§6055 Reporting of Health Insurance Coverage

Summary

If you provide minimum essential health coverage to someone during a calendar year, you must file a tax report in the form the tax official (the Secretary) requires. The report must give the primary insured’s name, address, and tax ID number (TIN) and the names and TINs of others covered. It must show the dates each person had coverage that year. If the coverage is health insurance, the report must say whether it is a qualified health plan sold through an Exchange and, for such plans, list any advance payments of premium tax credits or cost‑sharing reductions and any premium tax credit amounts (see sections 1412, 1402, and 36B). Group employer plans must also show the employer’s name, address, and employer tax ID (EIN), how much the employer pays toward premiums, and extra details for small‑group Exchange plans needed for the small employer credit (section 45R). You must also give each covered person a written statement with your contact info and the same coverage details for that person. That statement must be provided by January 31 of the year after the coverage year. Instead of sending it automatically, you may post a clear notice that people can request the statement; if asked, you must send it by the later of January 31 or 30 days after the request. A person is treated as agreeing to get the statement electronically if they previously said yes, unless they later revoke that consent in writing. Government units must have the official who agreed to provide coverage (or a designated person) do the reporting. Minimum essential coverage is defined in section 5000A(f).