United States Office of Personnel Management

The Federal Government’s Human Resources Agency

Benefits Administration Letter

Number: 22-204 Date: November 1, 2022 

Subject: Information to Fulfill Mandatory Reporting 

Requirements for Plan Year 2022 under Internal 

Revenue Code Sections 6056 and 4980H

I. Purpose

Employers, including Federal agencies, are subject to the Employer Shared 

Responsibility (ESR) provisions under sections 6056 and 4980H of the 

Internal Revenue Code (IRC). This Benefits Administration Letter (BAL) 

provides information to assist Federal agencies for reporting in 2023 for 

health insurance coverage in 2022. This BAL provides updates on 

affordability safe harbors and the lowest cost Federal Employees Health 

Benefits (FEHB) plan for the 2022 plan year. Please refer to BAL 15-204 for 

comprehensive guidance on IRC 6056 reporting. 

IRS Required Deadlines 

For health coverage provided in 2022, agencies must furnish statements to 

full-time employees using 2022 Form 1095-C on or before March 2, 2023. 

The deadline for agencies to file Forms 1094-C and 1095-C with the IRS is 

February 28, 2023 if filing on paper, or March 31, 2023 if filing electronically. 

The previously provided relief from certain penalties associated with 

incorrect or incomplete information is not available for tax year 2021 and 

subsequent years; however, extended deadlines for furnishing statements to 
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employees remain in effect.1 OPM will inform agencies should a future IRS 

Notice or regulation be issued.

II. Affordability 

Health coverage is considered affordable when the employee’s share of the 

premium for the Self Only coverage offered to the employee would cost the 

employee less than 9.61 percent of that employee’s annual household 

income.2 For purposes of ESR reporting for calendar year 2022, the lowest 

cost FEHB plan, as determined under 5 CFR 890.301(n)3, will in most cases 

be the GEHA Indemnity Benefit Plan (IBP) Elevate Option, Self Only, 

enrollment code 254. The GEHA IBP is the lowest cost nationwide plan 

without membership fees, which for 2022, had a cost share for non-Postal 

employees and annuitants at $105.61 per month or $1267.244 per year. 

Agencies may request further information on affordability as it relates to the 

FEHB Program at ESR@opm.gov. 

A. Affordability Safe Harbors 

For calendar year 2022, the GEHA IBP Elevate Option, Self Only enrollment 

type meets the threshold for the Form W-2 safe harbor for employees 

working a 40-hour schedule and employed as a Grade 1, Step 1 on the 

General Schedule.5 For calendar year 2022, the GEHA IBP Elevate Option, 

Self Only enrollment type may meet the threshold for the rate of pay safe 

harbor for hourly employees (non-salaried) depending on the number of 

hours worked and their hourly rate. It does meet the threshold for the 

federal poverty line (FPL) safe harbor using the 2022 FPL.6 Agencies may 

1 IRS Notice 2020-76. See also Notice of Proposed Rulemaking Information Reporting of 

Health Insurance Coverage and Other Issues. 2 IRS Rev. Proc. 2021-36, the affordability threshold for 2022 is 9.61%.

3 The lowest-cost nationwide plan option identified may not be a High Deductible Health 

Plan (HDHP) or an option from a health benefits plan that charges an association or 

membership fee.

4 $48.74 (bi-weekly rate) x 26 = $1,267.24.

5 The W-2 Safe Harbor calculation using the 2022 Grade 1, Step 1 Salary: $20,172 x 

9.61%= $1,938.53. 

6 Under 79 FR 8543, employers may use the FPL in effect 6 months prior to the beginning of 

the plan year. For 2022 plan year, using the published FPL rate in effect 6 months prior to 

the beginning of the plan year, the FPL safe harbor calculation is ($12,880 x 9.61%)/12 = 
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request further information on the safe harbors as they relate to the FEHB 

Program at ESR@opm.gov. 

B. Regional Low-Cost Plans 

Certain regional FEHB plans have a lower enrollee cost than the GEHA IBP 

Elevate Option, Self Only plan for calendar year 2022. A list of these plans 

is below by plan name, code, option, and 2022 Enrollee Share (monthly Self 

Only premium):

1. TakeCare, KX1, HDHP Option, Self Only, $30.58

2. Kaiser Foundation Health Plan of Southern California, FL1, Prosper 

Option, Self Only, $91.41

3. Kaiser Foundation Health Plan Mid-Atlantic States, T71, Basic Option, 

Self Only, $92.22 

4. Calvo’s SelectCare, B44, Standard Option, Self Only, $94.73

5. Kaiser Foundation Health Plan of Washington, PT4, Prosper Option, 

Self Only, $97.50i 

6. Triple-S, 891, High Option, Self Only, $97.51

7. Kaiser Foundation Health Plan of Colorado, N41, Basic Option, Self 

Only, $97.54 

Please contact ESR@opm.gov to request specific plan zip code information.

III. Certification of Eligibility 

Alternative methods of reporting under section 6056 were developed by the 

IRS to offer a simplified method of employer reporting, as explained in BAL

15-204. For calendar year 2022, the qualifying offer method is applicable to 

Federal agencies. Agencies may use the 98 percent method if 98 percent of 

$103.15 per month for self only coverage. The FPL Safe Harbor calculation using the 2022 

FPL is ($13,590 x 9.61%)/12 = $108.83 for self only coverage.
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their full-time employees have been offered affordable health insurance in 

calendar year 2022. 

If you have questions related to ESR reporting under section 6056 you may 

call the IRS Healthcare Hotline at 800-919-0452. If you have any questions 

regarding this BAL, please email ESR@opm.gov. 

Sincerely,

Laurie Bodenheimer

Associate Director

Healthcare and Insurance