Form 1094-C UT 2024-2025

Form 1094-C UT: What You Should Know

Questions and Answers about the Employer Shared Responsibility Provisions The employer shared responsibility provision of the Affordable Care Act (the Act) requires companies with 50 or more full-time workers (including those that are self-employed) to provide coverage for adults without regard to their or their child's age. Employers with 50 or more full-time workers will be responsible for a contribution for each full-time employee whose coverage they do not fully fund. The employer shared responsibility provision does not apply to a family's coverage under a qualified health plan or a health insurance coverage offered in the small business health insurance market. Individuals who are not qualified individuals may still qualify for the coverage provided through their primary care doctor. The employer shared responsibility provision does not apply to short-term disability coverage provided through self-insured plans of an employer's own. The employer shared responsibility provision does not apply to health coverage provided through the exchange or exchange-compliant non-group health plans. However, an employer who has more than 50 full-time employees who enroll through the exchange is required to offer coverage for them. The employer shared responsibility provision does not apply to coverage for an individual's dependent under either of: (1) an individual's current individual federal tax return or (2) a qualifying family arrangement return.   The employer shared responsibility provision only applies to a qualified health plan. Employers are not required to offer any other kind of health insurance coverage to their employees other than qualified health plans. In most cases, a person has access to health insurance coverage that is offered through the employer or that is self-funded, but coverage in an employer-sponsored plan or an exchange plan is treated as qualifying coverage for purposes of the employer shared responsibility provision. Employees who fail to maintain coverage provided under their employer's plan may be subject to a month-to-month penalty imposed by the employer for each month during which coverage lapses (exception is for people with qualifying coverage for whom an annual penalty for the non-complying month is only 95 if enrolled on September 11, 2013, through November 11, 2013) or to other penalties imposed by a plan issuer or the law. For additional information, please see our Employer Shared Responsibility Overview page. Additional Information about the Tax Reform Bill's Employer Shared Responsibility Provisions Additional information for the 2025 Tax Reform bill's employer shared responsibility provisions, including the Employee Health Insurance Tax and the Premium Tax Credit for Health Insurance Expansions.

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