Download this quick ACA form reference guide docx format of ACAforms_quick_reference.docx
for an overview of the different ACA forms, what they are, who is responsible for the form, where it is sent, and what the responsibility of the offline agency and municipality is.

For Municipalities and Offline Agencies Only

Under federal health reform - the Affordable Care Act (ACA) - employer shared responsibility reporting is required for the calendar year. The 1095-C form covers both the 6055 and 6056 individual mandate and employer shared responsibility reporting. Employers who are fully insured are only responsible for the 6056 reporting which is Parts I and II of the form. Part III is captured in the 1095-B form filed by the insurer. Based on the available IRS guidance, form instructions, and conversations we have had with the IRS, we believe you can consider yourself fully insured and therefore must only complete Parts I and II of the form. The GIC and our fully insured plans will be taking care of the individual mandate reporting for your employees enrolled in our plans.

Individual Mandate Requirement

The Individual Mandate Requirement (form 1095-B) applies to all covered employees and non-Medicare retirees. All housing, redevelopment authority and municipalities must designate the GIC as your Designated Governmental Entity (DGE) for purposes of the individual mandate reporting. See this website for additional details. If you submitted this form to the GIC last year, you do not need to submit it again. Otherwise, the form docx format of dge-form_2016.docx
must be signed and returned to us no later than December 1, 2017 to make this designation. Send the original signed form by mail to the attention of Andrew Stern, General Counsel. Under the regulations, we must agree to accept this designation and we will return to you a fully executed copy of the form. Note attached to the form are supporting materials from the federal guidance as background.

Offer of Coverage Requirement

With respect to the offer of coverage requirement (form 1095-C), the requirement only applies to Applicable Large Employers (i.e. employers with 50 or more full-time equivalent employees).  According to the ACA, full-time employees work 30 or more hours per week. If you are an Applicable Large Employer, you must report that you offered coverage to all eligible employees by filing form 1095-c with the Internal Revenue Service. 

Housing, Redevelopment, and Other Authorities: For Part II, box 15, of the 1095–C form, the UniCare/ Community Choice Plan is the lowest cost minimum value plan for all state employees (including housing and redevelopment authorities) residing in Massachusetts (except for Dukes and Nantucket counties).

For employees who reside outside of New England, UniCare/Basic is the only plan offered. If you are a housing or redevelopment authority and have employees who reside on the Massachusetts islands or other area states. See the attached spreadsheet xlsx format of Lowest_cost_plans_by_area7-1-17.xlsx
for the correct health plan and premium by state.

MA (Except Dukes and Nantucket counties) - UniCare/Community Choice 

MA Dukes county and Nantucket county – NHP

ME – PLUS 

NH – PLUS 

RI – PLUS

CT – PLUS

VT – UniCare Basic w/o CIC

NY – UniCare Basic w/o CIC

All other states – UniCare Basic w/o CIC

Municipalities: For Part II, box 15, of the 1095-C form, your municipality’s premium splits and employees’ residence will affect the plan premium indicated for a particular employee.