Revised January 11, 2017
State Payroll Processing Centers: Reporting Requirements for Health Insurance
As a state payroll processing center, you may be responsible under the federal Affordable Care Act (ACA) for reporting the provision of Minimum Essential Coverage (MEC) health insurance provided to your employees and their covered dependents. Please consult with your tax advisor or attorney to determine your reporting responsibilities under the law.
The Internal Revenue Service (IRS) and the Department of the Treasury provide extensive information for employers to assist in the implementation of the reporting requirements of the ACA. Below, ETF has compiled a list of useful links to some of the available information:
Frequently Asked Questions
As an employer, what information and data can I get from ETF in order to meet my reporting requirements?
ETF provides data that employers may access to complete some of the IRS-required forms under the ACA. The myETF Benefits System (MEBS) provides much of this in the Health Insurance Dependent Inquiry report for insured subscribers and their dependents as described below.
This data listed is available in MEBS under the tab Enrollment Reports, specifically in the report Health Insurance Dependent Inquiry. This report is a snapshot as of the time of the day it is pulled from the system. It can be exported and saved as a spreadsheet.
- Covered Individual
- Covered Individual SSN
- Covered Individual DOB (date of birth)
- Covered Individual months of coverage
I know that I need to report dependent Taxpayer Identification Numbers (TIN). How can I obtain a TIN if they are not readily available?
A significant number of dependents of employees are missing Taxpayer Identification Numbers (typically a Social Security number) in MEBS. ETF is aware that many health plans have been contacting employees to obtain missing TIN’s during 2015.
Please note the following guidance from the IRS: Reporting of TINs for all covered individuals is necessary for the IRS to verify an individual’s coverage without the need to contact the individual. If health coverage providers are unable to obtain a TIN after making a reasonable effort to do so, the provider may report a covered individual’s date of birth in lieu of a TIN. A health coverage provider will not be subject to a penalty if it demonstrates that it properly solicited the TIN.
How do I determine the employee share of lowest cost monthly premium for minimum value coverage’?
For state employers in the group health insurance program, use the employee share of the premium for single coverage in the It’s Your Choice High Deductible Health Plan (IYC HDHP) for those employees who are eligible for it. For employees who are not, such as graduate assistants, use the employee share of the premium for single coverage for the It’s Your Choice Access Health Plan (formerly the Standard Plan).
Do all plans offered under the group health insurance program offered to state employers exceed the federal minimum value standard?
Yes, per the actuarial certification of the Group Insurance Board’s consulting actuary.
Who is responsible for reporting this information for retirees and continuants?
ETF will provide the 1095-C form to certain non-Medicare retirees and Medicare retirees who cover non-Medicare dependents that participate in a self-funded health plan, which is the It’s Your Choice Access Health Plan (formerly the Standard Plan) or the State Maintenance Plan (SMP). ETF is not providing the form to participants in a fully-insured plan or those who have Medicare as their primary coverage.
For COBRA continuants, ETF will provide employers with a full data file of COBRA continuation enrollees. This file will be available to you on ETF’s secured FTP file server if you typically access files using FTP, or emailed to you directly. Once the file is available you will receive a notification email from ETF. ETF anticipates these files will be available soon.