This is an old revision of the document!

1095-C - HRS3880

Human Resources > Maintenance > ACA 1095 YTD Data > 1095-C

This page allows you to manually input and track year-to-date health coverage offers and health coverage enrollment details for employees and their covered individuals.

Notes:

You can import records by uploading a comma-delimited text (.txt) file using the Utilities > Import ACA 1095-B/1095-C Data page.
For employees with a self-insured insurance plan, you can extract insurance data from the Maintenance > Staff Demo > Insurance tab to this page by using the Utilities > Extract Insurance Data to 1095 Data utility.
For more information about Form 1095-C, click here and refer to the Instructions for Form 1095-C.
The page consists of two grids.

File layout

Enter 1095-C data:

Field	Description
Calendar Year	Populated with the current calendar year; however, you can enter a different year. The year must be greater than or equal to 2015.
Employee	Begin typing the employee name or number. As you type the data, a drop-down list of corresponding data is displayed. Select an employee and click Retrieve. Or, click Directory to perform a search in the Employees directory.

In the top grid:

Offer of Coverage	Make the necessary selections: If the employee received the same offer for the entire calendar year (January-December), in the All field, click to select the received offer of coverage. 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 the minimum value 1G - Employee not full-time and enrolled in self-insured coverage 1H - No offers 1I - Qualifying offer transition relief - This option is no longer available, it was only applicable for the 2016 tax year. 1J - Offer to employee, spouse conditional, not to dependents 1K - Offer to employee and dependents, spouse conditional If the employee received various offers during the calendar year, click for the individual month(s) and select the received offer of coverage. 1095-C Forms report notes: If the Offer of Coverage (line 14) is 1A, 1F, 1G or 1H, the Employee Share (line 15) field is blank. If the Offer of Coverage (line 14) is 1B-1E or 1J-1K, the Employee Share (line 15) field is printed. If the Offer of Coverage (line 14) code in all individual month (Jan-Dec) fields matches the code in the All field, then that code is printed in the All field, and the individual month fields are blank. If all individual month (Jan-Dec) fields are blank but the All field is populated, then that Offer of Coverage code is printed in the All field and the individual month (Jan-Dec) fields remain blank. If the Offer of Coverage code varies in the individual month (Jan-Dec) fields, then the All field is blank and the codes in the individual month (Jan-Dec) fields are printed.
Employee Share	Type the employee share amount of the lowest-cost monthly premium for self-only minimum essential coverage providing minimum value that is offered to the employee. 1095-C Forms report notes: If the value in all of the individual month (Jan-Dec) fields match the value in the All field, then that value is printed in the All field and the individual month fields are blank. If the value is zero in all individual month (Jan-Dec) fields but the All field is populated, then that value is printed in the All field and the individual month fields are blank. If the value varies in the individual month (Jan-Dec) fields, then the All field is blank and the values in the individual month (Jan-Dec) fields are printed.
Safe Harbor	Click to select the Section 4980H safe harbor employer relief code that applied to the employee. If the same safe harbor code applied to the employee for all 12 calendar months, select the applicable code in the All drop-down field. If different safe harbor codes applied to the employee throughout the 12 calendar months, select the applicable codes in the respective month (Jan-Dec) fields. 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 save harbor 2H - Rate of pay safe harbor 2I - Non-calendar year transition relief - This option is no longer available, it was only applicable for the 2016 tax year. Note: It is possible that more than one circumstance applied to the same employee in the same month; however, only one code can be selected per month. 1095-C Forms report notes: If the Safe Harbor (line 16) code in all individual month (Jan-Dec) fields matches the code in the All field, then that code is printed in the All field and the individual month fields are blank. If all individual month (Jan-Dec) fields are blank but the All field is populated, then that Safe Harbor code is printed in the All field and the individual month (Jan-Dec) fields remain blank. If the Safe Harbor code varies in the individual month (Jan-Dec) fields, then the All field is blank and the codes in the individual month (Jan-Dec) fields are printed.

Other functions and features:

	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.

Business

Sidebar

Table of Contents

1095-C - HRS3880

Enter 1095-C data:

Other functions and features:

Americans with Disabilities Act (ADA) and Web Accessibility

Business

User Tools

Site Tools

Sidebar

Table of Contents

1095-C - HRS3880

Enter 1095-C data:

Other functions and features:

Page Tools

Americans with Disabilities Act (ADA) and Web Accessibility