Instructions For Forms 1094-C And 1095-C - 2017 (Page 6 of 17) in pdf

on the ALE Member’s website. Statements reporting coverage

Original Alternative Furnishing Method under the Qualifying Offer

and offers of coverage under an expatriate health plan, however,

Method Statement Furnished to Employee

may be furnished electronically unless the recipient explicitly

IF any of the following are

THEN ...

refuses to consent to receive the statement in an electronic

incorrect ....

format. Specific information on consents to furnish statements

electronically can be found in Regulations section 301.6056-2.

Name, SSN, ALE Member EIN

• Submission to IRS:

Extensions of time to furnish statement to recipients. You

1. Prepare a new Form 1095-C

may request an extension of time to furnish the statements to

Offer of Coverage

2. Enter an “X” in the “CORRECTED”

recipients by sending a letter to Internal Revenue Service, Attn:

box at the top of the form

Extension of Time Coordinator, 240 Murall Drive, Mail Stop

3. Submit corrected Form 1095-Cs

4360, Kearneysville, WV 25430. The letter must include (a) filer

with a non-authoritative Form 1094-C

name, (b) filer TIN, (c) filer address, (d) type of return, (e) a

transmittal to the IRS

statement that extension request is for providing statements to

recipients, (f) reason for delay, and (g) the signature of the filer

• Furnish to employee

or authorized agent. Your request must be postmarked by the

If after the correction the ALE Member

date on which the statements are due to the recipients. If your

is still eligible to use the alternative

request for an extension is approved, generally you will be

furnishing method under the Qualifying

granted a maximum of 30 extra days to furnish the recipient

Offer Method, furnish the employee

statements. For purposes of requesting an extension of time to

either a Form 1095-C or corrected

statement.

furnish the statements, the term filer means the ALE Member, or

If the ALE Member is no longer eligible

the Designated Government Entity, if applicable.

to use the alternative furnishing method

Information reporting penalties. All employers subject to the

with respect to the employee, furnish a

employer shared responsibility provisions and other employers

Form 1095-C to the employee.

that sponsor self-insured group health plans that fail to comply

with the applicable information reporting requirements may be

subject to the general reporting penalty provisions for failure to

file correct information returns and failure to furnish correct

Furnishing Forms 1095-C To Employees

payee statements. For returns required to be made and

You will meet the requirement to furnish Form 1095-C to an

statements required to be furnished for 2017 tax year returns,

employee if the form is properly addressed and mailed on or

the following apply.

before the due date. If the due date falls on a weekend or legal

The penalty for failure to file a correct information return is

holiday, then the due date is the following business day. A

$260 for each return for which the failure occurs, with the total

business day is any day that is not a Saturday, Sunday, or legal

penalty for a calendar year not to exceed $3,218,500.

holiday.

The penalty for failure to provide a correct payee statement is

$260 for each statement for which the failure occurs, with the

An ALE Member must furnish a Form 1095-C to each of its

total penalty for a calendar year not to exceed $3,218,500.

full-time employees by January 31 of the year following the year

Special rules apply that increase the per-statement and total

to which the Form 1095-C relates.

penalties if there is intentional disregard of the requirement to file

Forms 1095-C for the 2017 calendar year must be furnished

the returns and furnish the required statements.

by January 31, 2018.

Waiver of penalties. Penalties may be waived if the failure

was due to reasonable cause and not willful neglect. See section

For more information on alternative furnishing methods for

6724 and Regulations section 301.6724-1 and Proposed

employers, see

A. Qualifying Offer

Method.

Regulations section 1.6055-1(h) (which relate to Form 1095-C,

Filers of Form 1095-C may truncate the social security

Part III). For additional information, see Pub. 1586.

number (SSN) of an individual (the employee or any family

member of the employee receiving coverage) on Form 1095-C

Specific Instructions for Form 1094-C

statements furnished to employees by showing only the last four

digits of the SSN and replacing the first five digits with asterisks

Part I—Applicable Large Employer Member

(*) or Xs. Truncation is not allowed on forms filed with the IRS. In

(ALE Member)

addition, an ALE Member's EIN may not be truncated on the

statements furnished to employees or the forms filed with the

Line 1. Enter employer's name. The employer is the ALE

IRS.

Member.

Except as provided below, statements must be furnished on

Line 2. Enter the ALE Member’s EIN. Do not enter an SSN.

paper by mail (or hand delivered), unless the recipient

Enter the 9-digit EIN including the dash.

affirmatively consents to receive the statement in an electronic

format. If mailed, the statement must be sent to the employee’s

If you are filing Form 1094-C, a valid EIN is required at

last known permanent address, or if no permanent address is

the time the form is filed. If a valid EIN is not provided,

known, to the employee’s temporary address.

Form 1094-C will not be processed. If you do not have

CAUTION

an EIN, you may apply for one online. Go to IRS.gov and enter

Consent to furnish statement electronically. An ALE

“EIN” in the search box. You may also apply by faxing or mailing

Member is required to obtain affirmative consent to furnish a

Form SS-4, Application for Employer Identification Number, to

statement electronically. This requirement ensures that

the IRS. See the Instructions for Form SS-4 and Pub. 1635,

statements are furnished electronically only to individuals who

Employer Identification Number.

are able to access them. The consent must relate specifically to

receiving the Form 1095-C electronically. An individual may

Lines 3–6. Enter the ALE Member’s complete address

consent on paper or electronically, such as by email. If consent

(including room or suite no., if applicable). This address should

is on paper, the individual must confirm the consent

match the ALE Member’s address used on Form 1095-C.

electronically. A statement may be furnished electronically by

email or by informing the individual how to access the statement

-6-

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

Instructions For Forms 1094-C And 1095-C - 2017 Page 6

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