Affordable Care Act Update 2023

Filing Deadlines

The filing deadline for employers to provide employees with a copy of their 2023 1095-C reporting form, as required by the Affordable Care Act, is March 4, 2024. The deadline for electronic submissions to the IRS is April 1, 2024 (submit filing via AATRIX by March 29th to guarantee compliance).

Lowest Cost for Offer of Coverage Code ‘1A’ Decreases for 2023

The lowest monthly amount the employee could have paid under the plan for self-coverage only (the cost for covering spouse or dependents is not included) and use Offer of Coverage code ‘1A’ was $103.15 for the 2022 tax year. In 2023 this amount has increased slightly to $103.28 (based on 9.12% of $13,590, the 2022 poverty level). In 2023, if the lowest monthly amount the employee could have paid is less than $103.28 per month for minimum value coverage as defined by the law, Offer of Coverage Code ‘1A’ can be used. If the lowest monthly amount is more than $103.23, Code ‘1A’ cannot be used and the employer should fill in the amount on the form (line 15) and use one of the ‘Safe Harbor Codes’, if applicable, to show that the employer is in compliance.

[For 2024 plans using the Poverty Level Safe Harbor to determine affordability, the employee’s premium payment will not be able to exceed $101.93 per month (based on 8.39% of $14,580  the 2023 poverty level). This is the lowest affordability threshold since the ACA employer mandate took effect in 2015.]

State Level Reporting

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, Rhode Island, Vermont, and the District of ColumbiaMassachusetts also has its own special ACA guidance.  Connecticut, Hawaii, Maryland, Minnesota, and Washington have proposed bills to follow suit in upcoming years as well.

New Jersey’s individual health coverage mandate requires third-party reporting to verify health coverage information supplied by individual payers of New Jersey’s Income Tax. The requirement includes both in-state and out-of-state employers who provide health coverage to New Jersey residents. New Jersey‘s electronic 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. Mailing in paper forms is NOT an option for New Jersey ACA filing.

When submitting forms electronically via Aatrix please make sure that you have marked the appropriate fields to indicate that Aatrix should also submit the required state ACA forms for employees who reside in those states.

Form 1095-C

IRS Forms 1094-C and 1095-C have not changed for 2023.