Pension & Benefits News Final regs require electronic filing of health insurance provider fee information
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Monday, November 18, 2019

Final regs require electronic filing of health insurance provider fee information

By Pension and Benefits Editorial Staff

The IRS has issued final regulations amending the health insurance provider fee under Section 9010 of the Patient Protection and Affordable Care Act (ACA). The final regulations require certain covered entities to electronically file Form 8963, Report of Health Insurance Provider Information. The amendments apply to any covered entity reporting more than $25 million in net premiums written on any Form 8963 filed after December 31, 2019. The electronic filing requirement will begin in the 2020 fee year because the fee will not be collected in 2019.

ACA Sec. 9010(a) imposes an annual fee on each covered entity engaged in the business of providing health insurance. The total aggregate “applicable” amount of the fee for all covered entities is determined by statute. A covered entity (including a controlled group) with no more than $25 million in net premiums written does not have any premiums taken into account and is not liable for a fee.

The Secretary must calculate the fee every year, and, to facilitate these calculations, each covered entity must report to the Secretary the covered entity’s net premiums written for health insurance for any United States health risk for the preceding calendar year by the date and in the manner prescribed by the Secretary. Information is reported to the IRS on Form 8963, Report of Health Insurance Provider Information, which must be filed in accordance with the form instructions by April 15 of the year following the calendar year for which data is being reported.

Under the final rule, a covered entity (including a controlled group) reporting more than $25 million in net premiums written on a Form 8963 or corrected Form 8963 must file these forms electronically, not on paper, after December 31, 2019. Forms 8963 reporting $25 million or less in net premiums written are not required to be electronically filed. If a Form 8963 or corrected Form 8963 is required to be filed electronically, any subsequently filed Form 8963 filed for the same fee year must also be filed electronically, even if such subsequently filed Form 8963 reports $25 million or less in net premiums written. Failure to electronically file will be treated as a failure to file.

SOURCE: 84 FR 61547, November 13, 2019.

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