Upcoming ACA Reporting Deadlines
Employers subject to Affordable Care Act (ACA) reporting under Internal Revenue Code Sections 6055 or 6056 should prepare to comply with reporting deadlines in early 2025.
For the 2024 calendar year, covered employers must:
- File electronic returns with the IRS by March 31, 2025 (February 28 for paper). Employers that file 10 or more returns during the calendar year must file electronically.
- Ensure that statements are furnished to individuals upon request by January 31 of the year following the calendar year to which the return relates or 30 days after the date of the request, whichever is later. Reporting entities must give individuals timely notice of this option, per any requirements set by the IRS.
Penalties may apply if employers are subject to ACA reporting and fail to file returns by the deadlines or furnish requested statements.
Covered Employers
The following employers are subject to ACA reporting:
- Employers with self-insured health plans (Section 6055 reporting)
- Applicable large employers (ALEs) with either fully insured or self-insured health plans (Section 6056 reporting)
ALEs are employers with 50 or more full-time employees (including full-time equivalent employees) during the preceding calendar year. ALEs with self-funded plans are required to comply with both reporting obligations; however, the IRS allows ALEs with self-insured plans to use a single combined form to report the required information under Sections 6055 and 6056.
Section 6055 and 6056 Reporting
- Section 6055 applies to providers of minimum essential coverage (MEC), such as health insurance issuers and employers with self-insured health plans. These entities generally use Forms 1094-B and 1095-B to report information about the coverage they provided during the previous year.
- Section 6056 applies to ALEs—generally, those employers with 50 or more full-time employees, including full-time equivalents, in the previous year. ALEs use Forms 1094-C and 1095-C to report information relating to the health coverage they offer (or do not offer) to their full-time employees.
Employers reporting under both Sections 6055 and 6056—specifically, ALEs with self-insured plans—use a combined reporting method by filing Forms 1094-C and 1095-C.
Annual Filing Deadline
Generally, forms must be filed with the IRS annually, no later than March 31 (or February 28, if filing on paper) of the year following the calendar year to which the return relates. Employers may receive an automatic 30-day extension to file with the IRS by completing and filing Form 8809 by the due date. Additional extensions of time to file may also be available under certain hardship conditions.
Individual Statements Upon Request
Under the original reporting rules, reporting entities had to furnish statements annually to each person provided with MEC (under Section 6055) and each of the ALE’s full-time employees (under Section 6056). These statements used Forms 1095-B and 1095-C; however, the IRS allows Forms 1095-B to be provided to individuals upon request if requirements are satisfied.
Under this alternative manner, reporting entities must:
- Post a clear and conspicuous notice on its website stating that responsible individuals may receive a copy of their statement upon request. The notice must include an email address, a physical address where the request may be sent, and a telephone number to contact the reporting entity with any questions. Sample notices.
- For 2024 statements, reporting entities must post the notice by March 3 and must retain the website notice through Oct. 15, 2025.
As we mentioned last month, the Paperwork Burden Reduction Act codifies this alternative manner of furnishing Forms 1095-B and extends this flexibility to furnishing Forms 1095-C. Accordingly, reporting entities are no longer required to send Forms 1095-B and 1095-C to covered individuals unless a form is requested.
Reporting entities must give individuals timely notice of this option as required by the IRS. While the IRS has not outlined the method for timely notice, the requirements regarding the alternative manner of furnishing Forms 1095-B still apply. The deadline for request fulfillment is January 31 of the year following the calendar year to which the return relates or 30 days after the date of the request, whichever is later.
In addition, the Employer Reporting Improvement Act provides that statements can be provided electronically to individuals if they have affirmatively consented “at any prior time” (unless they have revoked such consent in writing).
Electronic Filing
The electronic filing threshold for returns required to be filed on or after Jan. 1, 2024, is 10 or more returns (originally, the threshold was 250 or more returns). The instructions for 2024 returns (filed in 2025) provide the following clarifications and reminders:
- The 10-or-more return requirement applies in the aggregate to certain information returns. A reporting entity may be required to file fewer than 10 of the applicable Forms 1094 and 1095 but still have an electronic filing obligation based on other kinds of returns (e.g., Forms W-2 and 1099).
- The electronic filing requirement does not apply to reporting entities that request and receive a hardship waiver; however, the IRS encourages electronic filing even if a reporting entity is filing fewer than 10 returns.
- The formatting directions in the instructions are for the preparation of paper returns. When filing forms electronically, the formatting outlined in the “XML Schemas” and “Business Rules” published on IRS.gov must be followed. For more information regarding electronic filing, see IRS Publications 5164 and 5165.
Electronic filing uses the ACA Information Returns (AIR) Program. The IRS has provided guidance on electronic reporting through its AIR Program main page. This guidance is generally very technical and intended for software developers and other entities that plan. It delivers helpful information on standards and procedures for returns transmitted through the AIR Program.
Employer Takeaway
Be sure you are prepared to file. We are including our ACA Employer Reporting Guide for your assistance. Reach out to your Higginbotham representative if you have any additional questions.
U.S. Supreme Court Will Rule on ACA’s Mandate for Free Preventive Care

The U.S. Supreme Court has decided to review the constitutionality of a key component of the Affordable Care Act’s (ACA) preventive care mandate. This decision impacts the requirement for health plans and health insurance issuers to cover, without cost sharing, a wide range of preventive care services, including screenings for colorectal, lung and cervical cancers; medications for chronic conditions, such as cardiovascular disease; screening for HPV; depression and anxiety screenings; and hepatitis B and C virus screenings.
In June 2024, the 5th U.S. Circuit Court of Appeals ruled that a key component of the ACA’s preventive care mandate is unconstitutional. However, the 5th Circuit limited its ruling to the case plaintiffs, a small group of individuals and businesses from Texas. This means that health plans and issuers would continue to provide first-dollar coverage for the full range of recommended preventive health services. However, the Supreme Court’s decision could lead to a nationwide shift in coverage if the Court rules in the plaintiffs’ favor.
ACA’s Preventive Care Mandate
The ACA requires non-grandfathered health plans and issuers to cover a set of recommended preventive services without imposing cost-sharing requirements, such as deductibles, copayments or coinsurance, when the services are provided by in-network providers. The recommended preventive care services covered by these requirements are:
- Evidence-based items or services with an A or B rating in recommendations of the U.S. Preventive Services Task Force (USPSTF);
- Immunizations for routine use in children, adolescents and adults by the Advisory Committee on Immunization Practices;
- Evidence-informed preventive care and screenings in guidelines supported by the Health Resources and Services Administration (HRSA) for infants, children and adolescents; and
- Other evidence-informed preventive care and screenings in HRSA-supported guidelines for women.
Court Decisions
In March 2023, the U.S. District Court for the Northern District of Texas struck down a key component of the ACA’s preventive care mandate. The District Court ruled that the preventive care coverage requirements based on an A or B rating by the USPSTF on or after March 23, 2010, the ACA’s enactment date, violate the U.S. Constitution. More specifically, the District Court concluded that members of the USPSTF had not been appointed in a manner consistent with the Constitution’s Appointments Clause. The District Court also issued a nationwide injunction prohibiting the Biden administration from enforcing the affected preventive care mandates against any health plans or issuers.
The Biden administration appealed the District Court’s ruling to the 5th Circuit, which covers Texas, Louisiana and Mississippi. The 5th Circuit put the District Court’s decision on hold pending its ruling, which means health plans and issuers have been required to fully comply with the ACA’s preventive care mandate without interruption. The 5th Circuit agreed with the District Court that members of the USPSTF had not been validly appointed under the U.S. Constitution. However, the 5th Circuit limited its relief to the plaintiffs in the case and held that there was no basis for a nationwide injunction.
On Jan. 10, 2025, the Supreme Court agreed to hear the challenge to the ACA’s preventive care mandate during its 2024-25 term. Oral arguments are expected later this year, with a ruling likely in the first half of 2025.
Employer Takeaway
There is currently no nationwide injunction; health plans and issuers have been required to fully comply with the ACA’s preventive care mandate without interruption. We will continue to follow this case and keep you updated with any changes.
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2025 HR Compliance Calendar
An HR compliance calendar is a valuable tool to help your business stay on track with key employment-related deadlines throughout the year. Use this calendar to keep track of important compliance tasks for 2025.
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