About Form 1095-C: Employer-Provided Health Insurance Offer and Coverage

What Is Form 1095-C?

Form 1095-C is used to report information about each employee and summary information for each employer to the IRS. In addition, Forms 1094-C and 1095-C are used in determining whether an employer owes a payment under the employer shared responsibility provisions under section 4980H. Form 1095-C is also used in determining the eligibility of employees for the premium tax credit. Applicable Large Employers that offer employer-sponsored self-insured coverage use Form 1095-C to report information to the IRS and to employees. This includes information about individuals who have minimum essential coverage under the employer plan and therefore are not liable for the individual shared responsibility payment for the months that they are covered under the plan.

Who Needs To File Form 1095-C?

An employer subject to the employer shared responsibility provisions under section 4980H must file one or more 1094-C (including Form 1094-C designated as the Authoritative Transmittal, whether or not filing multiple 1094-C forms), and must file Form 1095-C for each employee who was a full-time employee of the employer for any month of the calendar year. The employer is required to furnish a copy of the Form 1095-C to the employee. See the official IRS instructions or use this tool to determine if you have a filing requirement.

Using Yearli To File Form 1095-C

Although managing the data required on Form 1095-C may seem like a daunting task, you can do it with Yearli and the ACA reporting experts at Greatland. Yearli was designed to allow you to easily import, add, edit, update and delete information required for reporting on Form 1095-C. Yearli simplifies the filing process, breaking the form into four logical sections:

ALE Information (Employer): Lines 7-13 on Form 1095-C

Yearli makes it easy to import and manage employer information required on Form 1095-C, with built-in features to make data import quick and easy, such as:

  • Multiple Employers: Keeping 1095-C records for more than one employer? Yearli allows you to easily import, enter and maintain multiple employers. Convenient drop-down arrows provide easy organization and reference for each EIN.
  • Data Validation: Yearli will flag you if you enter invalid employer data, such as EIN. This happens on a field-by-field basis during data entry. So, you don't have to wait until you are finished with the form before you are flagged for invalid data. When importing data, you'll receive a report identifying any validation errors with employer information.

Employee Information: Lines 1-6 on Form 1095-C

Importing or entering employee data into Yearli is extremely easy. Yearli's data entry form allows you to quickly toggle between employees from the same company, making data entry a snap. You can even save partial or incomplete data. That way, if you need to obtain additional information you can. Simply return to the data entry form at a later time and add the incomplete information. It's as easy as that!

  • Data Validation: Yearli's data entry form will flag you if you enter invalid employee data, such as SSN or zip code. This happens on a field-by-field basis during data entry. So, you don't have to wait until you are finished with the form before you are flagged for invalid data.
  • Multiple Forms: Adding additional forms for an employee is easy. Once the data is entered, you can easily use the same employee data to complete a W-2 form, for example

Employee Offer and Coverage: Lines 14-16 on Form 1095-C

Line 14: Offer of Coverage - Line 14 specifies the type of coverage, if any, offered to an employee, spouse and dependents. The code must indicate the coverage the employee was offered; however, it may not match the coverage in which the employee is actually enrolled. For example, if an employee is offered family coverage but enrolls in employee-only coverage, Line 14 must indicate that the employee was offered family coverage. A code must be entered for each calendar month even if the employee was not a full-time employee for one or more months. Alternatively, the "All 12 Months" box may be completed if the same offer applies to all 12 months.

Line 15: Employee Rquired Contribution - Enter the amount of the employee share of the lowest cost monthly premium for self-only minimum essential coverage (MEC) providing minimum value (MV) offered to the employee. This amount may not equal the amount the employee is actually paying for coverage. For example, an employee enrolls in family coverage with a monthly premium of $200.00. The monthly premium for employee-only coverage is $100.00 which is the amount that should be entered on Line 15. For additional rules on determining the amount of the Employee Required Contribution, including cases in which an Applicable Large Employer (ALE) makes available certain HRA contributions, cafeteria plan contributions, wellness program incentives, and opt-out payments, see Notice 2015-87.

Line 14 Code Descriptions and Line 15 Entry:

  • 1A: Qualifying offer: Minimum Essential Coverage (MEC) providing Minimum Value (MV) offered to full-time employee, and at least MEC offered to spouse and dependents. Employee Required Contribution is $94.75 or less (for 2016 calendar year plans). Line 15: Leave Blank
  • 1B: MEC providing MV offered to employee only. Line 15: Required
  • 1C: MEC providing MV offered to employee and at least MEC offered to dependents (no spouse). Line 15: Required
  • 1D: MEC providing MV offered to employee and at least MEC offered to spouse (no dependents) Do not use Code 1D if coverage for the spouse was offered conditionally. Instead, use Code 1J. Line 15: Required
  • 1E: MEC providing MV offered to employee and at least MEC offered to dependents and spouse. If Employee Required Contribution is more than $94.75 (for 2016 calendar year plans), use Code 1E. Do not use Code 1E if coverage for the spouse was offered conditionally. Instead, use Code 1K. Line 15: Required
  • 1F: Offer of MEC NOT providing MV was made to employee, or employee and spouse or dependents, or employee, spouse and dependents. Line 15: Leave Blank
  • 1G: Offer of coverage to individual who was not a full-time employee for any month and who enrolled in selfinsured coverage for one or more months. Line 15: Leave Blank
  • 1H: No offer of coverage to the employee, or the offer was not MEC. Line 15: Leave Blank
  • 1I: Not Applicable
  • 1J: MEC providing MV offered to employee and at least MEC conditionally offered to spouse; MEC not offered to dependents. Line 15: Required
  • 1K: MEC providing MV offered to employee; at least MEC offered to dependents; and at least MEC conditionally offered to spouse. Line 15: Required

Line 16: Section 4980H Safe Harbor Codes and Other Relief - Line 16 provides an opportunity for an employer to indicate an exception to a penalty. Completing this line is optional, however it is in the employer's best interest to provide the information if it is applicable

Line 16 Code Descriptions:

  • 2A: Employee not employed during the month
  • 2B: Employee is not a full-time employee
  • 2C: Employee enrolled in coverage offered
  • 2D: Employee is in a limited non-assessment period
  • 2E: Multiemployer interim rule relief
  • 2F: Section 4980H affordability Form W-2 safe harbor
  • 2G: Section 4980H affordability federal poverty line safe harbor
  • 2H: Section 4980H affordability rate of pay safe harbor

If more than one code applies to Line 16, use the following guidelines:

  • If 2E and any other Code series 2 applies, enter 2E
  • If 2C and any other Code series 2 applies other than Code 2E, enter 2C
  • If 2B and 2D apply, enter 2D

Note: Greatland Corporation does not provide tax, legal or accounting advice. This document has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, tax, legal or accounting advice. You should consult your own tax, legal and accounting advisors before engaging in any transaction.

Covered Individuals: Lines 17-22 on Form 1095-C

Yearli conveniently organizes covered individuals, closely linking them to the employee information. Through Yearli, you can quickly import, add, edit or remove covered individuals for each employee. Select each month individually or choose All 12 Months.

  • Data Validation: The fields in the covered individuals section contain validation to ensure you are compliant with IRS regulations, requiring you to enter "SSN" or "Date of Birth," for example.
  • Quick List: The covered individuals section provides a list of all covered individuals listed under the employee, providing easy reference with the ability to add, edit or delete covered individuals.