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) |
|
2 |
Employer identification number (EIN) |
|
3 |
Street address |
|
4 |
City or town |
|
5 |
State or province |
|
6 |
Country and ZIP or foreign postal code |
|
7 |
Name of person to contact |
|
8 |
Contact telephone number |
|
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? |
|
22 |
Certifications of Eligibility |
|
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 |
|
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 |
|
PART IV
Part IV lists all other members of the aggregated ALE group.
Form line |
Form label |
Where you set it |
---|---|---|
36 - 65 |
Name |
Note:
Applies to every TRU you identified as an aggregated ALE group member through Aggregated ALE Group Member. |
EIN |
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
-
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 |
|
2 |
Social security number (SSN) |
|
3 |
Street address |
|
4 |
City or town |
|
5 |
State or province |
|
6 |
Country and ZIP Code or foreign postal code |
|
7 |
Name of employer |
|
8 |
Employer identification number (EIN) |
|
9 |
Street address |
|
10 |
Contact telephone number |
|
11 |
City or town |
|
12 |
State or province |
|
13 |
Country and ZIP Code or foreign postal code |
|
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.
Here's how the flows derive the various values.
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.
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 |
|
(b) |
SSN |
|
(c) |
DOB |
|
(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. |