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How Do I Prepare For the New W-2 Reporting for Healthcare Coverage?

October 05, 2010

Over the next few years, employers will face a number of new compliance and reporting obligations, among others, as a result of the new healthcare reform package (the Patient Protection and Affordable Care Act).  On the horizon for employers is the requirement to report the value of health insurance coverage they provide to each employee on the employee's annual Form W-2, Wage and Tax Statement.  This new reporting requirement starts with the 2011 tax year and, according to the IRS, is for information purposes only.  Employees will not have to pay tax on the amount reported on the W-2 for healthcare coverage; thus, the new reporting requirement does not affect an employee's tax liability.

Employers should plan now in order to implement and navigate the new W-2 health coverage reporting requirement, and understanding the basics of this new obligation is an important first step.

Applicable coverage

Generally, employers must calculate and report the aggregate cost of all "applicable employer-sponsored coverage" provided to each employee annually on the employee's Form W-2, starting with the 2011 tax year.  "Applicable employer-sponsored coverage" is coverage under any group health plan made available to any employee by the employer which is excluded from the employee's gross income under Internal Revenue Code Sec. 106, or would be excludable. Applicable employer-sponsored coverage also includes coverage under a federal, state or local government group health plan.  Coverage is treated as applicable employer-sponsored coverage regardless of whether the employer or employee pays for the coverage.

Applicable employer-sponsored coverage that must be reported includes the following:

  • Medical plans;
  • Prescription drug plans;
  • Executive physicals;
  • On-site clinics, if they provide more than de minimus care;
  • Medicare supplemental policies;
  • Employee assistance programs; and
  • Coverage under dental and vision plans, unless they are "stand-alone" plans.

Excludable coverage

Employers do not need to report the following types of healthcare coverage on an employee's W-2: the cost of contributions made by employees (or their spouses) to Archer medical savings accounts (MSAs) or health flexible spending accounts (HSAs); salary reduction contributions to flexible spending arrangements (FSAs); long-term care, disability or accident income insurance; or specific disease or hospital/fixed indemnity plans.  These are all excluded from the new W-2 reporting requirement.

Aggregate cost

Employers must report the aggregate or total cost of employer-sponsored health insurance coverage.  This includes coverage paid for by both the employee and employer.  The IRS has advised that employers do not need to provide a specific breakdown of the different types of medical coverage; they must just report the total cost of all applicable coverage.

According to the IRS, the aggregate cost of coverage should be computed under rules similar to COBRA cost of coverage rules.  For fully insured plans, the COBRA cost of coverage is generally the amount of premiums paid to the insurer.  For self-insured plans, the COBRA cost of coverage is based upon an actuarial estimate of future costs.

Valuing coverage may pose a challenge to employers with respect to plans that are subject to the new W-2 reporting requirement but that have not yet been valued for COBRA purposes, such as on-site medical clinics.  Employers will need to determine reportable values for coverage under such programs.  The IRS is still hammering out applicable guidance for such situations, and we will keep you posted.

Updating payroll systems

However, because an employee whose employment is terminated before the close of a calendar year may request an early W-2 form from his or her former employer, employers must be prepared for and implement the new reporting requirements at the start of 2011.  Employers will also need to ensure that their payroll systems are updated to reflect these changes so that they will be able to provide W-2 forms that comply with the new requirements.

Although the new W-2 reporting rule does not kick in until the 2011 tax year, employers may want to start updating their payroll systems now, and do so by the end of January 2011.  Employers are not required to file Forms W-2 until January 31, 2012.  However, having payroll systems updated in order to comply with the new W-2 requirement by the start of 2011 is important particularly if an employee requests their W-2 prior to this date (such as an employee who has been terminated and requests an early W-2 form).  Employers must provide a W-2 upon an employee's request within 30 days.

Former employees
The new W-2 reporting requirement applies to all employees.  However, it may apply to former employees as well.  If a former employee (such as a retiree, terminated employee on COBRA or a surviving spouse) is provided with health insurance, you may be required to file a W-2 for the individual reporting their health coverage.  However, the IRS has not yet issued guidance on reporting requirements for former employees.  Our office will keep you updated on developments.

The new W-2 reporting requirement for healthcare coverage can be complicated, and the rules are still developing. If you have questions regarding your new reporting obligations, please contact us.

 

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