IRS PROVIDES ADDITIONAL GUIDANCE ON FORM W-2 REPORTING REQUIREMENT
January 10, 2012
The IRS recently released IRS Notice 2012-9 that provides employers additional guidance on the Form W-2 reporting requirement created under the Affordable Care Act1. The Notice clarifies a number of issues addressed in earlier guidance and extends the small employer exemption (for employers filing fewer than 250 W-2s) from the reporting requirement.
BACKGROUND
The Act established a requirement that employers must report the “aggregate cost” of employer-provided health coverage on an employee’s Form W-2. This requirement is informational and does not affect an employee’s taxable income.
The aggregate cost of coverage is the entire cost, including both the employer and employee contributions, to an applicable plan. Self-funded plans are generally allowed to utilize the method used to determine applicable COBRA rates to calculate the aggregate cost of a plan. Applicable cost must be calculated on a monthly basis, based on the specific coverage maintained by the employee.
The Form W-2 reporting requirement was originally effective for the 2011 tax year. However, in March 2011, the IRS provided interim guidance that delayed the requirement so that employers who file 250 or more Form W-2’s in the preceding calendar year were not required to report health costs on Form W-2 until the 2012 tax year (i.e. W-2’s that are provided to employees generally in January 2013). The guidance also delayed the requirement for smaller employers.
The requirement raised many questions from employers and plan administrators such as what types of coverage must be included on Form W-2 and how to calculate the cost of this coverage. The IRS solicited comments on various aspects of the reporting requirement, and as a result, has now amended its guidance to address some of these questions. The updated guidance is effective for reporting in 2012 and may be relied upon for employers who voluntarily report in 2011.
NEW GUIDANCE AND CLARIFICATIONS
Below is a summary of the guidance and clarifications:
- Employers who file fewer than 250 Form W-2’s in the preceding calendar year are exempt from the reporting requirement and “… until further guidance is issued, an employer is not subject to the reporting requirement for any calendar year if the employer was required to file fewer than 250 Forms W-2 for the preceding calendar year.”
- The reporting requirement does not apply to payments or reimbursements of health insurance premiums for a 2% shareholder-employee of an S corporation who is required to include the premium payments in gross income.
- Tribally chartered corporations that are wholly owned by a federally recognized Indian tribal government are exempt from the reporting requirement.
- The same standards that determine if a group dental or vision plan is subject to HIPAA will also be the same standards that apply to determine if the plan’s cost is includible in this reporting requirement (e.g. stand-alone plans are generally exempt from the reporting requirement).
- The reporting requirement does not apply to Health FSA coverage that is solely funded through employee salary reductions; however, employer contributions to a Health FSA are reportable.
- Employers who provide employees with access to Employee Assistance Programs (EAP), wellness programs or on-site health clinics are not required to include the cost of this coverage on Form W-2 if the employer does not charge a premium for that coverage for COBRA purposes; otherwise, this coverage would be included in the reported cost of coverage to the extent that it is a group health plan.
- Employers may include the cost of coverage under programs not required to be included under applicable interim relief, such as the cost of coverage under a Health Reimbursement Arrangement (HRA). Some employers may choose to include HRA costs, even though not required, since it may make it administratively easier to calculate an employee’s aggregate cost.
- An employer may use either a composite rate or other method used to calculate COBRA premiums. Regardless of which method is used, the employer must use that method consistently when reporting the cost of coverage.
- The cost of reported coverage may be based on the cost information available to the employer as of December 31 and does not need to be adjusted for future changes in enrollments.
- The guidance also addresses items such as the applicability of supplemental health benefits such as cancer policies, the reporting requirement for related employers that do not use a common paymaster and how to complete reporting for coverage provided during a payroll period that straddles two calendar years.
IRS Notice 2012-9
1 “Affordable Care Act” means The Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act of 2010 (HCERA).





