Configure the Form 1095-C Template

When preparing to print Form 1095-C, you have a couple configuration options.

• Print using ComplyRight paper stock with preprinted instructions

• Mask Social Security Numbers (SSNs)

If you're using ComplyRight paper stock

If you're using ComplyRight plain white paper stock with preprinted instructions, you must edit the predefined template to remove the instructions.

1. Configure the 1095-C template.

   1. From Tools, click Reports and Analytics.

   2. Click >>, and select Shared Folders.

   3. Expand Human Capital Management, Benefits, US, and then ACA.

   4. Click Edit for the 1095-C template.

      • The print folder is 1095c, and the template is 1095c_print_YYYY.

      • The online folder is US1095c, and the template is 1095c_online_YYYY.

      Where YYYY is the reporting year.

   5. Click Edit for the selected template.

      This downloads the template as an RTF file. Save it to an appropriate location.

   6. Open the file in a text editor, such as Microsoft Word.

   7. On the second page, navigate to the count CoveredIndividualGrp entry.

   8. Move it to after the PrintInstructionsEP entry on the first page.

   9. Delete the page that provides the instructions.

   10. Confirm that Page 3 has changed to Page 2.

   11. Save the template with a new name.

2. Upload the template.

   1. From Reports and Analytics, click >> and select Shared Folders.

   2. Expand Custom, Human Capital Management, Payroll, Regulatory and Tax Reporting, US, and then Year End.

   3. Select +Add New Layout.

   4. In Upload or Generate Layout, click Upload.

   5. In Upload Template File, enter or select the following.

      Field name	What you do
      Layout Name	Enter a memorable name.
      Template File	Select the file you just saved.
      Type	Select RTF Template.
      Locale	Select English.

   6. Click Upload.

If you need to mask Social Security Numbers

To mask the SSNs of employees and their dependents:

1. Open the appropriate predefined 1095-C template.

   1. From Tools, click Reports and Analytics.

   2. Click >>, and select Shared Folders.

   3. Expand Human Capital Management, Benefits, US, ACA, and then 1095c.

   4. Open the appropriate predefined 1095-C template.

      • The print folder is 1095c, and the template is 1095c_print_YYYY.

      • The online folder is US1095c, and the template is 1095c_online_YYYY.

      Where YYYY is the reporting year.

2. To mask the employee SSN:

   1. Navigate to Part 1: box #2 Social security number (SSN).

   2. Right-click SSN, and select BI-Publisher and then Properties.

   3. Replace:

      <?US_ACA_PER_PRIMARY_NID?>

      with:

      <?concat('XXX-XX-', substring(US_ACA_PER_PRIMARY_NID,string-length(US_ACA_PER_PRIMARY_NID)-4))?>

   4. Click Apply.

3. To mask dependent SSNs:

   1. Navigate to Part III: column (b) SSN or other TIN.

   2. Right-click SSN, and select BI-Publisher and then Properties.

   3. For the employee SSNs, replace:

      <?US_ACA_PER_PRIMARY_NID?>

      with:

      <?concat('XXX-XX-', substring(US_ACA_PER_PRIMARY_NID,string-length(US_ACA_PER_PRIMARY_NID)-4))?>

   4. For the dependent SSNs, replace:

      <?US_ACA_PER_DEP_INFO/US_ACA_DEP_PER_SSN?>

      with:

      <?concat('XXX-XX-', substring(US_ACA_PER_DEP_INFO/US_ACA_DEP_PER_SSN,string-length(US_ACA_PER_DEP_INFO/US_ACA_DEP_PER_SSN)-4))?>

   5. Click Apply.

4. Save the template with a new name.

5. Upload the template.

   1. Open the Custom folder.

   2. Select +Add New Layout.

   3. In Upload or Generate Layout, click Upload.

   4. In Upload Template File, enter or select the following.

      Field name	What you do
      Layout name	Enter a memorable name.
      Template File	Select the file you just saved.
      Type	Select RTF Template.
      Locale	Select English.

   5. Click Upload.