Supporting Affordable Care Act (ACA) 1094-C and 1095-C

By Craig Babigian

The Affordable Care Act (ACA) continues to be a major concern and challenge for many small and medium-sized businesses, leading them to seek help from PEOs and ASOs.

Beginning in 2016, the ACA requires 1094-C and 1095-C forms to be filed with the IRS, depending on the number of full-time equivalents (FTEs) in your client’s organization. Failing to do so could result in significant fines and penalties.

Our PEO and ASO customers often ask us how PrismHR supports 1094-C and 1095-C reporting requirements. Before we get to that, let’s review the purpose of forms 1094-C and 1095-C.

What is Form 1094-C?

Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, provides a summary of the coverage offered and employee enrollment. This includes a detailed account of your client’s FTEs, total organization headcount, the number of 1095-C forms to be filed and more.

Think of form 1094-C as a cover letter or a summary of all of the 1095-C forms.

What is Form 1095-C?

Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, is a form delivered to the employee from the employer.

1095-C shows the coverage offered to the employee, lowest cost premium available to the employee, the months that coverage was available and more. All employees eligible for coverage (for one month or more), should receive 1095-C, regardless of whether they participated in the plan offered by the employer.

How PrismHR Helps with 1094-C and 1095-C Reporting

PrismHR helps you and your clients adhere to 1094-C and 1095-C reporting requirements. By applying historic benefits and employee data to your individual client’s configuration, PrismHR intelligently determines how to complete the 1094-C and 1095-C forms.

The flexible PrismHR approach allows you to apply changes at a global level and override those changes at a client level, where needed. And, if you have incomplete data within our HR platform, you can import and manually enter data to fill the gaps.

Once you have all of the necessary data, it is combined and placed into a destination file. From there, the platform automatically generates the 1094-C and 1095-C forms that you can distribute as PDFs or ship off to a third party print provider.

For more information on how PrismHR can help you support your clients with ACA, contact us.