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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