1. US Affordable Care Act Year-End Processing Guide
  2. Understanding the Form 1095-C Workfiles Creation

Understanding the Form 1095-C Workfiles Creation

After setting the processing options for R08119 and after setting the AIR parameters, you create the AIR year-end workfiles.

When you submit the 1095-C Offer and Coverage Workfile Build for processing, it generates these three reports:

  • 1095-C Offer and Coverage Workfile Build report - R08119

  • 1095-C Covered Individuals File Build - R08120 (Optional)

  • Offer and Coverage Workfile report - R08119A

The 1095-C Offer and Coverage Workfile Build report (R08119) creates records in the F08119 table. The 1095-C Offer and Coverage Workfile Build report generates the status of the R08119 build and displays a list of employees enrolled for a plan but excluded from the ACA Health Coverage.

The R08119 report also provides details of the employee's eligibility status, effective date (beginning date of the employee's offer of coverage), Pay Status, Start Date, Termination Date, Benefit Group, and Union Code.

The 1095-C Covered Individuals File Build report (R08120) creates records in the F08120 table. This table supports Part III (Covered Individuals) of Form 1095-C and is only required if the employer offers self-insured health coverage. The 1095-C Covered Individuals File Build report details the dependents of the employee, the tax ID, the relationship of the dependent to the employee, the medical plan under which the dependent is covered, and months in the year for which the dependent is covered.

The Offer and Coverage Workfile report (R08119A) reports information from the F08119 and F08120 tables that were created for Form 1095-C Part II and Part III. The report includes the Summary and Detail records that were created in the reporting workfiles:

  • The Summary record in the report displays the coverage details of the employee for the specified year. Summary records are used for producing Form 1095-C.

  • The Detail record in the report displays more detailed information that influenced how the Summary record was created. The detail records are kept as an audit trail and research aid.

    It also lists the employee and their dependents under the Covered Individuals section, if generated.

After you process the workfile build, review the records using the Work with 1095-C Information program (P08119) and make any changes necessary before you begin printing Form 1095-C.