1095-C Offers of Coverage File Layout

This file record layout is used when importing a file to insert 1095-C insurance data records to the Personnel > Maintenance > ACA 1095 YTD Data > 1095-C page.

Sequence	Field	Length	Type	Description/Example
1	Employee Number or Social Security Number	Emp # - 6 or SSN - 9	Numeric	001511 or 123456789
2	Offer of Coverage for All Months	2	Alphanumeric	See notes section for code descriptions.
3	January Offer of Coverage	2	Alphanumeric	See notes section for code descriptions.
4	February Offer of Coverage	2	Alphanumeric	See notes section for code descriptions.
5	March Offer of Coverage	2	Alphanumeric	See notes section for code descriptions.
6	April Offer of Coverage	2	Alphanumeric	See notes section for code descriptions.
7	May Offer of Coverage	2	Alphanumeric	See notes section for code descriptions.
8	June Offer of Coverage	2	Alphanumeric	See notes section for code descriptions.
9	July Offer of Coverage	2	Alphanumeric	See notes section for code descriptions.
10	August Offer of Coverage	2	Alphanumeric	See notes section for code descriptions.
11	September Offer of Coverage	2	Alphanumeric	See notes section for code descriptions.
12	October Offer of Coverage	2	Alphanumeric	See notes section for code descriptions.
13	November Offer of Coverage	2	Alphanumeric	See notes section for code descriptions.
14	December Offer of Coverage	2	Alphanumeric	See notes section for code descriptions.
15	Employee Share for All Months	5.2	Numeric	Cannot be less than zero or greater than 99999.99
16	January Employee Share	5.2	Numeric	Cannot be less than zero or greater than 99999.99
17	February Employee Share	5.2	Numeric	Cannot be less than zero or greater than 99999.99
18	March Employee Share	5.2	Numeric	Cannot be less than zero or greater than 99999.99
19	April Employee Share	5.2	Numeric	Cannot be less than zero or greater than 99999.99
20	May Employee Share	5.2	Numeric	Cannot be less than zero or greater than 99999.99
21	June Employee Share	5.2	Numeric	Cannot be less than zero or greater than 99999.99
22	July Employee Share	5.2	Numeric	Cannot be less than zero or greater than 99999.99
23	August Employee Share	5.2	Numeric	Cannot be less than zero or greater than 99999.99
24	September Employee Share	5.2	Numeric	Cannot be less than zero or greater than 99999.99
25	October Employee Share	5.2	Numeric	Cannot be less than zero or greater than 99999.99
26	November Employee Share	5.2	Numeric	Cannot be less than zero or greater than 99999.99
27	December Employee Share	5.2	Numeric	Cannot be less than zero or greater than 99999.99
28	Safe Harbor for All Months	2	Alphanumeric	See notes section for code descriptions.
29	January Safe Harbor	2	Alphanumeric	See notes section for code descriptions.
30	February Safe Harbor	2	Alphanumeric	See notes section for code descriptions.
31	March Safe Harbor	2	Alphanumeric	See notes section for code descriptions.
32	April Safe Harbor	2	Alphanumeric	See notes section for code descriptions.
33	May Safe Harbor	2	Alphanumeric	See notes section for code descriptions.
34	June Safe Harbor	2	Alphanumeric	See notes section for code descriptions.
35	July Safe Harbor	2	Alphanumeric	See notes section for code descriptions.
36	August Safe Harbor	2	Alphanumeric	See notes section for code descriptions.
37	September Safe Harbor	2	Alphanumeric	See notes section for code descriptions.
38	October Safe Harbor	2	Alphanumeric	See notes section for code descriptions.
39	November Safe Harbor	2	Alphanumeric	See notes section for code descriptions.
40	December Safe Harbor	2	Alphanumeric	See notes section for code descriptions.

The uploaded file type must be in the comma-delimited text (.txt) or comma-separated values (.csv) format. Only the employee number is required.

The Length field provides the maximum number of allowed characters.

Offer of Coverage codes (columns 2-14):

1A - Qualifying Offer
1B - Offer to employee only
1C - Offer to employee and dependents
1D - Offer to employee and spouse
1E - Offer to employee, spouse, and dependents
1F - Offer of coverage not providing minimum value
1G - Employee not full-time and enrolled in self-insured coverage
1H - No offers
1J - Offer to employee, spouse conditional, not to dependents
1K - Offer to employee and dependents, spouse conditional
1L - Individual coverage HRA offered to employee only
1M - Individual coverage HRA offered to employee and dependents
1N - Individual coverage HRA offered to employee, spouse, and dependents
1O - Individual coverage HRA offered to employees using affordability safe harbor
1P - Individual coverage HRA offered to employee and dependents using affordability safe harbor
1Q - Individual coverage HRA offered to employee, spouse and dependents using affordability safe harbor
1R - Individual coverage HRA that is NOT affordable offered to employee
1S - Individual coverage HRA offered to an employee not full-time

Section 4980H Safe Harbor codes (columns 28-40):

2A - Employee not employed on any day of the month
2B - Employee not a full-time employee for the month and did not enroll in coverage
2C - Employee enrolled in coverage offered
2D - Employee was in a Limited Non-Assessment Period
2E - Multiemployer interim rule relief
2F - W-2 Safe Harbor
2G - Federal poverty line safe harbor
2H - Rate of pay safe harbor

Interfaces

1095-C Offers of Coverage File Layout

Americans with Disabilities Act (ADA) and Web Accessibility

Interfaces

User Tools

Site Tools

1095-C Offers of Coverage File Layout

Page Tools

Americans with Disabilities Act (ADA) and Web Accessibility