Sample for employers with less than 50 or more full-time and FTE employees that offer fully insured health plans

Affordable Care Act  Reporting Requirements

Dear Employee,

The Affordable Care Act (ACA) requires most Americans to maintain minimum essential coverage. Starting in 2016, you will receive information about [Company Name]’s health coverage.  You should receive Form 1095-B directly from [Insurer Name]. The 1095-B provides information to assist you in completing your income tax return by showing whether you and your family had minimum essential coverage during the year.  These forms will be issued by March 31, 2016.

If you have any questions, please contact [Company Contact].

Sample for employers with less than 50 full-time and FTE employees that offers self-insured health plans.

Sample for employers with 50 or more full-time and FTE employees that offer self-insured insured health plans

Sample for employers with 50 or more full-time and FTE employees that offer fully insured health plans

Dear Employee,


The Affordable Care Act (ACA) requires most Americans to maintain minimum essential coverage. Starting in 2016, you will receive information about [Company Name]’s health coverage.  You should receive Form 1095-C which includes information about the health coverage offered or not offered to you by [Company Name], even if you chose not to enroll. If you purchased health insurance coverage through the Health Insurance Marketplace and claimed or wish to claim the premium tax credit, this information will assist you in determining whether you are eligible.


If you enrolled in our company-sponsored plan in 2015, Part III of the 1095-C will provide information to assist you in completing your income tax return by showing whether you and your family had minimum essential coverage from [Company Name] during the year.   These forms will be issued by March 31, 2016.


If you have any questions, please contact [Company Contact].

Dear Employee,


The Affordable Care Act (ACA) requires most Americans to maintain minimum essential coverage. Starting in 2016, you will receive information about [Company Name]’s health coverage. You should receive Form 1095-C which includes information about the health coverage offered or not offered to you by [Company Name], even if you chose not to enroll.  If you purchased health insurance coverage through the Health Insurance Marketplace and claimed or wish to claim the premium tax credit, this information will assist you in determining whether you are eligible.


If you enrolled in our company-sponsored plan in 2015, you should also receive Form 1095-B from [Insurer Name].  The 1095-B provides information to assist you in completing your income tax return by showing whether you and your family had minimum essential coverage during the year.   These forms will be issued by March 31, 2016.


If you have any questions, please contact [Company Contact].

Sample Communications:

Dear Employee,

The Affordable Care Act (ACA) requires most Americans to maintain minimum essential coverage. Starting in 2016, you will receive information about [Company Name]’s health coverage.  You should receive Form 1095-B which provides information to assist you in completing your income tax return by showing whether you and your family had minimum essential coverage from [Company Name] during the year.  These forms will be issued by March 31, 2016.

If you have any questions, please contact [Company Contact].

The information below is provided for informational purposes only and may not be applicable in every situation. This language should not be consider legal advice or a legal opinion.  Please consult with your attorney for legal advice if you have questions specific to your individual circumstances.   If you use the information below either "as is" or by modifying the text, you are responsible for all content.