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Explaining the Law for Reporting Retirees

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The only time retirees come into play for reporting is if the retiree was enrolled in a self-funded employer sponsored health coverage. Fully insured – Nothing on our end needs to be done as the carrier will do the reporting via 1095-B. However, if the plan the retiree is enrolled in is self-insured then the company must report them on Part III of the 1095-C and reflect their coverage period. For Part II you would put in 1H/2A for the months they were retired. In some cases, that may be the entire year. We do not need any transactions for coverage.

If they have retired in previous years but still carry insurance into the next year, a 1G code is used on line 14 for all 12 months.  Click Here for more information on 1G.

The start date of coverage and end date of coverage on the Dependent maintenance is what drives what is reported on Part III. The retiree would be put in as if they were a dependent (we are changing this from Dependent Maintenance to Self-Insured Maintenance). The system will report them in Part III.

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Last Review: 9/17/2020 – Revision: 2.1

Applies To: ACA Compliance Solution

Categories:  Year End – 1095 & Filing

Keywords:  Retirees, 1G

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