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Select links below to access previous years' reporting forms & information

July 31, 2019 - PCORI Filing, CERF Payments, Form 720

This annual fee applies to insured and self-insured health plans with plan years beginning on or after October 2, 2011. This fee must be self-reported on Excise Tax Form 720 each year in July.

The required Form 720 and its instructions are available below:

For assistance, E.D.I.S. clients may contact our customer service department at 888-886-7973.

January 31, 2019 - Employer Mandate Reporting, 1094, 1095c

  • Statement to full time employees is due by January 31st of each year (EXTENDED to March 4, 2019.)

  • IRS Form is due by February 28th if paper, or March 31st if electronic, each year. (EXTENDED to April 1, 2019 if electronic.)

  • Small Group Information

  • Large Group Information

October 15, 2018 - Medicare Part D, Notice of Creditable Coverage

Employers who provide prescription coverage to Medicare Part D eligible individuals must notify these individuals whether the drug coverage they have is creditable or non-creditable.  This notice must be provided prior to October 15th of each year.  To pull the model notices direct from CMS, you may click here


Otherwise, you will find a reference chart and fillable notices below.

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