Reg. § 301.6056-1 Rules relating to reporting by applicable large employers on health insurance coverage offered under employer-sponsored plans.
(a) In general Section requires an applicable large employer subject to the requirements of section to report certain health insurance coverage information to the Internal Revenue Service, and to furnish certain related employee statements to its full-time employees. of this section contains definitions for purposes of this section. of this section prescribes general rules for filing the required information with the IRS and furnishing the required employee statements to employees. and of this section describe the information required to be reported on a section information return and the time and manner for filing. of this section provides information about the statement required to be furnished to a full-time employee. of this section prescribes the time and manner of furnishing the statement, including extensions of time to furnish, to a full-time employee. Paragraph (h) addresses corrections of returns. of this section describes the information return penalties applicable to section returns. of this section describes alternative reporting methods available to certain applicable large employers with certain employees. of this section describes certain special rules applicable to applicable large employers that are governmental units.
(b) Definitions
(1) In general The definitions in this apply for purposes of this section.
(2) Applicable large employer The term applicable large employer has the same meaning as in section and .
(3) Applicable large employer member The term applicable large employer member has the same meaning as in .
(4) Dependent The term dependent has the same meaning as in .
(5) Eligible employer-sponsored plan The term eligible employer-sponsored plan has the same meaning as in section and .
(6) Full-time employee The term full-time employee has the same meaning as in section and , as applied to the determination and calculation of liability under section and (b) with respect to any individual employee, and not as applied to the determination of status as an applicable large employer, if different.
(7) Governmental unit The term governmental unit refers to the government of the United States, any State or political subdivision thereof, or any Indian tribal government (as defined in section ) or subdivision of an Indian tribal government (as defined in section ).
(8) Agency or instrumentality of a governmental unit [Reserved]
(9) Minimum essential coverage The term minimum essential coverage has the same meaning as in section and the regulations issued under that section.
(10) Minimum value The term minimum value has the same meaning as in section and any applicable regulations.
(11) Person The term person has the same meaning as in section and applicable regulations.
(c) Content and timing of reporting by applicable large employer members
(1) In general Each applicable large employer member required to make a return and furnish a related statement to its full-time employees under section for a calendar year must make a return and furnish the related statement using such form(s) as may be prescribed by the Internal Revenue Service. An applicable large employer member will satisfy its reporting requirements under section if it files with the Internal Revenue Service a return for each full-time employee using Form 1095-C or another form the IRS designates, and a transmittal form using Form 1094-C or another form the IRS designates, as prescribed in this section and in the instructions to the forms. Each Form 1095-C and the transmittal Form 1094-C will together constitute an information return to be filed with the Internal Revenue Service.
(2) Reporting facilitated by third parties A separate section information return must be filed for each applicable large employer member. If more than one section information return is being filed for an applicable large employer member, there must be one authoritative section transmittal (Form 1094-C) reporting aggregate employer-level data for all full-time employees of the applicable large employer member, in accordance with forms and instructions. Additionally, there must be only one section employee statement (Form 1095-C) for each full-time employee with respect to that full-time employee's employment with the applicable large employer member, so that all required information for a particular full-time employee of the applicable large employer member is reflected on a single Form 1095-C.
(d) Information required to be reported to the Internal Revenue Service
(1) In general Except as provided in of this section (relating to alternative reporting methods for eligible applicable large employer members), every applicable large employer member must make a section information return with respect to each full-time employee. Each section information return must show—
(i) The name, address, and employer identification number of the applicable large employer member,
(ii) The name and telephone number of the applicable large employer member's contact person,
(iii) The calendar year for which the information is reported,
(iv) A certification as to whether the applicable large employer member offered to its full-time employees (and their dependents) the opportunity to enroll in minimum essential coverage under an eligible employer-sponsored plan, by calendar month,
(v) The months during the calendar year for which minimum essential coverage under the plan was available,
(vi) Each full-time employee's share of the lowest cost monthly premium (self-only) for coverage providing minimum value offered to that full-time employee under an eligible employer-sponsored plan, by calendar month;
(vii) The number of full-time employees for each month during the calendar year,
(viii) The name, address, and taxpayer identification number of each full-time employee during the calendar year and the months, if any, during which the employee was covered under the plan, and
(ix) Any other information specified in forms, instructions, or published guidance, see and .
(2) Form of the return A return required under this may be made on Forms 1094-C and 1095-C or other form(s) designated by the Internal Revenue Service, or a substitute form. A substitute form must include the information required to be reported on Forms 1094-C and 1095-C and must comply with applicable revenue procedures or other published guidance relating to substitute statements. See .
(e) Time and manner for filing return An applicable large employer member must file the return and transmittal form required under of this section on or before February 28 (March 31 if filed electronically) of the year succeeding the calendar year to which it relates in accordance with any applicable guidance and the instructions to the form. An applicable large employer member must file the return and transmittal form at the address specified on the return form or its instructions. For extensions of time for filing returns under this section, see and . See for rules relating to electronic filing.
(f) Statements required to be furnished to full-time employees
(1) In general Except as provided in of this section, every applicable large employer member required to file a return under section must furnish to each of its full-time employees identified on the return a written statement showing—
(i) The name, address and employer identification number of the applicable large employer member, and
(ii) The information required to be shown on the section return with respect to the full-time employee.
(2) Form of the statement A statement required under this may be made either by furnishing to the full-time employee a copy of Form 1095-C or another form the IRS designates as prescribed in this section and in the instructions to such forms, or a substitute statement. A substitute statement must include the information required to be shown on the return filed with the IRS and must comply with requirements in published guidance (see ) relating to substitute statements. An IRS truncated taxpayer identification number may be used as the identifying number for an individual in lieu of the identifying number appearing on the corresponding information return filed with the IRS.
(g) Time and manner for furnishing statements
(1) Time for furnishing —Except as otherwise provided in this , each statement required by this section for a calendar year must be furnished to a full-time employee on or before January 31 of the year succeeding the calendar year in accordance with applicable Internal Revenue Service procedures and instructions. Applicable large employers are granted an automatic, 30-day extension of time in which to furnish these statements.
(2) Manner of furnishing If mailed, the statement must be sent to the full-time employee's last known permanent address or, if no permanent address is known, to the employee's temporary address. For purposes of this , an applicable large employer member's first class mailing to the last known permanent address, or if no permanent address is known, the temporary address, discharges the requirement to furnish the statement. An applicable large employer member may furnish the statement electronically in accordance with .
(h) Correction of returns See .
(i) Penalties
(1) In general For provisions relating to the penalty for failure to file timely a correct information return required under section , see section and the regulations under that section. For provisions relating to the penalty for failure to furnish timely a correct statement to full-time employees required under section , see section and the regulations under that section. See section and the regulations under that section for rules relating to the waiver of penalties if a failure to file timely or accurately is due to reasonable cause and is not due to willful neglect.
(2) Application of section 6721 and 6722 penalties to section 6056 reporting For purposes of section reporting, if the information reported on a return (including a transmittal) or a statement required by this section is incomplete or incorrect as a result of a change in circumstances (such as a retroactive change in coverage), a failure to timely file or furnish a corrected document is a failure to file or furnish a correct return or statement under sections and .
(j) Alternative reporting methods for eligible applicable large employer members In lieu of the general reporting method described in of this section, eligible applicable large employer members may use the following alternative reporting methods described in this .
(1) Certification of qualifying offer An applicable large employer member is an eligible applicable large employer member and is treated as meeting its reporting obligation under section if:
(i) The applicable large employer member certifies on the section transmittal form, in accordance with the form and the instructions to the form, that it made a qualifying offer. A qualifying offer is an offer to one or more of its full-time employees for all months during the year for which the employee was a full-time employee and which are not within a limited nonassessment period (as defined in ), of minimum essential coverage providing minimum value at an employee cost for employee-only coverage not exceeding 9.5 percent of the mainland single federal poverty line, and that includes an offer of minimum essential coverage to the employees' spouses and dependents. For this purpose, the applicable federal poverty line is the federal poverty line as defined in , as calculated and applied to the 48 contiguous states and the District of Columbia;
(ii) The applicable large employer member provides on the Form 1095-C or other form as designated by the IRS, in accordance with the form and the instructions to the form, the information with respect to each full-time employee to whom a qualifying offer, as defined in of this section, is made for all twelve months of the applicable calendar year;
(iii) The applicable large employer member provides a statement to each full-time employee to whom a qualifying offer (as defined in of this section) was made for all twelve months of the applicable calendar year, in such form and manner as prescribed by the Secretary, or a copy of the Form 1095-C filed with the IRS with respect to that full-time employee; and
(D) The applicable large employer member files section returns and furnishes section employee statements with respect to all other full-time employees under the general reporting method described in of this section, in accordance with forms and instructions.
(2) Option to report without separate identification of full-time employees if certain conditions related to offers of coverage are satisfied (98 percent offers) An applicable large employer member that otherwise meets its reporting obligation under section is not required to identify on its section return whether a particular employee is a full-time employee for one or more calendar months of the reporting year or report the total number of its full-time employees for the reporting year, if it certifies that it offered minimum essential coverage providing minimum value that was affordable under section to at least 98 percent of the employees (and their dependents) with respect to whom it reports for purposes of section in accordance with of this section (regardless of whether the employee is a full-time employee for purposes of section for a calendar month during the year).
(k) Special rules for governmental units
(1) Person appropriately designated In the case of any applicable large employer member that is a governmental unit or any agency or instrumentality thereof, the person or persons appropriately designated under section for purposes of the filing and furnishing requirements of section must be part of or related to the same governmental unit as the applicable large employer member. The applicable large employer member must make (or revoke) the designation before the earlier of the deadline for filing the returns or furnishing the statements required by this section. A person that has been appropriately designated under section must file a separate section return and transmittal for each applicable large employer member for which the person is reporting. The person appropriately designated under section assumes responsibility for the section requirements on behalf of the applicable large employer member for which the person is designated. Notwithstanding the designation, a separate section information return must be filed for each applicable large employer member that is a governmental unit. If more than one section information return is being filed for an applicable large employer member, there must be one authoritative section transmittal (Form 1094-C) reporting aggregate employer-level data for all full-time employees of the applicable large employer member, in accordance with forms and instructions. In addition, notwithstanding the designation, there must be only one section employee statement (Form 1095-C) for each full-time employee with respect to that full-time employee's employment with the applicable large employer member, so that all required information for a particular full-time employee of the applicable large employer member is reflected on a single Form 1095-C.
(2) Written designation The designation under section must be made in writing, must be signed by both the applicable large employer member and the designated person, and must be effective under all applicable laws. The designation must set forth the name, address, and employer identification number of the designated person, and appoint such person as the person responsible for reporting under section on behalf of the applicable large employer member. The designation must contain information identifying the category of full-time employees (which may be full-time employees eligible for a specified health plan, or in a particular job category, as long as the specific employees covered by the designation can be identified) for which the designated person is responsible for reporting under section on behalf of the applicable large employer member. If the designated person is responsible for reporting under section for all full-time employees of an applicable large employer member, the designation must so indicate. The designation must contain language that the designated person agrees and certifies that it is the appropriately designated person under section , and an acknowledgement that the designated person is responsible for reporting under section on behalf of the applicable large employer member and subject to the requirements of section , including for purposes of information reporting requirements under sections , , and . The designation must also set forth the name and employer identification number of the applicable large employer member, identifying the applicable large employer member as the person subject to the requirements of section . An equivalent applicable statutory or regulatory designation containing the language described in this will be treated as a written designation for purposes of section and this section. The designation will not be submitted to the IRS and should be maintained under the normal record-retention rules under section .
(3) Application to alternative reporting methods A person designated under this may use the alternative reporting method identified in of this section for the full-time employees for which it is reporting with respect to a particular governmental unit if that particular governmental unit meets the eligibility requirements with respect to those employees, but may use the alternative reporting method identified in of this section only if the governmental unit on whose behalf it is reporting would itself be eligible to use that alternative reporting method.
(l) Additional guidance The Commissioner may prescribe additional guidance of general applicability, published in the Internal Revenue Bulletin (see ) to provide additional rules under section , including rules permitting use of alternative optional methods to meet reporting requirements.
(m) Applicability date Except as otherwise provided in this , this section applies for calendar years beginning after December 31, 2014. of this section applies for calendar years beginning after December 31, 2021, but applicable large employers may choose to apply of this section for calendar years beginning after December 31, 2020. Except as otherwise provided in this , paragraph (g)(1), as contained in 26 CFR part 1 edition revised as of April 1, 2021, applies to calendar years ending after December 31, 2014, and beginning before January 1, 2022.
[T.D. 9661, 79 FR 13247, Mar. 10, 2014, as amended by T.D. 9970, 87 FR 76576, Dec. 15, 2022; 88 FR 14259, Mar. 8, 2023]