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Health Care Reform-The Patient Protection and Affordable Care Act

 

Background

Beginning January 1, 2014, the Patient Protection and Affordable Care Act (PPACA) imposes a penalty tax on individuals who, for any month, do not have minimum essential coverage. This is known as the individual mandate. This assessment applies with respect to the individual or any dependents. Individuals without minimum essential medical coverage may be penalized for each full month the individual or his/her family member is uninsured. The penalty will be applied to Federal Income Tax Returns.

Minimum Essential Coverage

Pacific continues to provide medical plans with benefits that meet or exceed minimum essential requirements under the act including 100% coverage for preventative services, coverage for all Essential Health Benefits, no lifetime plan maximum and no annual plan year maximum among other benefits.

IRS Form 1095 (A, B & C)

As part of the employer responsibilities under the act, Pacific is required to notify eligible employees and the IRS of available medical coverage. This notification is referred to as the IRS Form 1095. Pacific will send eligible participants the Form 1095-C notification in March. The Form 1095-C will be sent to participants in the Pacific plans by U.S. mail to their W2 address on file. The Form 1095-B will be mailed to those who participated in the Kaiser plans. The form 1095-B will be mailed by Kaiser. The Form 1095-A is another version and is provided by the Health Insurance Marketplace such as Covered California for those enrolled in a Market Place plan during the tax year.

It is possible to receive all three forms, depending on how you were covered during the tax year. In 2016 you are not required to submit 1095 Forms to the IRS with your 2015 tax filing. Either the Health Insurance Market Place Plan, Kaiser Permanente and or Pacific will send the information directly to the IRS. The 1095 Forms are your "proof of coverage" for the PPACA Individual Mandate. Keep it with your other tax forms.

More Information

For tax-related questions about the IRS 1095 Tax form, contact the IRS Tax Help Line at 800-829-1040 (Mon-Fri, 7:00 a.m. - 7:00 p.m. local time).