USC Subpart D

in effect

26 U.S.C. § 6055 Reporting of health insurance coverage

(a) In generalEvery person who provides minimum essential coverage to an individual during a calendar year shall, at such time as the Secretary may prescribe, make a return described in subsection (b). (b) Form and manner of return(1) In generalA return is described in this subsection if such return—(A) is in such form as the Secretary may prescribe, and (B) contains—(i) the name, address and TIN of the primary insured and the name and TIN of each other individual obtaining coverage under the policy, (ii) the dates during which such individual was covered under minimum essential coverage during the calendar year, (iii) in the case of minimum essential coverage which consists of health insurance coverage, information concerning—(I) whether or not the coverage is a qualified health plan offered through an Exchange established under section 1311 of the Patient Protection and Affordable Care Act, and (II) in the case of a qualified health plan, the amount (if any) of any advance payment under section 1412 of the Patient Protection and Affordable Care Act of any cost-sharing reduction under section 1402 of such Act or of any premium tax credit under section 36B with respect to such coverage, and (iv) such other information as the Secretary may require. For purposes of subparagraph (B)(i), in the case of any individual whose name is required to be set forth in a return under subsection (a), if the person required to make a return under such subsection is unable to collect information on the TINs of such individuals, the Secretary may allow the individual’s full name and date of birth to be substituted for the name and TIN. (2) Information relating to employer-provided coverageIf minimum essential coverage provided to an individual under subsection (a) consists of health insurance coverage of a health insurance issuer provided through a group health plan of an employer, a return described in this subsection shall include—(A) the name, address, and employer identification number of the employer maintaining the plan, (B) the portion of the premium (if any) required to be paid by the employer, and (C) if the health insurance coverage is a qualified health plan in the small group market offered through an Exchange, such other information as the Secretary may require for administration of the credit under section 45R (relating to credit for employee health insurance expenses of small employers). (c) Statements to be furnished to individuals with respect to whom information is reported(1) In generalEvery person required to make a return under subsection (a) shall furnish to each individual whose name is required to be set forth in such return a written statement showing—(A) the name and address of the person required to make such return and the phone number of the information contact for such person, and (B) the information required to be shown on the return with respect to such individual. (2) Time for furnishing statementsThe written statement required under paragraph (1) shall be furnished on or before January 31 of the year following the calendar year for which the return under subsection (a) was required to be made. (3) 11 So in original. Two pars. (3) have been enacted. Alternative manner of furnishing statementsFor purposes of this subsection, any person required to make a return under subsection (a) shall be treated as timely furnishing the written statement required under paragraph (1) if—(A) such person provides clear, conspicuous, and accessible notice (at such time and in such manner as the Secretary may provide) that any individual to whom a statement would otherwise be required to be furnished under paragraph (1) may request a copy of such statement, and (B) such person, on request of any such individual, furnishes a copy of such statement to such individual not later than the later of—(i) January 31 of the year following the calendar year for which the return under subsection (a) was required to be made, or (ii) 30 days after the date of such request. (3) 1 Electronic deliveryAn individual shall be deemed to have consented to receive the statement under this subsection in electronic form if such individual has affirmatively consented at any prior time, to the person required to make such statement, to receive such statement in electronic form. The preceding sentence shall not apply if the individual revokes such consent in writing. (d) Coverage provided by governmental unitsIn the case of coverage provided by any governmental unit or any agency or instrumentality thereof, the officer or employee who enters into the agreement to provide such coverage (or the person appropriately designated for purposes of this section) shall make the returns and statements required by this section. (e) Minimum essential coverageFor purposes of this section, the term “minimum essential coverage” has the meaning given such term by section 5000A(f).

26 U.S.C. § 6056 Certain employers required to report on health insurance coverage

(a) In generalEvery applicable large employer required to meet the requirements of section 4980H with respect to its full-time employees during a calendar year shall, at such time as the Secretary may prescribe, make a return described in subsection (b). (b) Form and manner of returnA return is described in this subsection if such return—(1) is in such form as the Secretary may prescribe, and (2) contains—(A) the name, date, and employer identification number of the employer, (B) a certification as to whether the employer offers to its full-time employees (and their dependents) the opportunity to enroll in minimum essential coverage under an eligible employer-sponsored plan (as defined in section 5000A(f)(2)), (C) if the employer certifies that the employer did offer to its full-time employees (and their dependents) the opportunity to so enroll—(i) the length of any waiting period (as defined in section 2701(b)(4) of the Public Health Service Act) with respect to such coverage, (ii) the months during the calendar year for which coverage under the plan was available, (iii) the monthly premium for the lowest cost option in each of the enrollment categories under the plan, and (iv) the employer share of the total allowed costs of benefits provided under the plan, (D) the number of full-time employees for each month during the calendar year, (E) the name, address, and TIN of each full-time employee during the calendar year and the months (if any) during which such employee (and any dependents) were covered under any such health benefits plans, and (F) such other information as the Secretary may require. The Secretary shall have the authority to review the accuracy of the information provided under this subsection, including the applicable large employer’s share under paragraph (2)(C)(iv). (c) Statements to be furnished to individuals with respect to whom information is reported(1) In generalEvery person required to make a return under subsection (a) shall furnish to each full-time employee whose name is required to be set forth in such return under subsection (b)(2)(E) a written statement showing—(A) the name and address of the person required to make such return and the phone number of the information contact for such person, and (B) the information required to be shown on the return with respect to such individual. (2) Time for furnishing statementsThe written statement required under paragraph (1) shall be furnished on or before January 31 of the year following the calendar year for which the return under subsection (a) was required to be made. (3) 11 So in original. Two pars. (3) have been enacted. Alternative manner of furnishing statementsFor purposes of this subsection, any person required to make a return under subsection (a) shall be treated as timely furnishing the written statement required under paragraph (1) if—(A) such person provides clear, conspicuous, and accessible notice (at such time and in such manner as the Secretary may provide) that any individual to whom a statement would otherwise be required to be furnished under paragraph (1) may request a copy of such statement, and (B) such person, on request of any such individual, furnishes a copy of such statement to such individual not later than the later of—(i) January 31 of the year following the calendar year for which the return under subsection (a) was required to be made, or (ii) 30 days after the date of such request. (3) 1 Electronic deliveryAn individual shall be deemed to have consented to receive the statement under this subsection in electronic form if such individual has affirmatively consented at any prior time, to the person who is the employer of the individual during the calendar year to which the statement relates, to receive such statement in electronic form. The preceding sentence shall not apply if the individual revokes such consent in writing. (d) Coordination with other requirementsTo the maximum extent feasible, the Secretary may provide that—(1) any return or statement required to be provided under this section may be provided as part of any return or statement required under section 6051 or 6055, and (2) in the case of an applicable large employer offering health insurance coverage of a health insurance issuer, the employer may enter into an agreement with the issuer to include information required under this section with the return and statement required to be provided by the issuer under section 6055. (e) Coverage provided by governmental unitsIn the case of any applicable large employer which is a governmental unit or any agency or instrumentality thereof, the person appropriately designated for purposes of this section shall make the returns and statements required by this section. (f) DefinitionsFor purposes of this section, any term used in this section which is also used in section 4980H shall have the meaning given such term by section 4980H.