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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 employees with less than 50 full-time equivalent
                  employees or the         insurer may be required to issue form *1095-B to the
                  responsible individual and    file with the IRS as proof of healthcare coverage .
                                           *see 1095-B instructions for recipient requirements.

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

         1095-C   Employer Provided Health    Employers with 50+ full-time equivalent employees must file with the IRS
                  and may                  be required to issue form *1095-C to employees as proof of
                  healthcare coverage .    *see 1095-C instructions for recipient requirements.

         1094-C   Employer Health          This transmittal must accompany each batch of  1095-C forms when filing
                  Transmittal              to 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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