Automatic extension provided for furnishing health coverage statements

By Martha Waggoner

Final regulations providing an automatic extension of time for providers of minimum essential coverage (including health insurance issuers, self-insured employers, and government agencies) to furnish individuals statements regarding their minimum essential coverage were published in T.D. 9970 on Monday.

A 30-day extension beyond the statutory deadline of Jan. 31 for providing these information statements to responsible individuals (employees and other covered individuals) has been provided annually since the Patient Protection and Affordable Care Act (PPACA), P.L. 111-148, first required the statements. The information statements generally correspond to a taxpayer copy of Forms 1095-B, Health Coverage, and 1095-C, Employer-Provided Health Insurance Offer and Coverage, which also are filed with the IRS. Under the final regulations, reporting entities are granted an automatic, 30-day extension of time to furnish these statements.

Because this extension is automatic, the regulations eliminate the requirement in Regs. Sec. 1.6055-1(g)(4)(i)(B)(1) that a reporting entity make a written application to the IRS showing good cause to request an extension of time to furnish the statement.

The final regulations also provide an automatic extension of time for "applicable large employers" (ALEs) (generally employers with 50 or more full-time employees, including full-time equivalent employees) to furnish statements relating to health insurance that the ALEs offer to their full-time employees.

In addition, the final regulations provide an alternative method for a reporting entity to timely furnish Forms 1095-B to responsible individuals in years when the individual shared-responsibility payment amount is zero. Under this alternative method, the employer or other reporting entity must post a clear and conspicuous notice on its website, stating that responsible individuals can receive their Form 1095-B upon request, with email and physical addresses and a phone number for making the request. It must fulfill such requests within 30 days of when they were received. The notice must be retained in the same location on its website through Oct. 15 of the year following the calendar year to which the statements relate.

The regulations, however, do not amend the regulations under Sec. 6056 to allow an ALE to use this alternative method of providing the information to full-time employees enrolled in the employer's self-insured plan.

The regulations under Regs. Secs. 1.6055-1 and 301.6056-1 apply for calendar years beginning after Dec. 31, 2021. As discussed in the Proposed Applicability Date section of the 2021 proposed regulations, taxpayers may rely on Regs. Secs. 1.6055-1 and 301.6056-1 of the 2021 proposed regulations for calendar years beginning after Dec. 31, 2020, and before Dec. 15, 2022.

Medicaid coverage of COVID-19 services

In Notice 2020-66, the IRS provided that COVID-19 testing and services are not minimum essential coverage for purposes of the Sec. 36B premium tax credit. This means that an individual who had such Medicaid coverage for any month would be eligible for the premium tax credit for that month, assuming he or she met all other requirements.

The final regulations amend Regs. Sec. 1.5000A-2 to that effect. These regulations apply for months beginning after Sept. 28, 2020. For months beginning on or after Jan. 1, 2020, and before Sept. 28, 2020, taxpayers may continue to rely on Notice 2020-66.

— To comment on this article or to suggest an idea for another article, contact Martha Waggoner at Martha.Waggoner@aicpa-cima.com.

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