United States Office of Personnel Management 

The Federal Government’s Human Resources Agency 

Benefits Administration Letter 

Number: 21-205 Date: September 29, 2021 

Subject: Information to Fulfill Mandatory Reporting 

Requirements for Plan Year 2021 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 2022 for 

health insurance coverage in 2021. This BAL provides updates on 

affordability safe harbors and the lowest cost Federal Employees Health 

Benefits (FEHB) plan for the 2021 plan year. Please refer to BAL 15-204 for 

comprehensive guidance on IRC 6056 reporting. 

IRS Required Deadlines 

For calendar year 2022 (health coverage provided in 2021), agencies must 

furnish statements to full-time employees using 2021 Form 1095-C on or 

before January 31, 2022. Agencies must file information returns regarding 

health insurance coverage to the IRS by February 28 if filing on paper, or 

March 31 if filing electronically, following the calendar year. Previously, IRS 

has extended the deadlines for furnishing statements to employees and 

extended relief from certain penalties associated with incorrect or incomplete 

information. OPM will inform agencies should a future IRS Notice be issued. 
Benefits Administration Letter 21-205 

2 

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 9.83 percent of that employee’s annual household 

income.1

1 Under IRS Rev. Proc.2020-36, the affordability threshold for 2021 is 

9.83%. 

For purposes of ESR reporting for calendar year 2021, the lowest 

cost FEHB plan, as determined under 5 CFR 890.301(n)2

2

 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. 

, will in most cases 

be the GEHA Indemnity Benefit Plan (IBP) Elevate Self, enrollment code 254. 

The GEHA IBP is the lowest cost nationwide plan without a membership, 

which has a cost share for non-Postal employees and annuitants at $102.53 

per month or $1,230.323

3

 $47.32 (bi-weekly rate) x 26 = $1,230.32. 

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 2021, the GEHA IBP Elevate Option 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.4

4 The Safe Harbor calculation using the 2021 Grade 1, Step 1 Salary: 

$19,738 x 9.83%= $1,940.25.

For calendar year 

2021, the GEHA IBP Elevate Option plan 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 meets the threshold for the 

federal poverty line safe harbor.5

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

the beginning of the plan year. The FPL Safe Harbor calculation using the 

2021 FPL is: ($12,880 x 9.83%)/12= $105.51. The Safe Harbor calculation 

using the 2020 FPL is: ($12,760 x 9.83%)/12= $104.53.

Agencies may request further information 

on the safe harbors as they relate to the FEHB Program at ESR@opm.gov. 
Benefits Administration Letter 21-205 

3 

B. Regional Low Cost Plans 

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

Elevate Option for calendar year 2021. A list of these plans is below by plan 

name, code, Option, and 2021 Enrollee Share (monthly premium rate): 

1. TakeCare, KX1, HDHP Self, $30.13 

2. Health Net of California, P61, Basic Self, $91.01 

3. Kaiser Permanente Washington Core, PT4, Prosper Self, $97.50 

4. Puerto Rico Triple‐S Salud, Inc., 891, High Self, $97.51 

5. Kaiser Permanente - Northwest – Prosper Self, AM1, $97.94 

6. TakeCare, JK4, Standard Self, $101.11 

7. Medical Mutual of Ohio, X61, Basic Self, $101.32 

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 2021, the qualifying offer method is 

applicable to Federal agencies. Agencies may use the 98 percent method if 

98 percent of their full-time employees have been offered affordable health 

insurance in calendar year 2021. 

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 contact Julia Elam, Program Analyst, Healthcare 

and Insurance at (202) 606-2128 or email ESR@opm.gov. 

Sincerely, 

Laurie E. Bodenheimer 

Associate Director 

Healthcare and Insurance