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Human Resources > Utilities > Extract Insurance Data to 1095 Data
This page is used to extract insurance data from the Maintenance > Staff Demo > Insurance tab to the ACA Covered Individuals section on the Maintenance > 1095-B and 1095-C pages. The extract only includes those employees who have a self-insured insurance plan (i.e., Self-Insured is selected for the plan on the Tables > Insurance Company Codes page) on the Maintenance > Staff Demo > Insurance tab.
You must be logged on to a current year pay frequency to access this utility.
Notes:
If Insert new records from Staff Demo Insurance Records. is selected:
The All field is only selected if the employee has coverage for the entire year based on the Coverage Begin and Coverage End dates on the Maintenance > Staff Demo > Insurance page.
Individual month check boxes are selected based on the earliest Coverage Begin and latest Coverage End date.
Staff demo insurance coverage records are combined when multiple records have the same first name, middle name, last name, social security number, and date of birth.
If a staff demo insurance coverage record exists where the Coverage End date is less than the selected calendar year, or the Coverage Begin date is greater than the selected calendar year, then the 1095-B and 1095-C records are inserted without selected check boxes.
Under Extract Option, select one of the following options:
Under Plan Options, select one of the following plan options to extract:
Under Record Type, select one of the following options:
| Field | Description |
|---|---|
| Calendar Year (YYYY) | Type the calendar year for which you want to extract data. |
If ACA 1095-B is selected, in the Coverage Type field, click
to select the coverage type to be extracted.
A - Small business health options program (SHOP)
B - Employer-sponsored coverage
C - Government-sponsored program
D - Individual market insurance
E - Multiemployer plan
F - Miscellaneous minimum essential coverage
If ACA 1095-C is selected, enter data in the following fields:
| Plan Start Month | Type the two-digit number (01 through 12) indicating the calendar month during which the plan year begins for the health plan in which the employee is offered coverage (or would be offered coverage if the employee were eligible to participate in the plan). If more than one plan year could apply (for instance, if the ALE Member changes the plan year during the year), enter the earliest applicable month. | |
|---|---|---|
| Offer of Coverage | Click to select the coverage offer to be extracted. The selected Offer of Coverage code is populated in the All column. Coverage offers
| |
| Safe Harbor | Click to select safe harbor code to be extracted. The selected Safe Harbor code is populated in the All column. |
Under Employee Share of Lowest Cost Monthly Premium, type the set share of the lowest-cost monthly premium amount for employees in each pay type (1-4).
Note: When the data is extracted, if the All field is populated, the individual monthly fields are set to zero. If the individual monthly amounts are entered, the All column is set to zero and the individual monthly fields are populated.
Under Employees with Calendar YTD Data Who Do Not Have Staff Demo Insurance Records, select one of the following options:
Click Execute. If any errors are encountered, an Extract Staff Demo Insurance Data to 1095-B/1095C Error Report is displayed.
Review the report using the following buttons:
Click
to go to the first page of the report.
Click
to go back one page.
Click
to go forward one page.
Click
to go to the last page of the report.
The report can be viewed and saved in various file formats.
Click
to save and print the report in PDF format.
Click
to save and print the report in CSV format. (This option is not available for all reports.) When a report is exported to the CSV format, the report headers may not be included.
Click X to close the report window. Some reports may have a Close Report, Exit, or Cancel button instead.
Click Cancel to return to the Extract Insurance Data to 1095 Data page.
A message is displayed indicating that the process was successful. The extracted records can be viewed and modified on the Maintenance > ACA 1095 YTD Data page.
6. If ACA 1095-C is selected, enter data in the following fields:
● In the Plan Start Month, type the two-digit number (01 through 12) indicating the calendar month during which the plan year begins for the health plan in which the employee is offered coverage (or would be offered coverage if the employee were eligible to participate in the plan). If more than one plan year could apply (for instance, if the ALE Member changes the plan year during the year), enter the earliest applicable month.
● In the Offer of Coverage field, click to select the coverage offer to be extracted. The selected Offer of Coverage code is populated in the All column.
● In the Safe Harbor field, click to select safe harbor code to be extracted. The selected Safe Harbor code is populated in the All column.
● Under Employee Share of Lowest Cost Monthly Premium, type the set share of the lowest-cost monthly premium amount for employees in each pay type (1-4).
□ The Employee Share field should only be entered if the Offer of Coverage field is set to 1B (Offer to employee only), 1C (Offer to employee and dependents), 1D (Offer to employee and spouse), or 1E (Offer to employee, spouse, and dependents). Offer of coverage codes 1J - Offer to employee, spouse conditional, not to dependents and 1K - Offer to employee and dependents, spouse conditional are included if the Calendar Year is set to 2016.
□ If the set share of the lowest-cost monthly premium amount is the same for all 12 calendar months, type that monthly amount in the All field and do not enter data in the individual month fields.
□ If the set share of the lowest-cost monthly premium amount was not the same for all 12 calendar months, type that monthly amount in the respective month (Jan-Dec) fields.
Note: When the data is extracted, if the All field is populated, the individual monthly fields are set to zero. If the individual monthly amounts are entered, the All column is set to zero and the individual monthly fields are populated.
□ Only one set of values can exist for each local education agency (LEA); therefore, these values should not be updated by individual users.
□ The values are saved upon clicking Execute.
● Under Employees with Calendar YTD Data Who Do Not Have Staff Demo Insurance Records, select one of the following options:
□ Pay Type 1-3 Employees
□ Pay Type 1-4 Employees
| Delete a row.
Click to delete a row. The row is shaded red to indicate that it will be deleted when the record is saved.
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