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Proposed Rule on Employer Information Reporting Requirements; Potential Fix for the "Doc Fix"

Leslie J. Levinson
Edwards Wildman Palmer LLP - New York Office

Michaela ("Kayla") Tabela
Edwards Wildman Palmer LLP - Boston Office

September 24, 2013

Previously published on September 2013

On September 5, 2013, the U.S. Department of the Treasury and Internal Revenue Service jointly issued proposed regulations implementing the Affordable Care Act’s information reporting requirements for insurers and certain employers.

Under the Affordable Care Act, employers with at least 50 full-time employees are required to provide their employees with health coverage and report to the IRS information about their compliance with this mandate.

The proposed rule describes a variety of strategies to reduce the burden of information reporting, including:

  • replacing employee statements with W-2 based reporting on offers of employer-sponsored coverage to employees, spouses, and dependents;
  • eliminating the need to determine whether particular employees are full-time if adequate coverage is offered to all potentially full-time employees;
  • allowing employers to report the specific cost to an employee of purchasing employer-sponsored coverage only if the cost is above a specified dollar amount.
  • allowing self-insured group health plans to avoid furnishing employee statements by furnishing a single substitute statement;
  • providing for limited reporting for certain self-insured employers offering no-cost coverage to employees and their families;
  • permitting health insurers to forgo reporting on individual coverage offered through a marketplace; and
  • permitting health insurers, employers, and other entities to report only the months of coverage, the amount of any cost-sharing reductions, or the portion of the premium paid by an employer.

The proposed rule was published in the September 9, 2013 Federal Register. Comments on the proposed rule are due November 8, 2013.


The views expressed in this document are solely the views of the author and not Martindale-Hubbell. This document is intended for informational purposes only and is not legal advice or a substitute for consultation with a licensed legal professional in a particular case or circumstance.

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