Minimum Essential Coverage Reporting Activity

Health Net will begin requesting Subscriber and Dependent Social Security Numbers on September 21, 2015

The Affordable Care Act (ACA) Section 6055 requires Health Net to report Minimum Essential Coverage (MEC) data to the IRS about the coverage for each individual, including covered dependents starting in 2016.

Health Net will report MEC data to the IRS for all commercial fully insured business with the exception of Individual Marketplace (“on-exchange”) plans. Health Plans are not required to report for government programs including state health plans, Medicare, and Medicaid/Medi-Cal.

 

If we do not have a valid Social Security Number (SSN) or Taxpayer Identification Number (TIN) for the covered individual on file, the IRS requires Health Net to make three attempts to obtain it. The first attempt is upon enrollment. Starting in 2015, if we do not receive a SSN/TIN upon enrollment, Health Net must make a second attempt the same year the member enrolled, and a third attempt the following year.

 

What Health Net is Doing to Prepare for MEC Reporting in 2016

Beginning on September 21, 2015, Health Net will start mailing out the first annual SSN/TINs Request Packages to subscribers for whom we do not have a valid SSN/TIN for either the subscriber or the covered dependent(s).

The package consists of a cover letter with instructions and a “Request for Individual Taxpayer Identification Number and Certification Form,” and a postage paid envelope. Subscribers may also call Health Net to provide a SSN/TIN for themselves or their dependents.

If we do not receive a reply from the subscriber, we’ll send a second annual request package approximately one year after the first annual request is sent.

 

What’s Next

In January, 2016 Health Net will send subscribers a Form 1095-B which will show the months the subscriber and dependents were enrolled in the health plan in 2015. If we don’t have the subscriber or dependent’s SSN/TIN, we will use the subscriber or dependent date of birth, as required by the IRS.

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Jamey Mann