Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under Employer-Sponsored Plans

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 4423 Application for Filing Affordable Care Act (ACA) Information Returns	Form and Instruction	Modified	Available
Form Form 1095-C Employer-Provided Health Insurance Offer and Coverage	Form	Modified	Available
Form Form 1094-C Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns	Form	Modified	Available
1545-2251_Supporting_Statement.doc	Supporting Statement A	Uploaded 2015-02-02	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
214083	Form 4423	Form and Instruction	Modified	Application for Filing Affordable Care Act (ACA) Information Returns
214082	Form 1095-C	Form	Modified	Employer-Provided Health Insurance Offer and Coverage
214082	Form 1095-C	Instruction	Modified
210443	Form 1094-C	Form	Modified	Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns
210443	Form 1094-C	Instruction	Modified

ICR Details

OMB Control No: 1545-2251	ICR Reference No: 201701-1545-021
Status: Historical Active	Previous ICR Reference No: 201411-1545-073
Agency/Subagency: TREAS/IRS	Agency Tracking No: Ready
Title: Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under Employer-Sponsored Plans
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 02/28/2017
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/17/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/27/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2017	6 Months From Approved	02/28/2017
Responses	3,865,006	0	3,865,006
Time Burden (Hours)	810,002	0	810,002
Cost Burden (Dollars)	0	0	0

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Abstract: This document contains regulations providing guidance to employers that are subject to the information reporting requirements under section 6056 of the Internal Revenue Code, enacted by the Patient Protection and Affordable Care Act (P.L. 111-148 (124 Stat.119 (2010)). Section 6056 requires those employers to report to the IRS information about their compliance with the employer shared responsibility provisions of section 4980H of the Code and about the health care coverage, if any, they have offered employees. Section 6056 also requires those employers to furnish related statements to employees in order that employees may use the statements to help determine whether, for each month of the calendar year, they can claim on their tax returns a premium tax credit under section 36B of the Code (premium tax credit).

Emergency Justfication: The information collection included in OMB Control Number 1545-2251 is related to reporting employer sponsored health coverage by certain employers and health care coverage information by insurance issuers and other coverage providers, as required by section 6056 of the Internal Revenue Code. OMB Control Number 1545-2251, Forms 1094-C and 1095-C, was approved for a one year period and extended for two additional six month periods, which will expire on February 28, 2017. For the reasons stated below, we are requesting a six month emergency extension of the approval for OMB Control Number 1545-2251. Guidance issued in 2013 (Notice 2013-45), provided that reporting was voluntary for both employers and issuers for 2014. Very few employers participated in the voluntary filing year. In large part, participation was limited because the IRS had to make extensive systems changes and revise many technical publications that employers needed to have before they could develop, test, and submit the required information returns. In addition, system testing for the voluntary year did not begin until fall of 2014, leaving very little time for employers to pass testing and submit returns for the voluntary year. Consequently, minimal information was collected for 2014. Although filing was required for 2015, the due dates for 2015 were extended for all filers by Notice 2016-4 (May 31 for paper filers and June 30 for electronic filers) and we continued to receive returns after the due dates. While we have preliminary figures for the filings, we are still processing the data received so the preliminary figures include duplicate filings and corrected return filings. Therefore, the data is not yet ready to be able to update the number of estimated filers of Forms 1094-C and 1095-C at this time. The current versions of Forms 1094-C and 1095-C are being used for 2016 by the applicable taxpayers for both the initial filing and for any corrections that need to be made, which may be filed after the due date. In Notice 2016-70, the furnishing deadline for Form 1095 C was extended to March 2, 2017, while the filing deadlines remain February 28, 2017 for paper filers and March 31, 2017 for electronic filers. The clearance for OMB Control # 1545-2251 (which includes Forms 1094-C and 1095-C) is set to expire on February 28, 2017. Withdrawing OMB clearance for this collection would cause a major disruption to the collection of information required under section 6056 of the Internal Revenue Code, and potentially increase the burden on taxpayers and respondents. In addition, applicable taxpayers may view withdrawal of the OMB clearance as a signal that corrected returns are not required for 2016. Accordingly, we respectfully request a six month emergency extension of the OMB Control # 1545-2251 clearance.

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Authorizing Statute(s): US Code: 26 USC 6056 Name of Law: Information and Returns, Information Regading Health Insurance Coverage
   US Code: 26 USC 4980H Name of Law: Tax on reversion of qualified plan assets to employer
  

Citations for New Statutory Requirements: US Code: 26 USC 6056 Name of Law: Information and Returns, Information Regading Health Insurance Coverage

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Form 1094-C	Form 1094-C	Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns
Form 1095-C	Form 1095-C	Employer-Provided Health Insurance Offer and Coverage
Form 4423	4423	Application for Filing Affordable Care Act (ACA) Information Returns

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	3,865,006	3,865,006	0	0	0	0
Annual Time Burden (Hours)	810,002	810,002	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/27/2017

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