Under new tax guidance (Notice 2019-04), D.C. residents must have minimal essential health care coverage (MEC), have a coverage exemption, or pay a tax penalty for tax years ending on or after December 31, 2019. Insurance companies, business providing insurance to their employees, and other applicable entities are required to file information returns with the Office of Tax and Revenue (OTR) electronically through MyTax.DC.gov using OTR’s layouts and file formats. Applicable entities are also required to “furnish a statement about coverage to the individual covered.”
Coverage information applicable entities are required to file should be the same information they file with the IRS including Form 1094-B, Form 1095-B, Form 1094-C, and 1095-C. Third-party service providers may file information returns on behalf of applicable entities.
Failure to comply to the mandate may result in a penalty in the amount of 2.5% of their annual household income OR a per-person penalty of $695 per adult and $375.50 per child (whichever is higher).
*If you work in D.C. but are not a resident, this mandate does not apply.
These are defined as “employers or other sponsor of an employment-based health plan or an insurance issuer or carrier licensed to or otherwise authorized to offer minimum essential coverage. This includes the D.C. Department of Healthcare Finance (DHCF). Applicable entities include:
- Employers or other sponsors of employment-based health plans (including government agencies) that provide coverage for a minimum of 50 full-time employees, including at least 1 employee who is a D.C. resident in the applicable calendar year;
- Persons who provided MEC to a D.C. resident during the applicable calendar year;
- An insurance issuer or carrier license to or otherwise authorized to offer MEC in D.C. during the applicable calendar year; and
- Applicable entities should sign up with MyTax.DC.gov beginning immediately
- Deadline for uploading the information returns:
- For the tax year ending December 31, 2019, the deadline is June 30, 2020
- For tax years after 2019, the deadline is 30 days after the IRS deadline for submitting 1095-B or 1095-C forms (including any extensions IRS has granted).
Guidance for Applicable Entities Pursuant to the Individual Taxpayer Health Insurance Responsibility Requirement Amendment Act of 2018
Individual Taxpayer Health Insurance Responsibility Requirement Amendment Act of 2018, effective October 30, 2018 (D.C. Law 22-168)