Providers

The Patient-Centered Outcomes Research Institute (PCORI) fee under the Patient Protection and Affordable Care Act is due from sponsors of applicable self-funded health plans by July 31, 2025.

Under the Consolidated Appropriations Act, 2021, self-funded group health plans are required to submit certain information related to prescription drug and other health care spending to the Department of Labor, the Department of Health and Human Services, and the Department of Treasury (Departments).

Under the Affordable Care Act, employers must report information about the health coverage offered to employees, on a Form 1095-B or Form 1095-C, even though employees are not penalized for not having coverage. As the result of two bills recently signed into law, employers are no longer required to send employees a Form 1095.

The IRS has released final Affordable Care Act (ACA) information reporting forms and instructions for the 2024 calendar year. Form 1094-C or 1094-B is used to report to the IRS summary information for each employer and to transmit Forms 1095-C or 1095-B to the IRS. Form 1095-C or 1095-B is used to report information about each employee.

Under the Patient Protection and Affordable Care Act (ACA) Employer Mandate, ALEs must offer affordable health coverage that meets minimum value requirements to fulltime employees or face potential penalties.