ACA Reporting Requirements for Employers by Individual U.S. State
Check back periodically as we update this page when more info is released by states.
State Level Reporting Overview
In addition to the federal mandate that requires electronic submission of forms to the IRS, employers also have an obligation to submit returns at the state level in these states: California, New Jersey, and the District of Columbia. Massachusetts also has its own special guidance outlined below. Connecticut, Hawaii, Maryland, Minnesota, Rhode Island, Vermont and Washington have proposed bills to follow suit in upcoming years as well.
California‘s mandate is effective for the first time in the 2020 tax season and that requirement is continuing into the 2021 tax season. The file submission format is similar to the one used by the IRS. The penalty for employers who fail to comply is $50 per individual not reported to the State. Insurance providers are required to report health coverage information to California annually by March 31 or face a penalty. However, no penalty will apply if the return is filed on or before May 31. Employers are similarly required to report insurance information to us by March 31, but only if their insurance providers do not report to FTB.
New Jersey‘s filing is due March 31 following the end of the calendar year. Typically only self insured plans need to be reported as most fully insured plans are reported by the insurance carrier. There is no current employer penalty assessment in place for not filing, there most likely will be one after the state has finished reviewing and it will be posted as soon as they finalize the details. Health coverage provider (the insurer) files 1095 for each covered member of the plan. If an insurer will not meet its obligation, an employer is required to send the files itself. Also, unlike at the federal level, New Jersey requires that a 1095-B form be sent to each primary enrollee.
Washington DC‘s mandate is due April 30th, 2022 for the 2021 tax year. All employers who sponsor self-insured group health plans that have at least one DC resident, and all employers who sponsor fully-insured employment-based health plans with at least 50 total full-time employees, and all insurance companies who offer coverage to residents of DC all have to file returns.
Massachusetts has had a mandate for since 2006, but the filing requirements are typically satisfied by insurance carriers not employers. Employers with employees residing in the state will want to ensure that their filing obligations are met by insurance carriers. For employers issuing Form MA 1099-HC directly to employees, please see the MA state guidelines here for more details.
Rhode Island has no current employer penalty assessment in place for not filing, but they are expected in the future. Though the OHIC (Office of the Health Insurance Commissioner of the State of Rhode Island) does not regulate employers, it believes that the entire healthcare system runs more smoothly when employers understand their obligations toward their employees.
Vermont does not require reporting by employers unless and until the ACA reporting requirements are eliminated at the federal level.
Some states potentially allow for returns of non-residents to be included in the filing. That said, it is not a good practice because a security breach at the state level may cause non-residents unneeded exposure and open-up states / employers / third party processors to additional risks. Additionally, filing non-residents at the state level may violate privacy rights of individual employees.
As states finalize their specifications, ACAPrime will be ready to address the requirements and help ensure employers are in compliance at the state level in the most efficient way possible.
For more information, please see:
https://www.calpers.ca.gov/
https://www.ftb.ca.gov/file/
https://nj.gov/treasury/
http://www.ohic.ri.gov/ohic-
https://www.mass.gov/service-