IRS Forms 1094 and 1095 must be filed by any employer or entity that provided health coverage during the year, but the version you file depends on who you are. Applicable Large Employers, meaning businesses that averaged at least 50 full-time employees (including full-time equivalents) in the prior calendar year, file Forms 1094-C and 1095-C. Health insurance companies, government agencies running programs like Medicaid and Medicare, and smaller employers that self-insure their health plans file Forms 1094-B and 1095-B instead. The obligation comes from two sections of the tax code: Section 6055, which covers anyone providing minimum essential coverage, and Section 6056, which covers large employers specifically.
Employers Who File Forms 1094-C and 1095-C
The largest group of filers is Applicable Large Employers, or ALEs. A business is an ALE if it employed an average of at least 50 full-time employees on business days during the prior calendar year.1Office of the Law Revision Counsel. 26 USC 4980H – Shared Responsibility for Employers Regarding Health Coverage A full-time employee under the ACA is anyone averaging at least 30 hours of service per week.
Part-time staff count toward the threshold, just not one-for-one. The IRS converts part-time hours into full-time equivalents by adding all hours worked by non-full-time employees in a given month (capping each worker at 120 hours) and dividing the total by 120.2Internal Revenue Service. Determining if an Employer Is an Applicable Large Employer A company with 40 full-time workers and enough part-time hours to create 12 full-time equivalents clears the 50-employee line and becomes an ALE.
Every ALE must file one Form 1094-C, which serves as the transmittal summary for the whole company, along with a Form 1095-C for each full-time employee. That includes full-time employees who were offered coverage but declined it.3Office of the Law Revision Counsel. 26 USC 6056 – Certain Employers Required to Report on Health Insurance Coverage The IRS uses the data to check whether the employer met its shared responsibility obligations and whether any employee claimed a premium tax credit on the marketplace.
Related Businesses and the Controlled Group Rule
Companies that share common ownership get combined when the IRS counts employees. Under Section 414 of the Internal Revenue Code, businesses connected through parent-subsidiary relationships, brother-sister ownership, or other forms of common control are treated as a single employer for the 50-employee calculation.2Internal Revenue Service. Determining if an Employer Is an Applicable Large Employer If the combined headcount across all related entities meets the ALE threshold, each entity with employees becomes an ALE member and must file its own Forms 1094-C and 1095-C.
This catches more businesses than people expect. Two companies with 30 employees each might think they are safely below the line, but if the same person or family owns both, the IRS sees one 60-employee operation. Penalty liability, however, is still calculated separately for each entity.
Who Files Forms 1094-B and 1095-B
Form 1095-B covers anyone providing minimum essential coverage who is not already reporting through Form 1095-C. Three groups fall here.4Office of the Law Revision Counsel. 26 USC 6055 – Reporting of Health Insurance Coverage
Health insurance companies. Insurers file 1095-B for individual market policies and for fully insured group plans offered through employers. If your company buys coverage from Aetna or Blue Cross, the carrier handles the 1095-B filing, not you.5Internal Revenue Service. Instructions for Forms 1094-B and 1095-B (2025)
Government programs. The agency sponsoring the coverage files. State Medicaid offices file for Medicaid and CHIP enrollees. The Centers for Medicare and Medicaid Services files for Medicare beneficiaries, including Medicare Advantage participants.
Small self-insured employers. If your company has fewer than 50 full-time employees but self-funds its health plan (meaning the company pays claims directly rather than buying insurance), you must file Forms 1094-B and 1095-B. You do not owe the employer mandate penalties that ALEs face, but you still must report every covered individual to the IRS.
Form 1094-B is the transmittal cover sheet summarizing how many 1095-B forms you are sending. Each 1095-B identifies the covered individual, their dependents, and the months of coverage during the year.
Who Does Not Have to File
A small employer (fewer than 50 full-time equivalents) that buys a fully insured group health plan has no 1094 or 1095 filing obligation at all. The insurance company files Form 1095-B for the covered employees, and the employer’s involvement ends there. The filing duty attaches to self-insurance and to ALE status, not to the simple act of offering coverage.
What Each Filer Sends and to Whom
Whichever series applies, the structure is the same: one transmittal (1094-B or 1094-C) that acts as a cover summary for the batch, plus one individual return (1095-B or 1095-C) for each covered person or full-time employee. The IRS gets the full package. Covered individuals and full-time employees are entitled to their own copy of the 1095.
Starting with the 2025 tax year, employers can satisfy part of the individual furnishing requirement by posting a clear, conspicuous notice on the company website telling employees they may request a copy of their form. The notice must include an email address, a mailing address, and a phone number, and it must stay posted from March 2, 2026, through October 15, 2026. If someone requests their form, you have 30 days to provide it.6Internal Revenue Service. Instructions for Forms 1094-C and 1095-C (2025) For ALE members, this website-posting option applies only to non-full-time employees and nonemployees enrolled in self-insured coverage. Full-time employees are still covered by the standard furnishing rules unless the employer uses the Qualifying Offer Method or the general website notice approach described in IRS Notice 2025-15.
Filing Deadlines for the 2026 Season
For the 2025 tax year filed in 2026, the key dates are:
- March 2, 2026: deadline to furnish Form 1095-C or 1095-B to employees and covered individuals. This is an automatic extension from the statutory January 31 date, and no separate extension request is needed.6Internal Revenue Service. Instructions for Forms 1094-C and 1095-C (2025)
- March 2, 2026: deadline for paper filers to submit Forms 1094 and 1095 to the IRS.
- March 31, 2026: deadline for electronic filers to submit Forms 1094 and 1095 to the IRS.
Electronic Filing Threshold
Any filer submitting 10 or more information returns of any type during the calendar year must file electronically through the IRS Affordable Care Act Information Returns (AIR) system.7Internal Revenue Service. E-file Information Returns That 10-return threshold is cumulative across all information return types, so W-2s, 1099s, and ACA forms count together.8Federal Register. Electronic-Filing Requirements for Specified Returns and Other Documents In practice, virtually every ALE will exceed it.
If electronic filing creates genuine hardship, such as a rural business without reliable internet or a company in a federally declared disaster area, you can request a waiver by filing Form 8508 at least 45 days before the March 31 electronic filing deadline.9Internal Revenue Service. Form 8508 – Application for a Waiver from Electronic Filing of Information Returns Financial hardship claims require two cost estimates comparing electronic and paper filing. An approved waiver covers only one tax year.
Penalties for Not Filing or Filing Wrong
For returns due in 2026, per-return penalties under Sections 6721 and 6722 run as follows:10Internal Revenue Service. Information Return Penalties
- Filed up to 30 days late: $60 per return
- Filed 31 days late through August 1: $130 per return
- Filed after August 1 or not filed at all: $340 per return
- Intentional disregard: $680 per return
These penalties apply separately to the IRS filing under Section 6721 and to the employee statement under Section 6722, so one missed form can generate two penalties. For an ALE with hundreds of full-time employees, even the lowest tier adds up quickly. Annual maximums apply, but for larger filers they run well into six figures.
Missing Social Security Numbers or Taxpayer Identification Numbers for covered individuals generally will not draw a penalty if you can show documented solicitation attempts. Keep records of every request you made and every response you received; those records establish reasonable cause if the IRS later asks why a TIN is blank.