post-employment (non-COBRA) coverage on page 11, and Coverage of Non-Employee on page 13)

Information Reporting of Minimum Essential Coverage, Internal Revenue Service; Final Rule, Federal Register, March 10, 2014

The Tax Bill And The Individual Mandate: What Happened, And What Does It Mean? Health Affairs

Developed by International Foundation Information Center staff. This does not constitute legal advice. Please consult your plan professionals for legal advice.


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

Lois Gleason, CEBS

Instructional Designer, Online Learning at the International Foundation

Favorite Foundation service/product: The Employee Benefits Survey (conducted every few years; it is very comprehensive)

Benefits-related topic top picks: Affordable Care Act, multiemployer pension plans

Favorite Foundation conference moment: Working the bookstore/information center at the Employee Benefit Symposium and meeting our members

Personal Insight: When she’s away from work, Lois likes to dive into 19th century Brit lit novels by Dickens, Eliot, Hardy and the Bronte sisters. These works are spicy and action-packed when compared to the employee benefit rules and regulations she reviews all day.

2 thoughts on “Retirees Receiving Health Coverage: Must We Report Them?

  1. Brian Mosdale

    Does my wife need to file 1095 health insurance coverage if she hasn’t worked in years and on SSI?

  2. Dinah L Byerley

    how do i get my 1095c for tax purposes to show i had health benefits in 2020 after i retired in 2019.

Comments are closed.

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