ACA State Mandates: A Guide & Checklist

Poster map of United States of America with state names. Print map of USA for t-shirt, poster or geographic themes. Hand-drawn colorful map with states. Vector Illustration

When passed, the Affordable Care Act [ACA] required individuals to purchase & maintain qualifying health insurance coverage – or face a federal penalty. By reducing these penalties to zero in 2019, the federal Tax Cuts & Jobs Act [TCJA] effectively repealed the ACA individual mandate [as distinct from the ACA employer mandate].

Eleven US states have since formally eliminated the original federal ACA mandate on individuals and implemented [or are in the process of implementing] their own state ACA mandates on individuals in its place.

It is under these eleven state mandates that individual residents are now required to purchase & maintain health insurance – or face state penalties. This arrangement impacts ACA reporting for employers with employees in certain of those states.

Other than in Massachusetts, which has its own reporting system, these states typically gather information about the health coverage by piggybacking on IRS FORMs 1095 & 1094. This means that for certain states, in addition to ACA reporting to the IRS, ALEs must also report health coverage to state governments for any full-time employees resident in those states.

 

» NOTE: EMPLOYER VS EMPLOYEE LOCATION. The employer organization’s location is not the deciding factor concerning state ACA reporting obligations. The deciding factor is where the employee lives. This adds a layer of complexity for employers with employees who work remotely or commute to work from other states.

 

Below is a CHECKLIST of the eleven mandating states, the ACA forms [where specified] to be distributed and filed, and the relevant deadlines.

If you have questions about state ACA mandates & reporting or any other aspect of ACA compliance, please contact BENEFITSCAPE, the leading ACA specialist. BENEFITSCAPE provides best-in-class ACA services & Flag & Fix regtech diagnostics to 1000s of employers across all US states.

News & Latest Posts

ACA TY24: IRS Changes, Tips, & Common Errors

November 29, 2024

By BENEFITSCAPE CO-FOUNDER & CEO Kim Phillips. If you read only one…

ACA TY24: State Mandates Guide & Checklist

November 12, 2024

When passed, the Affordable Care Act [ACA] required individuals to purchase &…

ACA TY24: IRS Deadlines & Penalties

November 12, 2024

The IRS ACA reporting DEADLINES for TY24 [filing in 2025] are as…

Dayforce Strengthens BENEFITSCAPE Partnership

November 8, 2024

The annual Dayforce Discover event starts in Vegas on Monday, November 11….

IRS Publishes Forms 1095-B & C for TY24

November 6, 2024

The IRS has published the TY2024 ACA Compliance & Reporting templates for…

TY25: IRS Sets ACA Affordability at 9.02%

October 13, 2024

The TY25 AFFORDABILITY THRESHOLD for calculating employer ACA compliance has been increased…

Scroll to Top