Affordable Care Act
The Affordable Care Act (ACA) became federal law on March 23, 2010, and includes reforms to the affordability, quality, and accessibility of health insurance and cost-cutting measures, rules, and regulations.
ACA changes to health coverage
The ACA created new rules for health plans, including:
- Coverage for children up to age 26
- Coverage of essential health benefits
- Guaranteed coverage of people with pre-existing medical conditions
- Removal of annual or lifetime limits on coverage
- Limits on out-of-pocket costs
- Limiting employee Flexible Spending Account contributions to $2,500 per year
- Elimination of discriminatory benefits
ACA information reporting requirements: IRS Form 1095-C
Affordable Care Act tax provisions affect individuals, families, businesses, insurers, tax-exempt organizations, and government entities.
The ACA requires employers with 50 or more employees to offer health coverage that meets minimum standards to its full-time employees and their dependents. As part of this requirement, large employers must annually send IRS Form 1095-C to employees. This form shows whether you were offered health insurance by your employer during the year.
Per IRS Notice 2016-5: Form 1095-C is not necessary to file your tax return and you don’t have to send this form to the IRS. The majority of taxpayers simply check a box on their tax returns to indicate that each member of their family had qualifying health coverage. For additional information about the form, see Questions and Answers.
Transparency in Coverage: Links to Machine-Readable Files
The federal Transparency in Coverage Final Rules, a provision of the Affordable Care Act, require certain group health plans to disclose on a public website information regarding in-network provider rates and historical out-of-network allowed amounts and billed amounts for covered items and services in two separate machine-readable files (MRFs). The MRFs for King County’s health benefit plans are linked below:
- For the KingCare and KingCare Select plans, the MRFs are hosted by Regence BlueShield here. Search using King County’s Employer Identification Number (EIN) 916001327.
- For the SmartCare plan, the MRFs are hosted by Kaiser Foundation Health Plan of Washington (Kaiser Permanente) here.