United States Office of Personnel Management

Healthcare and Insurance

Benefits Administration Letter

Number: 23-204 Date: November 7, 2023 

Subject: Information to Fulfill Mandatory Reporting Requirements 

for Plan Year 2023 under Internal Revenue Code Sections 6056 and 

4980H 

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 with reporting in 2024 for health insurance coverage in 2023. This 

BAL provides updates on affordability safe harbors and the lowest-cost Federal 

Employees Health Benefits (FEHB) plan for the 2023 plan year. Please refer to BAL 15-

204 for comprehensive guidance on IRC 6056 reporting. 

IRS Required Deadlines 

For health coverage provided in 2023, agencies should furnish statements to full-time 

employees using 2023 Form 1095-C on or before January 31, 2024; however, agencies 

will be granted an automatic extension of time, not to exceed 30 days after January 31, 

during which they must furnish statements to full-time employees.1 The deadline for 

agencies to file Forms 1094-C and 1095-C with the IRS is February 28, 2024, if filing on 

paper, or March 31, 2024, if filing electronically. The previously provided relief from 

certain penalties associated with incorrect or incomplete information is not available 

1 26 CFR 1.6055-1(g)(4)
Benefits Administration Letter 23-204 

2 

for tax year 2022 and subsequent years; however, extended deadlines for furnishing 

statements to employees remain in effect.2 

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 

9.12 percent of that employee’s annual household income.3For purposes of ESR 

reporting for calendar year 2023, the lowest-cost FEHB plan, as determined under 5 

CFR 890.301(n),4 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 2023, had a cost share for non-Postal 

employees and annuitants of $109.83 per month or $1317.945 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 2023, 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.6 For calendar year 2023, 

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 2023 FPL.7 Agencies may request 

further information on the safe harbors as they relate to the FEHB Program at 

ESR@opm.gov.

2 See Final Rule Information Reporting of Health Insurance Coverage and Other Issues. 3 IRS Rev. Proc. 2022-36, the affordability threshold for 2023 is 9.12%. 4 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. 5 $50.69 (bi-weekly rate) x 26 = $1317.94 6 The W-2 Safe Harbor calculation usingthe2023 Grade 1, Step 1 Salary: $20,999 x 9.12%= $1,915.11. 7 Under 79 FR 8543, employers may use the FPL in effect 6 months prior to the beginning of the plan year. For 

2023 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 ($13,590 x 9.12%)/12 = $103.28 per month for self only coverage. The FPL Safe Harbor 

calculation using the 2023 FPL is ($14,580 x 9.12%)/12 = $110.81 for self only coverage. 
Benefits Administration Letter 23-204 

3 

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 2023. A list of these plans is below by plan 

name, code, option, and 2023 Enrollee Share (monthly Self Only premium):

Plan Code Name Plan Code Plan Option 

Type

Enrollment

Type

Price

TakeCare KX1 HDHP Self Only $29.99 

Kaiser Permanente- Southern California FL1 Prosper Self Only $91.33 

Kaiser Permanente-Mid Atlantic States T71 Prosper Self Only $94.92 

Kaiser Permanente-Washington Core PT4 Prosper Self Only $97.50 

Calvo's Select Care B44 Standard Self Only $101.16 

Health Net of California P61 Basic Self Only $101.44

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

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 2023, 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 2023. 

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