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A free scan shows the junk files, broken settings and background clutter dragging Windows down - then fixes them in one click.Free scan · Windows 10 & 11First, identify the IRS notice, tax year, legal entity and response deadline. If the correspondence is Letter 226J, the IRS is proposing an employer shared responsibility payment under Internal Revenue Code Section 4980H; it is not yet a final assessment. Assemble the monthly employee list, payroll and hours data, coverage-offer records and Forms 1094-C and 1095-C, then reconcile each employee and month before responding through the forms and instructions enclosed with the letter.
“IRS scrutiny” can also involve health-coverage reporting under Sections 6055 or 6056 or another tax issue. The steps below focus on the ACA employer shared responsibility and reporting pathway because that is the process in which Letter 226J, Forms 14764 and 14765, and employee-level monthly data are used. A different notice may require a different response.
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Identify exactly what the IRS is reviewing
Read every page of the correspondence before asking what the proposed amount means. Record the tax year, the employer’s legal name and EIN, the ALE member identified, the date received, the response deadline and the IRS contact information. Keep the complete notice, including all schedules and forms, in a controlled file.
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Letter 226J: a proposed employer shared responsibility payment
Letter 226J concerns a proposed payment under the Affordable Care Act’s employer shared responsibility provisions. It generally shows a proposed amount by month and lists employees associated with premium tax-credit information. The letter explains how to respond and is accompanied by Form 14764, the employer response form, and Form 14765, the employee-premium-tax-credit list used to examine the proposal.
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The letter is an opportunity to correct the IRS’s understanding before an assessment. The IRS states that an employer can respond before any assessment or notice and demand for payment is made. Do not treat the figure in the letter as the final amount owed, and do not substitute a deadline from an older example or a general website for the date printed on your correspondence.
Other health-plan inquiries
Sections 6055 and 6056 create reporting obligations that can be examined separately from a Letter 226J. A self-insured employer may have Section 6055 reporting duties even when it is not an applicable large employer (ALE). A notice about a return, a missing form or a different tax qualification issue is not automatically an ACA shared-responsibility case. Match your response to the notice’s authority, tax year and requested information.
Preserve the notice and route it to the right people
Assign one person to control the response calendar and one owner for the underlying benefits and payroll records. Send the notice promptly to the benefits administrator, payroll or HRIS owner, tax-reporting specialist and finance lead. If the proposed amount is material, the employee-month facts are disputed or multiple related entities are involved, consider an attorney or tax professional experienced in ACA employer shared responsibility matters. Professional advice is not an IRS prerequisite, but it can help separate a data error from a genuine coverage problem.
- Save a scanned, searchable copy of every page and retain the original.
- Note the receipt date and calculate internal milestones several days before the IRS deadline.
- Restrict edits to the working file; preserve the original payroll, enrollment and filed-return extracts.
- Use the EIN and legal entity on the letter when naming folders and calculations.
Confirm whether the employer was an ALE
The first substantive question is whether the relevant employer was an ALE for the tax year under review. In general, an employer is an ALE when it averaged at least 50 full-time employees, including full-time equivalents, during the preceding calendar year. The threshold is an average, not a year-end headcount, and special rules can affect the calculation.
Aggregate related entities before counting
Corporations, partnerships and other businesses under common ownership may have to be aggregated when determining ALE status. After that determination, each ALE member generally has its own reporting responsibility under its own EIN. A parent company’s headcount spreadsheet cannot by itself prove that a particular subsidiary’s 1094-C and 1095-C reporting was correct.
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Apply the Section 4980H full-time standard
For this provision, a full-time employee generally averages at least 30 hours of service per week or 130 hours of service in a calendar month. IRS rules provide methods for identifying full-time status, including measurement approaches for variable-hour and seasonal employees. Recalculate the status using the method the employer actually adopted and the records for the relevant year; do not infer status from a job title or a single pay period.
Build a population file showing, for each person, the entity, employment dates, hours of service, measurement and stability periods where applicable, and the months treated as full-time. Flag rehires, leaves, transfers, variable-hour schedules and employees who moved between related entities.
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Reconcile the coverage offer for every listed month
A Letter 226J review turns on what was offered, to whom and when. For each employee and month on Form 14765, compare the IRS entry with eligibility records, the offer or waiver transaction, enrollment records, employee contributions and the plan documents.
Check the offer population
The general rule described by the IRS requires an ALE to offer minimum essential coverage to at least 95% of its full-time employees and their dependents, subject to the rules for the applicable year. The offer must be made for the relevant months, not merely sometime during the year. Dependents, waiting periods, mid-month hires, termination dates and approved leave can change whether an offer counts for a particular month.
Check minimum essential coverage, affordability and minimum value
Document that the offered plan was minimum essential coverage and that it met the applicable affordability and minimum-value standards for the year. An offer can fail even when an employee declined enrollment. Compare the required employee contribution with the affordability safe harbor or method used by the employer, and preserve the rate sheet and contribution calculation that applied to each month.
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The IRS describes potential exposure when an ALE fails the offer rules and at least one full-time employee receives a premium tax credit. A premium tax credit entry is therefore a trigger for investigation, not proof that the employer’s records are wrong or that the proposed payment is final.
Reconcile the IRS data with payroll and filed forms
Use the notice’s monthly summary and employee list as the index for a controlled reconciliation. For every listed employee-month, tie the IRS entry to source records and then to the filed forms. Practical records include:
- Payroll registers, hours-of-service reports and employment-status history.
- Eligibility, measurement-period and stability-period calculations.
- Offer letters, enrollment or waiver transactions, dependent-offer records and effective dates.
- Plan documents, employee contribution tables and affordability calculations.
- Filed Forms 1094-C and 1095-C, transmission confirmations and any prior corrections.
- Entity-structure and EIN records showing which ALE member employed the person.
This is a fact-finding checklist, not a universal IRS document list. Keep a source reference for every change in your reconciliation so another reviewer can reproduce the conclusion.
Understand which form carries which duty
| Situation | Primary reporting responsibility | What to verify |
|---|---|---|
| ALE with insured coverage | Section 6056 reporting on Forms 1094-C and 1095-C | ALE member EIN, full-time status, offer codes, months of offer and employee contribution data |
| Self-insured employer that is not an ALE | Section 6055 reporting for covered individuals | Covered-person identifying data and months of minimum essential coverage |
| Self-insured ALE | Generally combines Section 6056 and Section 6055 reporting on Forms 1094-C and 1095-C | Both offer-of-coverage fields and covered-individual information |
Section 6056 applies to ALEs. Section 6055 applies to providers of minimum essential coverage, including self-insured employers regardless of ALE status. Form selection follows the employer’s status and funding arrangement, so do not “correct” a form by copying a code from another entity or plan.
Compare the two most common explanations for a proposed month
For each employee-month, write down the competing explanations instead of forcing one conclusion across the whole notice. The same letter can contain a genuine coverage gap for one person and a coding or entity error for another.
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| Question | Coverage or eligibility issue | Reporting or data issue |
|---|---|---|
| Which months and employees are listed? | The person may have been full-time and lacked a qualifying offer in those months. | The IRS may have matched a person, month or EIN to the wrong record. |
| Was the employer an ALE member? | The entity may have been an ALE member after aggregation. | The return may identify the wrong ALE member or EIN. |
| Was an offer made? | Eligibility, waiting-period, dependent or effective-date rules may have prevented a valid offer. | An offer may exist in enrollment records but be represented by an incorrect code. |
| Did affordability and minimum value apply? | The employee contribution or plan design may not satisfy the applicable standard. | The filed contribution amount or safe-harbor code may not match the source record. |
| Do Forms 1094-C and 1095-C match? | The form may accurately report a month in which no offer was made. | A transcription, transmission, correction or aggregation error may explain the mismatch. |
Respond through the actual Letter 226J instructions
If the proposed amount appears correct
Complete the response required by the letter and follow its instructions for agreeing with the proposal. Do not send an informal explanation instead of the prescribed form. If the IRS later determines that a payment is due, a notice and demand will explain how to pay. The payment amount is indexed and depends on the tax year and facts, so a figure from another year cannot be reused.
If you disagree in whole or in part
Use Form 14764 and the response method specified in the letter. Identify each disputed employee-month, state the reason, and attach a clear schedule tying the correction to payroll, hours, offer, affordability or filing records. If the dispute concerns a coded field, show the filed value, the corrected value and the document supporting the correction. Address undisputed items separately rather than withholding the entire response while one data point is investigated.
Meet the printed deadline even if a vendor or adviser is still reviewing records. If information is missing, contact the IRS using the details in the correspondence and document the conversation; do not assume that an extension exists without confirmation.
Correct reporting only after the facts are established
When the reconciliation finds an error, ask the responsible tax or reporting adviser whether a correction is required for the relevant form and year. Correction procedures vary with the year, filing method, error type and whether the IRS has already contacted the employer. The governing sources establish the reporting duties and form purposes, but there is no single correction procedure that fits every fact pattern.
Keep the notice, response, calculations, employee-level schedules, source records, corrected forms or transmissions and IRS follow-up together. Record who approved each change and when it was made. Preserve the original return data so a later reviewer can distinguish an original filing from a correction.
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Common mistakes that weaken an IRS response
- Using the wrong tax year. Thresholds, affordability amounts and form instructions can change. Label every calculation with its year.
- Counting only the year-end workforce. ALE status uses the preceding calendar year’s average, including full-time equivalents.
- Ignoring related entities. Aggregation may determine ALE status, while reporting remains tied to each ALE member’s EIN.
- Assuming enrollment equals an offer. An employee’s waiver or non-enrollment does not prove that a timely, qualifying offer was made.
- Checking annual totals instead of months. Letter 226J and Form 14765 operate at the employee-month level.
- Changing a code without source support. Every revised field should trace to a contemporaneous payroll, benefits or plan record.
- Paying before contact. IRS guidance says employers should not calculate liability or make a payment before the IRS contacts them. Once contacted, follow the notice rather than sending an unsolicited amount.
Build a repeatable prevention process
After the response, turn the findings into a control for the next reporting cycle.
- Confirm the aggregated entity list, ALE-member EINs and responsible owners before the calendar year begins.
- Document the measurement method for variable-hour and seasonal employees and lock the relevant periods.
- Capture offer, dependent, affordability and minimum-value data at the time of eligibility and enrollment.
- Reconcile payroll, benefits and HRIS data monthly, including hires, rehires, leaves, transfers and terminations.
- Review Forms 1094-C and 1095-C against the reconciled ledger before filing and retain transmission evidence.
- Run an employee-month exception report and resolve missing offers, implausible hours and entity mismatches before year-end.
These controls do not eliminate the possibility of an IRS inquiry, but they make it possible to answer a notice with contemporaneous evidence instead of reconstructing a year from memory.
When specialized advice is justified
Consider qualified tax or benefits counsel when the notice covers several ALE members, the ownership structure is complex, the proposed amount is significant, employees changed status repeatedly, self-insured reporting is involved, or the employer cannot reproduce its affordability and measurement calculations. Ask the adviser to review the notice and tax year first, then define the specific records and response work needed. A general tax preparer may not have the operational ACA data needed to test employee-month coverage facts.
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