January Is ACA Danger Season – What Brokers Really Need to Know About ACA in 2026

Quick Answer 

This January is a bit different from previous ACA compliance cycles for brokers and their employer clients. Rather than providing 1095 forms proactively to employees, employers can provide instructions on their public website how to request a 1095 (except for NJ residents, who still must be proactively sent the 1095). A newly granted six-year statute of limitations for the IRS to pursue employer shared responsibility penalties does not begin until accurate and complete forms are submitted to the IRS, so auditing ACA Reporting is vital, including the employer’s XML file. And substantial increases to both group and individual health insurance premiums are stressing families and employers. It’s critical to navigate the shifting landscape with clarity. 

Why This Matters to You and Your Clients

You just closed the year and you’re already staring down ACA Reporting requirements. But this January is different – it’s when ACA compliance deadlines with new reporting relief for employers converge with major marketplace changes that your clients will feel in their businesses and conversations with employees. Whether they’re a small business or an applicable large employer (ALE), what happens now affects their penalties, their employees’ coverage experience, and your credibility as their advisor.

What’s Happening with ACA Subsidies in January 2026

One of the biggest ACA stories heading into the new year is the lapse of enhancements to the premium tax credits that helped millions keep premiums low on the individual marketplace. Without congressional action before December 31, 2025, these enhanced subsidies have expired – meaning fewer people were expected to enroll, thus increasing insurance premiums for marketplace enrollees. ALEs who have moved away from sponsoring a medical plan to instead sponsor an individual coverage health reimbursement arrangement (ICHRA) will find the premium increases making it more difficult to offer an affordable ICHRA.

Here’s the key context for you and your clients:

• Expanded subsidies that kept individual premiums affordable are no longer in effect as of Jan. 1, 2026, unless Congress acts in January. Subsidies revert back to pre-pandemic rules.

• Market premium increases are significant – some projections show average premiums increasing many multiples above what’s typical without Premium Tax Credits support. 

• Enrollment behavior may change as some individuals drop coverage or seek alternatives if premiums spike. 

  
  

While this primarily affects individuals outside employer plans, there’s employer relevance too: employees who previously relied on marketplace coverage may now turn to employer coverage, ask more questions about affordability, or seek midyear changes. Being ready to answer those questions is a competitive differentiator for brokers.

And of course, there is some impact to affordability for ALEs who offer ICHRAs, as substantial increases to individual premiums directly affect the employer’s ability to offer an affordable ICHRA.

ACA Compliance Deadlines in March

January isn’t just about marketplace policy – it’s ACA reporting season for employers with coverage obligations under the law (especially those with 50+ full-time and equivalent employees). 

Key Employer ACA Deadlines (Typical for Employers)

Most employers should be working through their ACA Reporting now to prepare for the following deadlines:

• March 2 – Deadline to furnish Forms 1095-C or 1095-B to employees. This is the first big deadline of the year. Many employers slip here if they delay data gathering or didn’t sign a contract with an ACA Reporting vendor last fall.

• March 31 – IRS submission deadline for providing 1095 forms with 1094 transmittal cover sheet to the IRS (virtually all size employers must file electronically)

  
  

What Often Gets Missed

• Eligibility tracking throughout the prior year – if your clients don’t track hours and status changes monthly, year-end reporting becomes a scramble with higher error risk. To do this well, ALEs need to understand rehire rules and possibly utilize the lookback method.

• Affordability standards – affordability thresholds change annually; employers should confirm their employee cost-share meets the current standard to avoid penalties. 

• State-specific reporting requirements – states like Massachusetts and others have their own mandates that may not align with federal deadlines. 

• Electronic filing rules – only employers filing very few forms can still submit on paper; most now must file electronically. 

  
  

What Your Employers Should Be Focusing On

Right Now (January):

• Get ACA reporting tasks started immediately – don’t wait.

• Validate eligibility and coverage offer data from the prior calendar year.

• Confirm whether coverage offered met affordable and minimum value criteria.

• Prepare 1095s for employees and confirm delivery plans (mail/email portal). The employer may want to post instructions on their public website how to request a 1095 to enable only providing a 1095 when requested (except for NJ residents, who still must be proactively provided the 1095).

• Verify compliance with state reporting rules and deadlines, as applicable (CA, DC, MA, NJ, RI).

• Discuss employee demand shifts because of individual market premium increases and what that could mean for employer plans.

  
  

Broker Action Steps – January Checklist

Compliance & Reporting

• Ensure your clients’ ACA tracking systems are accurate (hours, offers, affordability).

• Confirm deadlines and deliverables: March 2 for employee statements; March 31 IRS deadline; public website instructions to request a 1095, if employer wants to provide the 1095 only upon request.

• Review any state-specific ACA requirements that apply to your clients.

  
  

Marketplace Awareness

• Educate your employer clients about the individual market Premium Tax Credits changes so they’re prepared for employee questions.

• Help clients consider whether plan design or communication adjustments are needed midyear in response to broader health cost discussions. Certain direct primary care arrangements can be compatible with health savings accounts (HSAs) this year, so new ways are always emerging to help employees with the rising cost of care.

  
  

Communication & Support

• Encourage early internal audits so the January rush doesn’t become a penalty risk.

• Provide template communication to HR teams about ACA reporting timelines and new website disclosures.

  
  

FAQs for Brokers to Use with Clients

Q: Why are ACA marketplace premiums going up in 2026?A: Enhanced premium subsidies that lowered consumer costs expired at the end of 2025, so without legislative action premiums shift back higher as subsidies revert to pre-pandemic levels and rules. 

Q: Do these Premium Tax Credits changes affect employer-sponsored plans?A: Not usually – employer plans are separate. But employees may ask about coverage options or cost-sharing if marketplace alternatives get more expensive. And ALEs sponsoring an ICHRA may find it costing more to keep the ICHRA affordable.

Q: What’s the most important ACA deadline?A: March 2 is the key deadline to furnish 1095 statements to employees, or to post instructions on the employer’s public website how to request a 1095. And March 31 is the key deadline to furnish all 1095 forms with a 1094 cover sheet electronically to the IRS and to start the new six-year statute of limitations protecting employers from penalties.

Q: What penalty risks should employers preempt?A: Late or inaccurate ACA reporting can result in penalties per form and per missing deliverable and delay the start of a six-year statute of limitations protecting employers from penalties. Electronic filing requirements are stricter now too. Employers should be asking for and auditing the XML file their ACA Reporting vendor actually sends the IRS…if they have never seen their XML file before and have no idea how to audit it, now’s the time to educate.

Q: How can brokers support employers this ACA season?A: By helping them organize data early, clarify eligibility tracking, verify affordability, and prepare reports ahead of deadlines.

Final Thoughts

January might feel like just after holiday chaos – but in the ACA world, it’s a make-or-break month for compliance. For brokers, this is a moment to step in as a trusted advisor: anticipate common pitfalls, help employers get ahead of deadlines, and translate complicated regulatory shifts into clear, actionable guidance.

With Premium Tax Credits debates heating up in Congress and employers juggling reporting responsibilities including those tied to exercising new reporting relief, the advisors who keep clients compliant – and calm – will be the ones clients remember.