ACA Compliance

Who must file Forms 1094-C and 1095-C, and what counts as a return.

Applicable large employers, generally those that averaged at least 50 full-time employees including equivalents in the prior year, report offers of coverage every year. Each form is its own return for penalty purposes.

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The Filers

Which employers report.

Applicable Large Employers

Employers that averaged at least 50 full-time employees, including full-time equivalents, in the prior calendar year.

Controlled Groups

Each member of a controlled group files for its own employees.

Self-Insured Smaller Employers

An employer under 50 that self-insures reports coverage on Forms 1094-B and 1095-B.

What Counts as a Return

Why the per-form math matters.

Each 1095-C Is a Return

One submission covering 100 employees is 100 returns, each with its own penalty exposure.

The 1094-C Is One Too

The Form 1094-C transmittal is an information return as well.

The Statement Penalty Doubles It

Section 6722 adds a matching penalty for each statement not furnished to the employee.

Caps Soften the Total

Annual caps apply, starting at $244,500 for smaller employers corrected within 30 days, for returns due in 2027.

Common Questions

Quick answers.

Short answers. This is general information, not legal or tax advice.

Is There a Size Cutoff?

The line is 50 full-time employees including equivalents for the employer mandate and its reporting, measured on the prior calendar year.

Do We File if We Offer No Coverage?

An applicable large employer files either way, because the form also reports that coverage was not offered.

Who Prepares the Forms?

Most employers use payroll and enrollment data. We can help you with the filing and help keep you ERISA compliant.

Sources

Where the rules and figures come from.

Each figure on this page comes from the source below. Amounts are indexed or updated over time, so confirm current figures before relying on them.

Instructions for Forms 1094-C and 1095-C

Due dates, extensions, the posted notice option, e-filing and the $100 safe harbor.

Read the Source

26 U.S.C. 4980H

Shared responsibility for employers regarding health coverage.

Read the Source

IRS Employer Shared Responsibility

Letter 226-J, Letter 227 and the employer mandate overview.

Read the Source

Let’s Get to Work

Send us your renewal.

We’ll tell you whether it looks competitive, where we see opportunity, and the five questions we’d put to your carrier. No cost, and no obligation to move anything.

What to send

The renewal letter
Your current plan summary
Contribution split by tier
Enrolled counts by tier

Four documents — two more if your group is 50 or more. Nothing else; every extra one is a reason to postpone.

CFH Insurance Consultants

An independent employee benefits consulting firm. We look at the entire benefits program — cost, plan performance, risk and administration.

Switch to CFH. Unhappy with your broker? Your employees won’t notice. You will. →

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