What is an IRS Form 1095B and can I ask the Fund to send me a copy?
For several years after passage of the Affordable Care Act of 2010, individuals who failed to maintain healthcare coverage during a tax year were required to report this on their IRS Form 1040 and pay an Individual Mandate tax penalty. The Benefits Fund was required to report the months on which it provided coverage to both the member and to the IRS. However, the Individual Mandate penalty was repealed as of 2019. Since most members will not need month-to-month coverage verification, the Benefits Fund will no longer be obligated to automatically issue Form 1095B.
The Benefits Fund is still required to report month-to-month coverage provided to each member to the government and can provide such information to you upon written request. You may need this information if you had received “Premium Tax Credits” for ACA Marketplace coverage during the tax year.
The
IRS has many extensive
explanations posted
on its website on
the many ACA topics.
The IRS webpages specifically
explaining the Form
1095 series information
returns can be followed
here:
https://www.irs.gov/Affordable-Care-Act/Individuals-and-Families.
Is medical coverage through
the Benefits Fund
“minimal essential
coverage”?
All medical
plans provided by
the Benefits Fund are
considered to be “minimum
essential coverage”.
Each month of coverage
provided to each member
of your family by
the Benefits Fund is
shown on IRS Form
1095B.
What information can
the Fund provide to
a large employer who is
required to report
on whether “Affordable”
coverage of “Minimum
Value” is provided
to its employees in
connection with the
“Employer Mandate”?
The ACA contains
provisions which may
allow the IRS to impose
penalties under the
employer shared responsibility
provisions of the
ACA (the so-called
“Employer Mandate
Penalty”). Employers
with less than 50
“full-time equivalent”
(FTE) employees are
not subject to this
provision, but those with 50 or more FTE employees are required to file annual reports with the government declaring whether they offer coverage. If an employer
questions how it determines
whether it has 50
or more FTE employees,
or believes it may
qualify for transitional
relief, it should
seek advice from its
tax consultant or
refer to guidance
published by the IRS
in Q&A format
found here
.
Beginning in the 2016
tax season, large
employers became obligated
to submit IRS Informational
Forms 1094-C and 1095-C
to enable the IRS
to examine whether
they offered affordable
coverage of a minimum
value to substantially
all its full time
employees. The
Fund does not have
information needed
to establish whether
an employer provides
“Affordable”
coverage. The law
does not obligate
the Fund to prepare
these forms for contributing
employers because
some of the participant
and dependent information
possessed by the Fund
is private and other
information is not
possessed by the Fund.
However the Fund can
confirm that from
2014 to the present
all its medical plans
satisfy the ACA “Minimum
Value” standard.
Does the Benefits Fund
impose a waiting period
in excess of 90-Days?
No. This
is relevant because
the ACA prohibits
plans from imposing
waiting periods in
excess of 90-Days.
The terms of the Benefits
Fund provide that
an employee is covered
on the first day of
the second month after
the employee has satisfied
any applicable work
(compensable service)
requirement specified
for the covered classification
as defined in the
applicable collective
bargaining agreement.
CBAs of different
employers set forth
numerous job classifications,
such as full-time,
part-time, casual,
trainee, apprentice,
temporary, probationary,
and summer help. CBAs
are negotiated by
employers and labor
unions to provide
different compensation
and rights to employees
performing different
functions.
Since the Benefits Fund provides
coverage no more than
61-Days after an employee
is otherwise eligible
to be enrolled after
satisfying the applicable
CBA’s substantive
requirement for eligibility, the Benefits Fund does not impose a waiting period in excess of 90-Days.
Are employers
required to report
the cost of health
coverage on IRS
Form W-2s they issue
to employees covered
under this multiemployer
fund?
Since
the IRS has granted
employers who contribute
to multiemployer
plans a temporary
W2 reporting exception
for health coverage
provided by multiemployer
plans, the Benefits
Fund does not report
the cost of medical
coverage.
The IRS states reporting
requirements for
multiemployer fund
contributions may
change in the future,
but as of this time,
W-2 reporting is
voluntary with respect
to employees receiving
health care coverage
through a multiemployer
fund.
While
not legally required,
an employer can
voluntarily report
the “medical
only” COBRA
rate provided by
the Benefits Fund
on the W-2. The
IRS Affordable Care
Act Tax Provisions
Home Page states
that the amount
reported does not
affect tax liability,
as the value of
the employer excludible
contribution to
health coverage
continues to be
excludible from
an employee's income,
and it is not taxable.
This reporting is
for informational
purposes only, to
show employees the
value of their health
care benefits.
For
additional information
see the article
on the IRS website:
Form
W-2 Reporting of
Employer-Sponsored
Health Coverage