The Centers for Medicare & Medicaid Services (CMS) has decided to let itself phase in implementation of the new Patient Protection and Affordable Care Act (PPACA) coverage reporting requirement.
CMS will let its Center for Medicare division wait until the 2016 coverage year to send out 1095-B coverage reporting notices to all Medicare enrollees.
PPACA requires health insurers and other coverage providers to use the 1095-B forms to show enrollees whether they had minimum essential coverage (MEC), and in what months. Consumers are supposed to use the forms when they file their income tax returns, to show whether or not they’re subject to the penalty that PPACA now imposes on many taxpayers who fail to meet PPACA coverage requirements.
See also: Meet the 2015 PPACA tax forms
Coverage providers that file their first batch of 1095-B forms, for 2015, electronically are supposed to send the forms out to employees by Jan. 31, 2016, and to the Internal Revenue Service (IRS) by March 31. Coverage providers that file the 2015 forms on paper are supposed to mail them by Feb. 29, 2016, according to the IRS.
A coverage provider can get an automatic 30-day extension of the filing time, without providing a signature or explanation, by filing Form 8809 on or before the 1095-B due date, IRS officials say. Coverage providers can also ask for an additional 30-day hardship exemption.
For the 2015 coverage year, the Medicare program will send out 1095-B coverage notices only to enrollees who seem likely to have more trouble than other enrollees with showing that they have MEC, CMS officials say.
The Center for Medicare will send 1095-Bs to enrollees under age 65, enrollees who signed up for Medicare Part A coverage for the first time in 2015, and enrollees who had Medicare Part A coverage during just part of 2015, officials say.
Enrollees over 65 who have had Medicare Part A coverage for more than a year will be able to document that they had MEC in 2015 by checking a box on their tax returns, officials say.
Officials say they will also organize a campaign to inform Medicare enrollees that Medicare Part A coverage counts as MEC.
“Ninety-nine percent of seniors are insured, largely thanks to Medicare, so getting the mailed notice from Medicare documenting their MEC is less needed than for other groups,” officials say.
The PPACA public exchanges had to send a similar form, Form 1095-A, to 2014 exchange plan users earlier this year.
See also: IRS offers 1095-A glitch relief
Employer health plan sponsors are supposed to start filing the employer coverage reporting form, Form 1095-C, according to the same schedule the 1095-B senders use. Employers are supposed to mail paper 1095-C forms for 2015 by Feb. 29, 2016, and to send out electronic 1095-C forms for 2015 by March 31, 2016.