Agents, brokers and other benefits advisors may sell insurance products and related products and services, but what you really do every day is help clients analyze, and protect themselves against, catastrophes. Early death. Disabling illnesses and injuries.
Acute conditions that could easily leave patients with $100,000 bills, and long-term conditions that could easily saddle patients with $500,000 bills.
Now, you can warn your benefits clients, and individual clients who help run midsize businesses, about Patient Protection and Affordable Care Act (PPACA) tax forms, including the 1095-C, the form an “applicable large employer” (ALE) is now supposed to use to describe the health benefits they offered employees.
Originally, employers were supposed to get the first wave of 1095-C forms to employees, and former employees, by Feb. 1. If employers were filing electronically, they had until March 31 to get copies of the forms to the Internal Revenue Service (IRS).
The IRS recently pushed the deadline for getting the forms to current and former employees back two months, to March 31, and the deadline for getting the forms to the IRS to June 30.
See also: IRS extends some PPACA reporting requirements for employers
That means ALEs have two more months to prepare to send out 1095-C’s, but that doesn’t mean all ALEs are ready.
Insurers have to send a similar form to enrollees: the 1095-B. One of the coverage providers required to send 1095-B’s is Medicare.
The process of sending 1095-B’s is so daunting that the Centers for Medicare & Medicare Services (CMS) decided, in November, to give Medicare managers permission to wait until the 2016 coverage year to come into full 1095-B form compliance.
See also: PPACA Form 1095-B: CMS to put off full Medicare compliance
The PPACA public exchange programs are supposed to send similar forms of their own, the 1095-A. The exchange program managers live and breathe PPACA. They are PPACA coverage warriors. But even they are facing barrages of government agency reports taking note of their problems with sending out accurate 1095-A’s in a timely fashion.
In other words: This stuff is hard even for government agencies that love PPACA.
What hope do your poor clients have? Their hope might be you.
For a look at three reasons that could be good for your revenue, read on.
1. Many employers are completely lost.
One interesting thing about the 1095-C advice opportunity is that even benefits professionals who simply know that 1095-C’s exist, and are important, may be ahead of the game.
ADP, a company that has used payroll services as a path into the benefits administration market, found in August when it surveyed benefits and human resources managers at 435 likely ALES — employers with 50 to 999 employees — that 43 percent had not heard of the 1095-C.
They were not able to answer any of the other questions about 1095-C preparedness because they had no idea what that meant.
To fill out accurate 1095-C’s, employers need month-by-month information about each employee’s health benefits.