Which states are affected by the ACA state individual mandate?
Currently there are 6 states that have passed legislation establishing an individual ACA mandate:
There are at least 5 states with proposed ACA legislation:
- Connecticut
- Hawaii
- Maryland
- Minnesota
- Washington
It is not at all clear what the reporting requirements will be so it is likely we will update this ACA article quite often as things become more clearly defined.
Employee ACA Requirements
Employees will need to verify their individual health coverage in a similar fashion they did for the Federal government. When filing state tax returns, taxpayers will be required to confirm if they were enrolled in health coverage during the calendar year and may also be required to submit documentation.
Many states require a similar reporting process as was done with the Fed 1095 C or B. Some states have passed an individual mandate and have yet to establish a reporting process. It is likely that States will also require employers to report as well.
Employer ACA Requirements
Employer reporting requirements have been defined by a few states but there is a great deal of uncertainty of how many of these states will move forward. Much of this agenda has been delayed due to Covid-19 and how soon pending legislation will move forward is again uncertain.
Employers will certainly have some ACA reporting responsibility, so for these businesses in states affected will have to stay informed and react accordingly.
It is almost certain more states will follow, and reporting requirements will be different in almost every state affected.
California ACA
The State of California’s individual ACA mandate, requiring residents to have qualifying coverage throughout the year, went into effect January 1, 2020. Employers are required to file annually. The first deadline for filing is March 30, 2021.
Any employer in or out of state is required to report enrolled coverage of employees as described in section 6065 of the Affordable Care Act.
The penalty for employers who fail to comply is $50 per individual not reported to the state.
District of Columbia ACA
The District of Columbia (D.C.) individual ACA mandate, requiring residents to have qualifying coverage throughout the year, went into effect on January 1, 2019. DC’s mandate is due April 30th, 2021.
Employers in or out of state are required to report coverage whether or not they withhold and pay payroll taxes for the employee in the District of Columbia. ALE requirements apply whether the employer offers coverage or is fully funded self-insured.
Massachusetts ACA
Massachusetts has had an individual ACA mandate since 2006. Reporting is annual utilizing the 1099HC Form. Most employers will rely on their insurance companies to make this state ACA filing, but they are encouraged to make certain their insurance company is filing correctly. The reporting period is November 1 to November 30.
Employers are also required to file the Health Insurance Responsibility Disclosure (HIRD) form with the state DOL.
New Jersey ACA
The New Jersey ACA individual mandate, requiring residents to have qualifying coverage throughout the year, went into effect on January 1, 2019.
Employers in or out of state are required to report coverage whether or not they withhold and pay payroll taxes for the employee in the state of New Jersey. ALE requirements apply whether the employer offers coverage or is fully-funded self-insured.
Employers are required to report annually using the same 1095 used for Federal filing. The filing deadline is March 30 unless extended by the state as it was in 2020 due to Covid-19.
Rhode Island ACA
The State of Rhode Island’s individual ACA mandate, requiring residents to have qualifying coverage throughout the year, went into effect January 1, 2020.
Filing methods, deadlines, and other requirements have not been released at the time of this article.
Vermont ACA
The State of Vermont’s individual ACA mandate, requiring residents to have qualifying coverage throughout the year, went into effect January 1, 2020.
Vermont does not require reporting by employers unless and until the ACA reporting requirements is eliminated at the federal level.
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