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Broker News | October 2015 | Vol. 10 No. 9
Broker News | October 2015 | Vol. 10 No. 9

New Information Reporting Requirements under the Affordable Care Act

Beginning in January 2016 for reporting year 2015, Excellus BlueCross BlueShield must report certain health coverage informa­tion to the IRS for individual direct pay members off exchange, Small Business Health Options Program (SHOP), small groups and large groups insured.  The information pro­vided will include any months when individuals were covered by minimum essential coverage and will be used to verify the individual shared responsi­bility requirement.

In addition to the IRS reporting, Excellus BlueCross BlueShield must also send statements to individuals (Form 1095-B) who had minimum essential coverage in the reporting year. These statements are similar to W2 forms and will include the same information that is reported to the IRS. They give individuals information they will need when they file their taxes – only these statements are used to determine if they will have to pay the Individual Shared Responsibility Payment for not having minimum essential coverage.

Excellus BlueCross BlueShield is also now required to ask for individual Social Security numbers in order to meet new reporting obligations under the Affordable Care Act. The IRS will use the individual name and Social Security number combination to match coverage reported on Form 1095-B to the coverage reported on tax Form 1040. As a result, Social Security number solicitation letters have been created and will be mailed periodically by Excellus BlueCross BlueShield to individuals who have a missing or invalid Social Security number.

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