FAQ: Now that some states have enacted individual mandates for their own state residents, is there any associated employer reporting?

February 4, 2020

In connection with the ACA’s individual mandate penalty being zeroed out in 2019 (meaning US residents can forego individual health insurance coverage and will not have to pay a tax penalty), some states have stepped in and enacted their own state individual mandates. Under those mandates, residents of the state must have some level of MEC, or pay a state tax penalty. While these state individual mandates are not employer mandates (i.e., the state laws do not force employers to offer MEC or other coverage), the ACA’s employer mandate remains in effect. The states, though, may require employers to report whether their employees have MEC or some other level of coverage. The reporting generally relates to employees who reside in that state (rather than the state in which they work).

The two newest requirements for 2020 apply to employers with employees who reside in New Jersey and Washington, D.C., as outlined below.

New Jersey
Individual Mandate: Effective 1/1/19
Employer Reporting: Yes
Employer Size: All size employers
Form to File: Form 1095-C
Due Date: March 31, 2020
Applies to: NJ residents (those living in NJ) covered under the group health plan
File through: NJ Division of Taxation (same as where employers file W-2s with the state)
More/Final Info »

D.C.
Individual Mandate: Effective 1/1/2019
Employer Reporting: Yes
Employer Size: 50 or more FT employees (same as the ACA’s employer mandate)
Form to File: Form 1095-C
Due Date: June 30, 2020
Due Date in Future Years: 30 Days following the IRS deadline
Applies to: D.C. residents (those living in D.C.) covered by a group health plan
File Through: D.C. Office of Tax and Revenue, MyTax.DC.gov website
More/Filing Info »

States with similar reporting obligations that will take effect in 2021 include California, Rhode Island, and Vermont (more information to come on those filing obligations). Also, while not directly connected to state individual mandates, Massachusetts (relating to the Health Insurance Responsibility Disclosure (HIRD) forms) and San Francisco (relating to the Health Contribution Security Ordinance (HCSO)) also have reporting requirements. Massachusetts requires employers to file a HIRD form (reporting plan-level information not employee-specific information) by the end of November each year (although the Massachusetts website appears to extend this to December 15), while San Francisco requires employers to file the HCSO contribution form by the end of April each year.

Additional information on MA and SF are available here:
MA »
SF: HCSO Reporting Web Site »
(2020 filing information usually posted it in March)