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ACA ORDERING INFORMATION                                                                                         12


        1095 Ordering Information



        >>  IRS Reporting
           Order the official IRS landscape format.  Only
           the official landscape format can be used when
           reporting to the IRS.
        >>  Recipient Reporting                              PORTRAIT                    LANDSCAPE

           Order either the official IRS landscape format
           or portrait style recipient formats, designed for
           easy printing and mailing.   Confirm software
           compatibility.
        >>  Employer Reporting (File Copy)

             Order either the official IRS landscape format or
           portrait style recipient formats.  The employer
           needs to retain a copy of what was filed to the IRS
           and recipient for their records.







         Form     Title                    Who Uses This Form
         1095-B   Health Coverage          Self-insured employers with less than 50 full-time equivalent employees or the
                                           insurer must issue form 1095-B to the responsible individual and file with the
                                           IRS as proof of healthcare coverage .

         1094-B   Transmittal of Health    This transmittal must accompany each batch of  1095-B forms when filing to
                  Coverage                 the IRS . This form is not required when issuing recipient copies .

         1095-C   Employer Provided Health    Employers with 50+ full-time equivalent employees must issue form 1095-C
                  Insurance                to employees and file with the IRS as proof of healthcare coverage .

         1094-C   Employer Health          This transmittal must accompany each batch of  1095-C forms when filing to
                  Transmittal              the  IRS . This form may have up to 3 pages depending on whether or not the
                                           transmittal is being filed as the authoritative transmittal and if the filer is a
                                           member of an aggregate ALE group . This form is not required when issuing
                                           recipient copies .






           ACA 1095 REPORTING DEADLINES

           Type of Reporting                Deadline
           1095 Recipient Reporting         March 2*
           1095 Federal Reporting           February 28**
           * If the due date falls on a Saturday, Sunday, or legal holiday,
            the due date is the next business day .
           **Due date is March 31 if filed electronically
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