How the ACA Flows Obtain Their Info

The info the ACA flows use to populate your Forms 1094-C and 1095-C come from multiple sources.

For further info, see Configure for Affordable Care Act Reporting in the Help Center.

Form 1094-C

The Form 1094-C electronic XML file reports your employer info as well as the related 1095-C info.

PART I

This section provides info on the form's ALE (Applicable Large Employer) member.

Form line	Form label	Where you set it
1	Name of ALE Member (Employer)	Legal Reporting Unit Registrations task United States Federal Tax jurisdiction Registered Name
2	Employer identification number (EIN)	Legal Reporting Unit Registrations task United States Federal Tax jurisdiction EIN or TIN
3	Street address	Legal Reporting Unit Registrations task, United States Federal Tax jurisdiction, Registered Address
4	City or town	Legal Reporting Unit Registrations task United States Federal Tax jurisdiction Registered Address
5	State or province	Legal Reporting Unit Registrations task United States Federal Tax jurisdiction Registered Address
6	Country and ZIP or foreign postal code	Legal Reporting Unit Registrations task United States Federal Tax jurisdiction Registered Address
7	Name of person to contact	Manage Legal Reporting Unit HCM Information task Tax Reporting Unit Federal ACA Reporting Information ACA Contact First Name ACA Contact Middle Name ACA Contact Last Name
8	Contact telephone number	Manage Legal Reporting Unit HCM Information task Tax Reporting Unit Federal ACA Reporting Information ACA Contact Phone
9	Name of Designated Government Entity	Designated Government Entities (DGEs) aren't supported
10	Employer Identification Number (EIN)	DGEs aren't supported
11	Street address	DGEs aren't supported
12	City or town	DGEs aren't supported
13	State or province	DGEs aren't supported
14	Country and ZIP or foreign postal code	DGEs aren't supported
15	Name of person to contact	DGEs aren't supported
16	Contact telephone number	DGEs aren't supported
18	Total number of Forms 1095-C submitted with this transmittal	Value is derived by the report flow

PART II

This section collects ALE member (ALEM) info.

Form line	Form label	Where you set it
19	Is this the authoritative transmittal for this ALE Member?	Value is derived by the report flow
20	Total number of Forms 1095-C filed by or on behalf of ALE Member	Value is derived by the report flow
21	Is ALE Member a member of an Aggregated ALE Group?	Manage Legal Reporting Unit HCM Information task Tax Reporting Unit Federal ACA Aggregated Group Information Aggregated ALE Group Member
22	Certifications of Eligibility	Manage Legal Reporting Unit HCM Information task Tax Reporting Unit Federal ACA Reporting Information Qualifying Offer Method 98 Percent Offer Method

PART III

Part III reports the following for the ALEM.

Minimum essential coverage offered by the ALEM to full-time employees
Full-time employee count
Total employee count

Form line	Form label	Where you set it
23 (a)	Minimum Essential Coverage Offer Indicator	Manage Legal Reporting Unit HCM Information task Tax Reporting Unit Federal ACA Reporting Information Minimum Coverage Offered All 12 Months
23 (b)	Full-Time Employee Count for ALE Member	Value is derived by the report flow
23 (c)	Total Employee Count for ALE Member	Value is derived by the report flow
23 (d)	Aggregated Group Indicator	Value is derived by the report flow
24 - 35 (a - d)	Minimum Essential Coverage Offer Indicator	Manage Legal Reporting Unit HCM Information task Tax Reporting Unit Federal ACA Reporting Information Minimum Coverage Offered All 12 Months

PART IV

Part IV lists all other members of the aggregated ALE group.

Form line	Form label	Where you set it
36 - 65	Name	Legal Reporting Unit Registrations task United States Federal Tax jurisdiction Registered Name Note: Applies to every TRU you identified as an aggregated ALE group member through Aggregated ALE Group Member.
	EIN	Legal Reporting Unit Registrations task United States Federal Tax jurisdiction EIN or TIN Note: Applies to every TRU you identified as an aggregated ALE group member through Aggregated ALE Group Member.

Form 1095-C

This form reports info about your ALEs and the group health coverage they offer to your ACA full-time employees. You must provide Form 1095-C to your employees and file electronic copies, along with Form 1094-C (transmittal form), to the IRS.

Before generating this form, be sure you have:

Identified all ACA eligible full-time employees. Make sure you date-effectively update any changes to their status.
Identified which employees are in limited nonassessment periods. Make sure you date-effectively update any changes to their status.
Identified if you offer employer-sponsored self-insured health coverage in which the employee or other individual is enrolled.
Provided an SSN for all employees.
Provided at least one of the following for each employee dependent:
- SSN or TIN
- Date-of-birth

PART I

Identifies info about you as the employer and your employees.

The employer details in Form 1095-C are the same as the employer details on the corresponding 1094-C transmittal file you send to the IRS.

Form line	Form label	Where you set it
1	Name of employee	Person task Person Information Name and Addresses Last Name First Name
2	Social security number (SSN)	Person task Person Information National Identifiers
3	Street address	Person task Person Information Name and Addresses Address Line 1
4	City or town	Person task Person Information Name and Addresses City
5	State or province	Person task Person Information Name and Addresses State
6	Country and ZIP Code or foreign postal code	Person task Person Information Name and Addresses Country Postal Code
7	Name of employer	Legal Reporting Unit Registrations task United States Federal Tax jurisdiction Registered Name
8	Employer identification number (EIN)	Legal Reporting Unit Registrations United States Federal Tax jurisdiction EIN or TIN
9	Street address	Legal Reporting Unit Registrations task United States Federal Tax jurisdiction Registered Address
10	Contact telephone number	Manage Legal Reporting Unit HCM Information Tax Reporting Unit Federal ACA Reporting Information ACA Contact Phone
11	City or town	Legal Reporting Unit Registrations task United States Federal Tax jurisdiction Registered Address
12	State or province	Legal Reporting Unit Registrations task United States Federal Tax jurisdiction Registered Address
13	Country and ZIP Code or foreign postal code	Legal Reporting Unit Registrations task United States Federal Tax jurisdiction Registered Address

PART II

Reports info about your offer of group health coverage.

Form line	Form label	Where you set it
14	Offer of Coverage	The report flow uses this hierarchy to determine the Offer of Coverage value. Checks for an override at the legal employer level. For further info, see Configure for Affordable Care Act Reporting in the Help Center. Uses the ACA Override Upload process to check for an override. For further info, see ACA Override Upload in the Help Center. Derives the value. Here's how the flows derive the various values. 1A Qualifying offer. Minimum essential coverage that provides minimum value. Available to full-time employees with: Self-only coverage contributions equal to or less than 9.5% of the mainland single federal poverty line At least minimum essential coverage offered to their spouse and dependents Note: Set these on the legal entity:These fields are available in the Legal Entity HCM Information task in Federal ACA Reporting Information. 1B Minimum essential coverage. Provides minimum value to the employee. 1C Minimum essential coverage. Provides: Minimum value to the employee At least minimum essential coverage to their dependents but not the spouse 1D Minimum essential coverage. Provides: Minimum value offered to the employee At least minimum essential coverage offered to their spouse but not their dependents 1E Minimum essential coverage. Provides: Minimum value to the employee At least minimum essential coverage offered to their dependents and spouse Note: The report flow checks the employees' contact info to derive the 1 series codes. To submit 1095-C forms to all ACA-eligible employees with 1E code, enter an override in Offer of Coverage Override Value at the Legal Employer level.For further info, see Configure for Affordable Care Act Reporting in the Help Center. 1F Minimum essential coverage that doesn't provide minimum value to: The employee The employee and their spouse or dependents The employee, their spouse, and their dependents 1G Offer of coverage to employees that: Weren't full-time employees for any month of the calendar year Enrolled in self-insured coverage for one or more months of the calendar year Note: The report uses this coverage code for employees that have ACA Full Time set to No but are enrolled into qualified ACA plans. 1H No offer of coverage. The employee: Isn't offered health coverage at any point during the month Is offered coverage that's not minimum essential coverage 1J Minimum essential coverage. Provides: Minimum value to the employee At least minimum essential coverage conditionally offered to their spouse Minimum essential coverage isn't offered to their dependents 1K Minimum essential coverage. Provides: Minimum value offered to the employee At least minimum essential coverage offered to their dependents At least minimum essential coverage conditionally offered to their spouse 1L Individual coverage HRA. Provides affordable coverage to the employee only. Determines affordability based on the employee's primary residence ZIP Code. 1M Individual coverage HRA. Provides affordable coverage to the employee and dependents but not the spouse. Determines affordability based on the employee's primary residence ZIP Code. 1N Individual coverage HRA. Provides affordable coverage to the employee, spouse, and dependents. Determines affordability based on the employee's primary residence ZIP Code. 1O Individual coverage HRA. Provides affordable coverage to the employee only. Determines affordability based on the employer's primary location ZIP Code. 1P Individual coverage HRA. Provides affordable coverage to the employee and dependents but not the spouse. Determines affordability based on the employer's primary location ZIP Code. 1Q Individual coverage HRA. Provides affordable coverage to the employee, spouse, and dependents. Determines affordability based on the employer's primary location ZIP Code. 1R Individual coverage HRA. Doesn't provide affordable coverage. 1S Individual coverage HRA. Offered to employees who weren't full-time for any month of the calendar year. 1T Individual coverage HRA. Provides affordable coverage to the employee and spouse. Determines affordability based on the employee's primary residence ZIP Code. 1U Individual coverage HRA offered to employee and spouse. Uses the employer's primary employment location ZIP Code affordability safe harbor. Alternately, you can use the ACA Override Upload task to override the line 14 data. For further info, see ACA Override Upload in the Help Center. Note: You might also need to set the minimum essential coverage and Minimum value for your benefit plan. For further info, see Configure for Affordable Care Act Reporting in the Help Center.
15	Employee Share of Lowest Cost Monthly Premium, for Self-Only Minimum Value Coverage	Value is derived by the report flow Use the ACA Override Upload task to override any incorrect values. For further info, see ACA Override Upload in the Help Center.
16	Applicable Section 4980H Safe Harbor	The report process uses this hierarchy to determine the appropriate Safe Harbor value. 2A Not employed for any days in the reporting month. 2B One of the following. The employee isn't an ACA full-time employee for the month and didn't enroll in minimum essential coverage (if offered). The employee: Is an ACA full-time employee for the month. Their offer of coverage (or coverage if the employee was enrolled) ended before the last day of the month. It ended solely because the employee terminated employment during the month. 2C Employee with an active assignment is enrolled in the offered coverage. Use the ACA Override Upload task to override value 2C for employees. For further info, see ACA Override Upload in the Help Center. 2D Employee's ACA Full Time is set to No, and their Limited Nonassessment Period is set to Yes. To use codes 2E, 2F, 2G, or 2H, use Safe Harbor Override on the Employment task to override this value at the employee level. Alternately, use the ACA Override Upload task to override any incorrect values. For further info, see ACA Override Upload in the Help Center.

Form line

Form label

Where you set it

Offer of Coverage

The report flow uses this hierarchy to determine the Offer of Coverage value.

Checks for an override at the legal employer level.

For further info, see Configure for Affordable Care Act Reporting in the Help Center.
Uses the ACA Override Upload process to check for an override.

For further info, see ACA Override Upload in the Help Center.
Derives the value.

Here's how the flows derive the various values.

1A

Qualifying offer. Minimum essential coverage that provides minimum value. Available to full-time employees with:
- Self-only coverage contributions equal to or less than 9.5% of the mainland single federal poverty line
- At least minimum essential coverage offered to their spouse and dependents
Note: Set these on the legal entity:These fields are available in the Legal Entity HCM Information task in Federal ACA Reporting Information.
1B

Minimum essential coverage. Provides minimum value to the employee.
1C

Minimum essential coverage. Provides:
- Minimum value to the employee
- At least minimum essential coverage to their dependents but not the spouse
1D

Minimum essential coverage. Provides:
- Minimum value offered to the employee
- At least minimum essential coverage offered to their spouse but not their dependents
1E

Minimum essential coverage. Provides:
- Minimum value to the employee
- At least minimum essential coverage offered to their dependents and spouse
Note: The report flow checks the employees' contact info to derive the 1 series codes. To submit 1095-C forms to all ACA-eligible employees with 1E code, enter an override in Offer of Coverage Override Value at the Legal Employer level.For further info, see Configure for Affordable Care Act Reporting in the Help Center.
1F

Minimum essential coverage that doesn't provide minimum value to:
- The employee
- The employee and their spouse or dependents
- The employee, their spouse, and their dependents
1G

Offer of coverage to employees that:
- Weren't full-time employees for any month of the calendar year
- Enrolled in self-insured coverage for one or more months of the calendar year
Note: The report uses this coverage code for employees that have ACA Full Time set to No but are enrolled into qualified ACA plans.
1H

No offer of coverage. The employee:
- Isn't offered health coverage at any point during the month
- Is offered coverage that's not minimum essential coverage
1J

Minimum essential coverage. Provides:
- Minimum value to the employee
- At least minimum essential coverage conditionally offered to their spouse
- Minimum essential coverage isn't offered to their dependents
1K

Minimum essential coverage. Provides:
- Minimum value offered to the employee
- At least minimum essential coverage offered to their dependents
- At least minimum essential coverage conditionally offered to their spouse
1L

Individual coverage HRA. Provides affordable coverage to the employee only. Determines affordability based on the employee's primary residence ZIP Code.
1M

Individual coverage HRA. Provides affordable coverage to the employee and dependents but not the spouse. Determines affordability based on the employee's primary residence ZIP Code.
1N

Individual coverage HRA. Provides affordable coverage to the employee, spouse, and dependents. Determines affordability based on the employee's primary residence ZIP Code.
1O

Individual coverage HRA. Provides affordable coverage to the employee only. Determines affordability based on the employer's primary location ZIP Code.
1P

Individual coverage HRA. Provides affordable coverage to the employee and dependents but not the spouse. Determines affordability based on the employer's primary location ZIP Code.
1Q

Individual coverage HRA. Provides affordable coverage to the employee, spouse, and dependents. Determines affordability based on the employer's primary location ZIP Code.
1R

Individual coverage HRA. Doesn't provide affordable coverage.
1S

Individual coverage HRA. Offered to employees who weren't full-time for any month of the calendar year.
1T

Individual coverage HRA. Provides affordable coverage to the employee and spouse. Determines affordability based on the employee's primary residence ZIP Code.
1U

Individual coverage HRA offered to employee and spouse. Uses the employer's primary employment location ZIP Code affordability safe harbor.

Alternately, you can use the ACA Override Upload task to override the line 14 data. For further info, see ACA Override Upload in the Help Center.

Note: You might also need to set the minimum essential coverage and Minimum value for your benefit plan. For further info, see Configure for Affordable Care Act Reporting in the Help Center.

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

Value is derived by the report flow

Use the ACA Override Upload task to override any incorrect values. For further info, see ACA Override Upload in the Help Center.

Applicable Section 4980H Safe Harbor

The report process uses this hierarchy to determine the appropriate Safe Harbor value.

2A

Not employed for any days in the reporting month.
2B

One of the following.
- The employee isn't an ACA full-time employee for the month and didn't enroll in minimum essential coverage (if offered).
- The employee:
  1. Is an ACA full-time employee for the month.
  2. Their offer of coverage (or coverage if the employee was enrolled) ended before the last day of the month. It ended solely because the employee terminated employment during the month.
2C

Employee with an active assignment is enrolled in the offered coverage.

Use the ACA Override Upload task to override value 2C for employees. For further info, see ACA Override Upload in the Help Center.
2D

Employee's ACA Full Time is set to No, and their Limited Nonassessment Period is set to Yes.

To use codes 2E, 2F, 2G, or 2H, use Safe Harbor Override on the Employment task to override this value at the employee level.

Alternately, use the ACA Override Upload task to override any incorrect values. For further info, see ACA Override Upload in the Help Center.

PART III

This section provides info about your self-funded health coverage (if any), including the covered individuals' names, SSNs, and dates-of-birth. The report flow automatically completes this section if you have employees or other individuals enrolled in employer-sponsored self-insured health coverage.

Form line	Form label	Where you set it
(a)	Name of covered individual	Person task Contacts Last Name First Name
(b)	SSN	Person task Contacts TIN Number
(c)	DOB	Person task Contacts Date of Birth
(d)	Covered all 12 months	Value is derived by the report flow
(e)	Months of Coverage	Value is derived by the report flow if you don't select Covered all 12 months Use the ACA Override Upload task to update coverage info for the employees and dependents. For further info, see ACA Override Upload in the Help Center.