Understanding Offer and Coverage Setup
You can use the Work With Employee Offer and Coverage Setup program (P08117) to set up values for lines 14, 15, 16 and 17 of Form 1095-C, Part II. You can also use the import functionality to create information in this table, or you can use the Offer and Coverage Employee Overrides report (R08117) to generate records with similar values for selected employees.
Form 1095-C Part II Employee Offer and Coverage includes four lines:
Line 14 - Offer of Coverage
Line 15 - Employee Share of Lowest Cost Monthly Premium, for Self-Only Minimum Value Coverage
Line 16 - Applicable Section 4980H Safe Harbor
Line 17 - ZIP Code
The offer of coverage code from IRS Code Series 1 that applies to an employee for each month of the year or for all 12 months of the year is reported on Form 1095-C, Part II, Line 14 in the All 12 Months column or in the Jan-Dec columns.
The amount that represents the Employee Share of Lowest Cost Monthly Premium for Self-Only Minimum Value Coverage is reported on Form 1095-C, Part II, Line 15 in the All 12 Months column or in the Jan-Dec columns. This amount may not be the amount that the employee is paying for the coverage. For example, if the employee chose to enroll in more expensive coverage such as family coverage. Complete Line 15 only if code 1B, 1C, 1D, or 1E is entered in Line 14.
Line 16 reports the applicable IRS code from Code Series 2 to report certain situations indicating safe harbor or other relief for employers administration. The IRS instructions state that Line 16 can be blank.
Line 17 reports the applicable ZIP code your employer uses for determining the availability for an individual coverage HRA. If code 1L, 1M, or 1N is used in Line 14, the ZIP code will be for the employee's primary residence location. If code 1O, 1P, or 1Q is used in Line 14, the ZIP code will be for the employee's primary work location. Line 17 will be blank for any other code that is entered in Line 14.
The Offer and Coverage values can be set by:
Plan/Plan Option
DBA, with or without Union code
Employee
When retrieving codes and values from Employee Offer and Coverage Setup, the system associates codes as follows:
Based on an employee's benefit enrollment, setup values are determined based on Plan/Plan Option setup
Note: If your reportable plans are set up with plan options, you must also set up offer and coverage values by plan/plan option.Based on employee DBA Transaction history (F0719), setup values are determined based on the DBA number, with or without Union Code.
The setup associated to an employee number overrides other setup values.
JD Edwards Health Coverage Information Returns processing is designed to accommodate, to the extent possible, the reporting of health coverage information for customers using Benefits Administration and for customers who do not use Benefits but instead set up and process DBAs for employees through payroll processing.
For enrollment that is done through Benefits Administration, the system refers to Benefits Enrollment (F08334) information to establish an employee's offer of health insurance coverage.
When enrollment is not done through benefits, and outside of any months where benefits enrollment is found, the system will check both DBA Instructions (F06106) and DBA Transaction Detail History (F0719) to establish an employee's offer of coverage. In this case, any F0719 amount in a month indicates an offer of coverage for the month. In addition, the Employee Master category code that indicates the employee was offered coverage but waived coverage is also considered.