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. Under the ACA, King County is required to submit a Form 1095-C to the IRS annually, as well as send a copy of that form to employees or former employees who were covered. A sample of this form is shown below:
Form 1095-C identifies the months in the previous year that King County offered health insurance to individuals and their dependents. If you notice an error on the form (for example, wrong months of coverage, a misspelled name, or incorrect Social Security Number), please contact the King County Affordable Care Act Office at the number listed in Box 10 of the form, 206-263-0793, so it can be corrected. There are also occasions where we may reach out to you to correct an error. If you receive an email or phone call about an error on Form 1095-C, you can call 206-263-0793 if you want to verify that it is a legitimate request.
Form 1095-C is sent at the end of January for the previous tax year, and you should receive it by Feb. 15. Per IRS Notice 2016-5, Form 1095-C is not necessary to file your tax return and you don’t have to send it to the IRS. Most taxpayers simply check a box on their tax returns to indicate that each family member had qualifying health coverage.
For additional information about the form, see Questions and Answers.
How to order a copy of Form 1095-C
If you need another copy of your Form 1095-C, log into ADP’s secure website. You can download 1095-C and W2 forms from any of the last three years. To create a new account, use the instructions below and provide the items in bold.
- Go to my.adp.com
- Select Create account, then I have a registration code
- Enter the Registration Code: KINGC-W2
- Enter your name and select W-2 Services as the service (even if you want to view your 1095-C; they are both classified under the same service).
- The following information is required for validation purposes:
- Year of W-2: 20XX (use the most recent tax year, even if you want to download a previous year’s form)
- Employee ID: PeopleSoft Employee Number (including leading zeros)
- Company code: TQO (capital letters t, q, o)
- Employee Zip Code: XXXXX (5 digits only)
- Employee’s Social Security Number: XXXXXXXXX (no dashes)
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.