Which States Have Requirements?
Four states currently have separate state ACA reporting requirements in addition to the federal Form 1095-C. These states are:
- California
- Massachusetts
- New Jersey
- Rhode Island
- District of Columbia
Employer Action
For fully insured plans, these obligations are generally fulfilled by the insurer.
For self-funded plans, the employer bears the responsibility to satisfy the state reporting obligations.
Deadlines to Furnish Notice to Individuals
The timing of the requirements to provide notices to individuals also vary for some states (compared to the current ACA deadlines).
- CA and MA: Must be provided by January 31, 2023
- DC, NJ, and RI: Must be provided by March 02, 2023
If an employer missed the dates to furnish the California or Massachusetts notices, the recommendation action is to promptly furnish the requisite notices to individuals and then complete the necessary filing with the states in a timely manner.
Deadlines to File Notices with State
The four states (California, Massachusetts, New Jersey, and Rhode Island) have a filing deadline of March 31, 2023, which is in line with the ACA filing deadline with the IRS.
The filing deadline for the District of Columbia is 30 days after the federal filing date. For 2023, it is May 1st as a result of April 30, 2023, falling on a Sunday.
Overview of State Requirements
The state requirements largely follow the federal Form 1094-1095 reporting requirements. Following is an overview of the specifics for each state:
- California: Self-funded employers must report all employees and dependents who had health coverage at any point during the year. The penalty for failure to report timely is $50 per covered individual who was provided health coverage.
- Massachusetts: State filings do not need to contain employee-level details as is required under the ACA filings to the IRS and are generally completed by insurance carriers on behalf of individual employers. Employers must also issue Form 1099-HC to their employees and report information to the state Department of Revenue. The filing deadline for the 1099-HC is January 31, 2023. Organizations that fail to comply with 1099-HC requirements could be subject to a penalty of $50 per employee, up to a maximum of $50,000.
- New Jersey: ALEs use the same IRS form 1094-C/1095-C to report health insurance information to the state. No additional or "special" forms are required.
- Rhode Island: Rhode Island maintains an individual penalty for residents not maintaining health insurance. Furnishing federal Form 1095s to employees satisfies the requirement to furnish notice to employees. However, employers must also submit these returns to the state’s Division of Taxation (DOT) to fully meet the notice requirements.
- District of Columbia: Applicable entities must submit an information return regarding MEC coverage provided to the Office of Tax and Revenue (OTR). Information regarding the individuals’ type of coverage must also be submitted. While similar, it should be noted that these filing requirements are not the same as ACA requirements.
Potential Future State Reporting
A number of additional state legislatures are either in the process of passing or have already passed ACA reporting requirements. This includes Connecticut, Hawaii, Maryland, Minnesota, and Washington. Employers in these states should anticipate additional responsibilities with regard to state reporting and watch for details on required forms and filing procedures.
Conclusion
In addition to federal reporting, a patchwork of state-level ACA reporting has developed over recent years. This creates a myriad of complexities for employers, especially for employers with operations in multiple states.
As a final reminder, enforcement efforts at the federal level are ramping up, and employers can no longer rely on the comfort of “good faith effort” in their federal 1095 reporting.
