Affordable Care Act (ACA)

The documents below, frequently asked questions and answers, provide additional information about the 1095-C and the 1095-B to provide a better understanding of the forms and what to do if/when you receive one.


 

Under the Affordable Care Act (ACA), Individuals are required to report on their health insurance coverage when filing their tax returns.  To assist with this reporting requirement, large employers such as UMass are required to issue 1095 tax forms to certain employees, defined under the ACA as those regularly working 30 hours or more a week or 130 hours or more a month (ACA full time employees).  

UMass/Commonwealth employees that meet the definition of a full time employee under the ACA regulations will receive the below described 1095 tax forms for 2018. If you have worked in more than one Commonwealth department/agency (including UMass) during 2018 you will receive only one instance of each applicable form.

1)    Form 1095-C, Employer-Provided Health Insurance Offer and Coverage- This form will be sent from the Commonwealth and will contain important information for ACA full time employees, which indicates the status of the offer and coverage of employer provided health insurance in 2018.

2)    Form 1095-B, Health Coverage- This form will be sent from the Group Insurance Commission (GIC), or directly from the GIC Health Care Provider, and will contain information indicating that the employee had health insurance coverage considered Minimum Essential Coverage during the 2018 tax year. If you were not enrolled in a GIC health plan at any point during the year, you will not receive a 1095-B form from the GIC/Health Care Provider.

The 1095-C form uses a set of codes to determine what kind of coverage was offered and whether it was affordable.  The following are the codes generally used by the Commonwealth:

Box 14 Code Description Box 16 Code Description
1E Minimum essential coverage providing minimum value offered to you and minimum essential coverage offered to your dependent(s) and spouse. 2C

Employee enrolled in coverage offered

2H Section 4980H affordability rate of pay safe harbor.
       
1H

No offer of coverage (you were NOT offered any health coverage or you were offered coverage that is NOT minimum essential coverage).

All months are populated including months prior to hire or after termination.

2A Employee Not Employed during the month
2B Employee not a full-time employee
2D Employee is a section 4980H(b) Limited   Non-Assessment Period.

 

 

 

 

 

 

 

 

 

 

For box 15, ACA requires that the value listed will be the Employee Share of Lowest Cost Monthly Premium, for Self-Only Minimum Value Coverage, and that amount is displayed from the plans offered to you, based on your home Zip Code, whether or not it was the plan you chose.

Part III of the 1095-C form will be blank for all employees.  Proof of Enrollment will be on separate form 1095-B issued by GIC or Health Care Provider.  

According to the IRS, the information on the 1095 forms may assist tax payers in preparing their 2018 tax return, but the forms are not required to file your return.  You can find more information about these IRS Forms and the filing of your 2018 Tax Return on the IRS website at https://www.irs.gov/affordable-care-act/questions-and-answers-about-health-care-information-forms-for-individuals.

If you have questions about your 1095-C or believe you should have received one but did not, please email aca@umassp.edu or contact your campus HR office.   If you have questions regarding the 1095-B you may have received, please call the Group Insurance Commission at 617.727.2310 ext. 1.  However, if you were a member of the GIC’s Fallon Health, Health New England or Neighborhood Health Plans, you should call those plans directly with any questions.

Please note that the 1095 forms do not replace the MA 1099-HC, which has very similar information to that of the federal Form-1095-B, but is used for Massachusetts state taxes. You will still receive the MA 1099-HC form from your health insurance carrier and should contact them if you have questions about it.