6 Reviewing ACA Information Returns (AIR) Workfile Information

This chapter contains the following topics:

Section 6.1, "Reviewing the AIR Year-End Workfiles"

Section 6.2, "Working with Form 1095-C Workfiles Information"

Section 6.3, "Working with Form 1094-C Workfile Information"

6.1 Reviewing the AIR Year-End Workfiles

After you create Affordable Care Act Health Coverage Information Returns (AIR) year-end workfiles, you review the information in the workfiles for accuracy. If required, you can revise the information and re-create the workfiles to ensure that the correct information prints on the year-end forms (Form 1095-C).

You can also edit records created by the workfile build process, or manually create new records or delete records in the workfile using the Work with Form 1095-C Information program (P08119).

This chapter provides an overview of workfile reviews and discusses how to:

  • Edit records in the workfile.

  • Manually add records to the workfile.

  • Delete records from the workfile.

  • Import records to the workfile.

6.1.1 Understanding the AIR Year-End Workfiles Information

The 1095-C workfiles contain data necessary for AIR reporting and also contain additional information that identifies an employee's enrollment, such as plan ID, plan option, and enrollment dates.

From the Work with Form 1095-C Information form, you can access data in the 1095C Offer and Coverage (F08119) and 1095C Covered Individuals (F08120) tables. The Form 1095-C form displays data in a format similar to the Form 1095-C.

The Build 1094-C HCIR Workfile contains data necessary to report summary information for each employer and to transmit Forms 1095-C to the IRS.

From the Work with Form 1094-C form, you can access data in the 1094 C ALE Member Information (F08121), 1094C ALE Member Information - Monthly (F08122), and 1094C Other Aggregated ALE Group Members (F08123) tables. The Form 1094-C form displays data in a format similar to the Form 1094-C.

6.2 Working with Form 1095-C Workfiles Information

This section provides an overview of the Work with Form 1095-C Information program and discusses how to use the application to:

  • Review information created by the Form 1095-C workfile build processes

  • Edit records and manually add new records in the workfiles

  • Delete records from the workfiles

  • Import records into the workfiles

6.2.1 Understanding Form 1095-C Information

You use the Work with Form 1095-C Information program (P08119) to inquire on data in the 1095-C Offer and Coverage Workfile and 1095-C Covered Individuals File or to add, modify, and delete records in the workfiles. You can also import records to the workfiles and modify as required before printing Form 1095-C.

Note:

The Form 1095-C batch processes create records for employees and does not create records for individuals who have not been employees. If you need to produce a Form 1095-C for a recipient who is not an employee, you can add or import records to the reporting workfiles. Before you add or import a record for a recipient who is not an employee, you must create an Address Book record to identify the recipient.

When creating a record using the Work with Form 1095-C Information program, the following information is mandatory:

  • AIR ID

  • Employee Number

  • Tax ID

  • Year

When you run the Work with Form 1095-C Information program (P08119), the system retrieves AIR year-end workfiles information from the F08119 and F08120 tables. If you make any changes to the information, the system updates these two tables.

The Work with Form 1095-C Information program (P08119) initially displays only the summary records, which can be edited either through the Form 1095-C Part II and Part III form, the Offer and Coverage Detail Form, or the Covered Individuals Detail form. The header and Part II information in the form are retrieved from the F08119 table and Part III information is retrieved from the F08120 table.

When you add a record to a workfile table, the system assigns a control number (a unique identifier) for the record. If you are adding Form 1095-C data that includes F08120 Part III data, you should add the F08119 Part I and II data first. When the system creates a control number for a record, it checks for the instance in the F08119 table and if available, uses the same control number for the record in the F08120 table. Therefore, to import a record into the workfile, ensure that you first import the data for the 1095C Offer and Coverage table (F08119) followed by the data for the 1095C Covered Individuals table (F08120).

6.2.1.1 Deleting Records from the Workfiles

When you delete a record from the 1095C Offer and Coverage table (F08119), the system deletes the corresponding record from the 1095C Covered Individuals table (F08120) table. Also, when you delete a summary record, the system deletes the corresponding detail records.

After you submit Form 1095-C to the IRS, you cannot delete records from the 1095C Offer and Coverage table or the 1095C Covered Individuals table.

You cannot delete covered individuals records from the Work with Form 1095-C Information form or the 1095-C Part II and Part III form. To delete a record from the 1095C Covered Individuals table (F08120) table, select the record from the Work with Form 1095-C Information form or the 1095-C Part II and Part III form and access the Covered Individuals Detail form.

If you manually update any information in a record, flag it as protected if you do not want any subsequent batch processes to update or delete the record. You can set the Protected flag individually for records in the 1095C Offer and Coverage table (F08119) and the 1095C Covered Individuals table (F08120).

From the Work with Form 1095-C Information form, you can go to the following forms:

  • Form 1095-C Part II and Part III

  • ACA Eligibility

  • Employee Information

  • Offer and Coverage Detail

  • Covered Individuals Detail

  • Import Offer and Coverage

  • Import Covered Individuals

  • Additional Information

  • Work With Enrollment With Eligibility

  • Enrollment Overrides

6.2.2 Understanding 1095-C Covered Individuals Report (R08120)

As a Benefits Administrator, you run the 1095-C Covered Individuals Workfile Build to include information about covered individuals including any employee (full-time or not full-time) and their family members who are enrolled in a self-insured plan, in Part III of Form 1095-C.
If you do not have any self-insured plans, you do not need to run the R08120 process build.

On running R08120, the system retrieves information from the participant table (F08901) and the Dependent/Beneficiary Cross-Reference table (F08336) and updates the records in the 1095C Covered Individuals table (F08120). This table contains the Detail records by Home Company and Summary records by Tax ID, for each employee and their dependents. The Covered Individuals table provides information for reporting covered individuals in Part III of Form 1095-C and can be managed from the 1095-C Offer and Coverage program (P08119).

You can also import data from a third-party administrator or other source into the workfile by using the standard functionality of importing grid data on the Import Covered Individuals form.

6.2.3 Forms Used to Manage Form 1095-C Information

Form Name Form ID Navigation Usage
Work with Form 1095-C Information W08119A On the ACA Information Returns Inquiries menu (G07BACAI), select Form 1095-C Information. Select an AIR record.
Form 1095-C Part II and Part III W08119D On the Work with Form 1095-C Information form, click Add.

OR

Select an AIR ID and click Select.

Create a new Form 1095-C record, or update an existing Form 1095-C record.
Offer and Coverage Detail W08119C On the Work with Form 1095-C Information form, select an AIR record and then select Offer/Cov Detail from the Form menu.

OR

On the Form 1095-C Part II and Part III form, select Offer Cov. Detail from the Form menu.

Simultaneously edit and delete Part II data for multiple records from the F08119 table.

This form lists summary and detail records; only summary records can be edited.

Covered Individuals Detail W08119E On the Work with Form 1095-C Information form, select an AIR record and then select Covered Individuals from the Form menu.

OR

On Form 1095-C Part II and Part III select Covered Ind. from the Form menu.

Simultaneously edit and delete Part III data for multiple records from the F08120 table.

This form lists summary and detail records; only summary records can be edited.

Additional Information W08119B On the Form 1095-C Part II and Part III form, select Additional Info from the Form menu. Review additional details about the record.
Import Offer and Coverage Summary Information W08119C On the Work with Form 1095-C Information form, select Import Offer/Cov. from the Form menu. Import summary records for offer and coverage reporting.
Import Covered Individuals Summary Information W08119E On the Work with Form 1095-C Information form, select Import Covered Ind. from the Form menu. Import summary records for covered individuals reporting.
Work With Enrollment With Eligibility W08334A On the Work with Form 1095-C Information form, select an AIR record in the detail area and then select Enrollment w. Elig. from the Form menu. Enroll employees using eligibility.

See "Enrolling Employees Using Eligibility" in the JD Edwards EnterpriseOne Applications Benefits Implementation Guide.

Enrollment Overrides W08330B On the Work with Form 1095-C Information form, select an AIR record in the detail area and then select Enrollment Overrides from the Form menu. Enroll employees using overrides.

See "Enrolling Employees Using Overrides" in the JD Edwards EnterpriseOne Applications Benefits Implementation Guide.


6.2.4 Adding or Updating 1095-C Information

Access the Work with Form 1095-C Information form and click Add to view the Form 1095-C Part II and Part III form.

AIR ID

An alphanumeric value similar to a Payroll ID or a W2 ID, which identifies a customer-defined set of AIR records within one reporting year.

Employer Tax ID

A number that identifies your company to the tax authority. This number can include the tax ID number for an individual, a federal or state corporate tax ID, a sales tax number, and so on.This number has specifically been established for the Payroll system to handle the requirements of taxing authorities that require more than 9 positions for the tax identification number.Do not enter hyphens (dashes), slashes, spaces, or other punctuation in the tax identification number.

Reporting Company

The company under which this Form 1094-C/1095-C will be reported. The Reporting Company details are used to obtain the name and address information for the Federal Employer Identification Number (FEIN). The Reporting Company is the employer, which is equivalent to the ALE Member (Applicable Large Employers Member) for purposes of Affordable Care Act Health Coverage Information Returns (AIR) reporting.

Reporting Year

The calendar year for which the AIR is being produced.

Address Number

A number that identifies an entry in the Address Book system, such as employee, applicant, participant, customer, supplier, tenant, or location.

Corrected

A flag to indicate if Form 1095-C has been corrected.

Blank: The form has not been corrected.

X: The form has been corrected.

Void

A flag to indicate if Form 1095-C has been voided.

Blank: The form has not been voided.

X: The form has been voided.

Note:

This value is currently informational only and its use has not been defined by the IRS.
Control Number

This field is a unique number used to identify a record in a file.

Record Type

Indicates whether the Affordable Care Act (ACA) work file record is a summary record used to report information to the IRS and other agencies or a detail record used to support the information reported. Record Type 1 indicates a Detail record and Record Type 2 indicates a Summary record.

Protected

A flag to indicate that a record has been manually modified and the subsequent batch processes should not change the existing record.

Blank: The record has not been manually modified.

X: The record has been manually modified and subsequent batch processes should not update it.

Record Origination

A code to indicate the source of a 1095-C Offer and Coverage record.

C: Indicates that the record was computer generated during the 1095-C Offer and Coverage Workfile Build Process.

M: Indicates that the record was manually entered into the Form 1095-C Information application(P08119). If records are imported, they should be imported with the value M.

Self-Insured Coverage

A flag to indicate whether the employer offers employer-sponsored self-insured health coverage in which the employee or other individuals are enrolled.

Blank: The employer does not provide self-insured coverage.

X: The employer does provide self-insured coverage.

Review Status

A user-defined code (08/RV) that allows the user to flag records that may or may not need further review.

Last Date Started

The date on which the employee reported to work in the most recent period of hire.

The default original hire date is when an employee initially begins working. If no original hire date exists, the system uses the current date. This field can be updated multiple times if, for example, an employee is a seasonal worker.

For the calculation tables in the Payroll system and the eligibility tables and date codes in the Human Resources system, the system also uses this date as a start date when it calculates deductions, benefits, and accruals.

Last Date Terminated

The date on which the employee was terminated, if applicable.

Offer of Coverage (enter required code)

Enter the IRS-defined Code Series 1 indicator that specifies the type of coverage, if any, offered to an employee, the employee's spouse, and the employee's dependents.
If the code applies for all 12 months of the reporting year, enter the code in the All 12 Months box: otherwise, enter the code in the respective month's box.

Employee Share of Lowest Cost Monthly Premium, for Self-Only Minimum Value Coverage

The amount of the employee share of the lowest-cost monthly premium for self-only minimum essential coverage providing minimum value that is offered to the employee.
If the value applies for all 12 months of the reporting year, enter the value in the All 12 Months box: otherwise, enter the code in the respective month's box.

Applicable Section 4980H Safe Harbor (enter code, if applicable)

The IRS-defined Code Series 2 indicator to report that one of the following situations applied to the employee for all 12 months of the calendar year:

  • The employee was not employed.

  • The employee was not a full-time employee.

  • The employee enrolled for the minimum essential coverage offered.

  • The employee was in a Limited Non-Assessment Period.

  • Non-calendar year transition relief applied to the employee.

  • The employee met one of the 4980H affordability safe harbors.

  • The employer was eligible for multiemployer interim rule relief.

If the safe harbor code applies for all 12 months of the reporting year, enter the value in the All 12 Months box; otherwise, enter the code in the respective month's box.

6.2.5 Importing 1095-C Offer and Coverage and Covered Individuals Information

Access these forms to import offer and coverage and covered individuals details for a record:

  • Import Offer and Coverage Summary Information - to import summary records for offer and coverage details.

  • Import Covered Individuals Summary Information - to import summary records for covered individuals details.

6.2.5.1 Importing to 1095C Offer and Coverage table (F08119)

When importing records to the 1095C Offer and Coverage table (F08119), you must ensure that imported records have a valid Address Book number.

If you are importing records for non-employees, such as non-employee COBRA participants, prior year retirees under medical plans, or other form recipients, you must first create an Address Book record for those form recipients. Address Book number is a part of the table key, and the address book record is used for entering Form 1095-C Part I name and address information.

6.2.5.2 Importing to 1095C Covered Individuals table (F08120)

When importing records to the 1095C Covered Individuals table, you must ensure that related 1095C Offer and Coverage (F08119) records exist. The F08120 records are dependent on the F08119 records.

When importing covered individuals from an external source, the covered individuals do not require an Address Book number (PAN8) in the JD Edwards Address Book. This field can be left blank.

Note:

For more information, see My Oracle Support Document ID 2065515.1">>2065515.1.

6.3 Working with Form 1094-C Workfile Information

This section provides an overview of the Work with Form 1094-C program and discusses how to use the application to:

  • Review information created by the Form 1094-C workfile build process

  • Edit records and manually add new records in the workfile

  • Delete records from the workfile

  • Import records into the workfile

6.3.1 Understanding Form 1094-C Information

You use the Work with Form 1094-C program (P08121) to inquire on data in the Build 1094-C HCIR Workfile to add, modify, and delete records in the workfile. You can also import records to the workfile and modify as required before Form 1094-C transmission.

When you run the Work with Form 1094-C program, the system retrieves Build 1094-C HCIR Workfile information from the F08121, F08122, and F08123 tables. If you make any changes to the records, the system updates these tables.

If you create a new record using the Work with Form 1094-C program, the system creates the new record in the F08121 and F08122 tables. The F08123 table is a system generated table and is created only when you run the R08121A build process.

6.3.2 Components of Form 1094-C

Part I of Form 1094-C pertains to information regarding the employer or ALE Member who is filing Form 1094-C or on whose behalf the form is filed.

Part II, III, and IV of Form 1094-C are applicable and enabled only if the Form 1094-C is an Authoritative Transmittal form. Part IV of Form 1094-C is only required if the ALE Member is part of an Aggregated ALE Group.

Only one Form 1094-C can be the Authoritative Transmittal form for an ALE Member in a filing year.

6.3.3 Forms Used to Manage Form 1094-C Information

Form Name Form ID Navigation Usage
Work with Form 1094-C W08121B On the ACA Information Returns Processing menu (G07BACAP), select Work with Form 1094-C. Select an AIR record.
1094-C W08121C On the Work with Form 1094-C form, click Add.

OR

Select an AIR ID and click Select.

Create a new Form 1094-C record, or update an existing Form 1094-C record.

6.3.4 Creating or Updating Form 1094-C Information

The Work with Form 1094-C program (P08121) provides information about the ALE Members. The records displayed are fetched from these tables:

  • F08121 - 1094 C ALE Member Information

  • F08122 - 1094C ALE Member Information - Monthly

  • F08123 - 1094C Other Aggregated ALE Group Members

Access the Work with Form 1094-C form and click Add to view the 1094-C form. Enter the details in this form to create the record. The system saves the records in the F08121 and F08122 tables. The 1094C Other Aggregated ALE Group Members table (F08123) is created only when the R08121A report is created.

6.3.4.1 Part I - Applicable Large Employer Member

AIR ID

Enter an alphanumeric value similar to a Payroll ID or a W2 ID, which identifies a customer-defined set of AIR records within one reporting year.

Reporting Company

The company under which this Form 1094-C/1095-C will be reported. The Reporting Company details are used to obtain the name and address information for the Federal Employer Identification Number (FEIN). The Reporting Company is the employer, which is equivalent to the ALE Member (Applicable Large Employers Member) for purposes of Affordable Care Act Health Coverage Information Returns (AIR) reporting.

The address of the employer must match the address on the corresponding Forms 1095-C.

Government Entity

Enter the Address Book number of the Designated Government Entity (DGE) that is part of or related to the Governmental Unit.

Government employers can designate a sister agency as the reporting entity for all returns related compliance requirements.

Note:

You can skip Line 9 through 16, of Form 1094-C, if you are not a government employer or not using a DGE for reporting.
Reporting Year

The calendar year for which the AIR is being produced.

Rep. Company Contact

Enter the Address Book number of the contact for the Reporting Company.

Government Entity Contact

Enter the Address Book number of the contact for the Designated Government Entity (DGE).

Employer Tax ID

A number that identifies your company to the tax authority. This number can include the tax ID number for an individual, a federal or state corporate tax ID, a sales tax number, and so on.This number has specifically been established for the Payroll system to handle the requirements of taxing authorities that require more than 9 positions for the tax identification number.Do not enter hyphens (dashes), slashes, spaces, or other punctuation in the tax identification number.

1095-C Forms Count

Enter the total number of Forms 1095-C submitted with the associated Form 1094-C transmittal.

Corrected

When you correct a Form 1094-C, the system automatically checks the Corrected flag on the original Form 1094-C and creates a new record with the corrected values using the Correction AIR ID.

Valid values are:

Blank: The form has not been corrected.

X: The form has been corrected.

Authoritative Transmittal

Enter X to indicate whether this Form 1094-C is the authoritative transmittal for the ALE Member.

Valid values are:

Blank: The 1094-C Form is not the authoritative transmittal for the ALE Member.

X: The 1094-C Form is the authoritative transmittal for the ALE Member.

Note:

There can be only one authoritative transmittal for an ALE Member.

6.3.4.2 Part II - ALE Member Information

ALE Member Information is only required on the Authoritative Transmittal Form 1094-C.

Auth Transmittal Form Count

Enter the total number of Forms 1095-C that are filed by and on behalf of the employer for all Form 1094-Cs.

Aggregated ALE Group

Enter X if the employer was a member of an Aggregated ALE Group during any month of the reporting calendar year.

If you enter X, Part IV of Form 1094-C is enabled.

6.3.4.3 Part III - ALE Member Information Monthly

ALE Member Monthly Information is only required on the Authoritative Transmittal Form 1094-C.

(a) Minimum Essential Coverage Offer Indicator

Enter X in the All 12 Months corresponding Yes box if you offered minimum essential coverage to at least 95% of your full-time employees and their dependents for the entire calendar year.

If you offered minimum essential coverage to at least 95% of you full-time employees and their dependents only for certain months of the calendar year, enter X in the Yes column's boxes corresponding to those months. For the remaining months that you did not offer coverage, enter X in the No column's boxes corresponding to those months.

Note:

An employee in a Limited Non-Assessment Period is not considered when determining the percentage of employees to whom minimum essential coverage was offered.
(b) Full-Time Employee Count for ALE Member

Displays the number of full-time employees for each month excluding employees in a Limited Non-Assessment Period. This value is populated automatically from the Build 1094-C Workfile (R08121A) process.

(c) Total Employee Count for ALE Member

For each month, displays the total number of employees including your full-time employees, non full-time employees, and employees in a Limited Non-Assessment Period. This value is populated automatically from the Build 1094-C Workfile (R08121A) process.

(d) Aggregated Group Indicator

If the ALE member was a member of an Aggregated ALE Group for all or any month of the reporting calendar year, enter X in the All 12 Months box or the corresponding month's box as appropriate.

This field is enabled only if you have selected the Aggregated ALE Group field in Part II of the 1094-C form.

(e) Section 4980H Transition Relief Indicator

If you have selected Section 4980H Transition Relief flag (Part II) indicating that you are eligible for the transition relief, enter:

  • A to specify that you are eligible for the 50 to 99 Relief.

  • B to specify that you are eligible for the 100 or More Relief.

6.3.4.4 Part IV - Other ALE Members of Aggregated ALE Group

Name and EIN

Part IV of Form 1094-C is populated automatically by the Build 1094-C Workfile (R08121A) process. You can also add and delete individual records manually. If entering the record manually, enter the names and EIN of other ALE members of the Aggregated ALE Group. You can enter names of up to 30 Aggregated ALE Group members.

If there are more than 30 ALE Members, report the 30 biggest ALE Members as determined by average full-time employee (FTE) count.

Note:

Part IV of Form 1094-C is enabled only if you have selected the Aggregated ALE Group field in Part II.
6.3.4.4.1 Adding ALE Members that are not JDE Companies

To add the Name and EIN of other ALE Members that are not JD Edwards companies and are not added in the JD Edwards EnterpriseOne system, create a UDC value in the UDC table 08/XC to identify and populate the Name and EIN of the business entity.

To create the UDC value in 08/XC, enter the nine-digit Federal EIN of the other ALE Member and then enter the company name in the Description1 field.