Instructions For Forms 1094-C And 1095-C - 2017 (Page 16 of 17) in pdf

(including disability), layoff, jury duty, military duty, or leave of

employee, but, during the initial measurement period, the

absence. An hour of service does not include any hour of service

employee has a change in employment status such that, if the

performed as a bona fide volunteer of a government entity or

employee had begun employment in the new position or status,

tax-exempt entity, as part of a Federal Work-Study Program (or

the employee would have reasonably been expected to be a

a substantially similar program of a State or political subdivision

full-time employee, the period beginning on the date of the

thereof) or to the extent the compensation for services

employee’s change in employment status and ending not later

performed constitutes income from sources outside the United

than the end of the third full calendar month following the change

States. For additional rules for determining hours of service, see

in employment status. If the employee is a full-time employee

Regulations sections 54.4980H-1(a)(24), 54.4980H-3(b) and

based on the initial measurement period and the associated

Notice 2015–87, Q&A 14, at

stability period starts sooner than the end of the third full

ar11.html. See section VI of the preamble to the section 4980H

calendar month following the change in employment status, this

regulations for a discussion of determination of hours of service

Limited Non-Assessment Period ends on the day before the first

for categories of employees for whom the general rules for

day of that associated stability period.

determining hours of service may present special difficulties

First Calendar Month of Employment. If the employee’s first

(including adjunct faculty and commissioned salespeople) and

day of employment is a day other than the first day of the

certain categories of work hours associated with some positions

calendar month, then the employee’s first calendar month of

of employment, including layover hours (for example, for certain

employment is a Limited Non-Assessment Period.

airline employees), on-call hours, and work performed by an

Minimum essential coverage (MEC). Although various types

individual who is subject to a vow of poverty as a member of a

of health coverage may qualify as minimum essential coverage,

religious order.

for purposes of these instructions, minimum essential coverage

Limited Non-Assessment Period. A Limited Non-Assessment

refers to health coverage under an eligible employer-sponsored

Period generally refers to a period during which an ALE Member

plan. For more details on minimum essential coverage, see

will not be subject to an assessable payment under section

Minimum essential coverage in Pub. 974.

4980H(a), and in certain cases section 4980H(b), for a full-time

Minimum value. A plan provides minimum value if the plan

employee, regardless of whether that employee is offered health

pays at least 60% of the costs of benefits for a standard

coverage during that period.

population and provides substantial coverage of inpatient

The first five periods described below are Limited

hospitalization services and physician services.

Non-Assessment Periods with respect to sections 4980H(a) and

Offer of health coverage. An ALE Member makes an offer of

4980H(b) only if the employee is offered health coverage by the

coverage to an employee if it provides the employee an effective

first day of the first month following the end of the period. Also,

opportunity to enroll in the health coverage (or to decline that

the first five periods described below are Limited

coverage) at least once for each plan year. For this purpose, the

Non-Assessment Periods for section 4980H(b) only if the health

plan year must be 12 consecutive months unless a short plan

coverage that is offered at the end of the period provides

year of less than 12 consecutive months is permitted for a valid

minimum value. For more information on Limited

business purpose. An ALE Member makes an offer of health

Non-Assessment Periods and the application of section 4980H,

coverage to an employee for the plan year if it continues the

see Regulations section 54.4980H-1(a)(26).

employee’s election of coverage from a prior year but provides

First Year as ALE Period. January through March of the first

the employee an effective opportunity to opt out of the health

calendar year in which an employer is an ALE, but only for an

coverage. If an ALE Member provides health coverage to an

employee who was not offered health coverage by the employer

employee but does not provide the employee an effective

at any point during the prior calendar year.

opportunity to decline the coverage, the ALE Member is treated

Waiting Period under the Monthly Measurement Method. If an

as having made an offer of health coverage to the employee only

ALE Member is using the monthly measurement method to

if that health coverage provides minimum value and does not

determine whether an employee is a full-time employee, the

have an Employee Required Contribution for the coverage for

period beginning with the first full calendar month in which the

any calendar month of more than 9.5% (as adjusted) of a

employee is first otherwise (but for completion of the waiting

monthly amount determined as the mainland federal poverty line

period) eligible for an offer of health coverage and ending no

for a single individual for the applicable calendar year, divided by

later than two full calendar months after the end of that first

12.

calendar month.

For purposes of reporting, an offer to a spouse includes an

Waiting Period under the Look-Back Measurement Method. If

offer to a spouse that is subject to one or more reasonable,

an ALE Member is using the look-back measurement method to

determine whether an employee is a full-time employee and the

objective conditions, regardless of whether the reasonable,

employee is reasonably expected to be a full-time employee at

objective conditions are satisfied. For example, an offer of

his or her start date, the period beginning on the employee’s

coverage that is available to a spouse only if the spouse certifies

that the spouse does not have access to health coverage from

start date and ending not later than the end of the employee’s

another employer is treated as an offer of coverage to the

third full calendar month of employment.

Initial Measurement Period and Associated Administrative

spouse for reporting purposes. Note that this treatment is for

Period under the Look-Back Measurement Method. If an ALE

reporting purposes only, and generally will not affect the

Member is using the look-back measurement method to

spouse’s eligibility for the premium tax credit if the spouse did

not meet the condition and therefore did not have an actual offer

determine whether a new employee is a full-time employee, and

of coverage. A conditional offer to a spouse is reported by

the employee is a variable hour employee, seasonal employee

or part-time employee, the initial measurement period for that

entering code 1J or 1K (as applicable) on line 14 of Form

employee and the administrative period immediately following

1095-C. See the instructions for line 14 for more information. An

the end of that initial measurement period.

offer to a dependent does not include an offer to a dependent

that is subject to one or more reasonable, objective conditions

Period Following Change in Status that Occurs During Initial

Measurement Period Under the Look-Back Measurement

unless the dependent satisfies the conditions and the dependent

Method. If an ALE Member is using the look-back measurement

actually had an offer of coverage. In addition, an offer of

method to determine whether a new employee is a full-time

coverage is treated as made to an employee’s dependents only

employee, and, as of the employee’s start date, the employee is

if the offer of coverage is made to an unlimited number of

a variable hour employee, seasonal employee or part-time

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Instructions for Forms 1094-C and 1095-C (2017)

Instructions For Forms 1094-C And 1095-C - 2017 Page 16

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