IRS Form 1095-C

Form 1095-C: Employer-Provided Health Insurance

Report health insurance coverage offers and enrollment information for Applicable Large Employers (ALE) under the Affordable Care Act.

Filing Deadline

February 28 (paper) or March 31 (electronic)

Employee Copy

Due by January 31

Who Files

Applicable Large Employers (50+ FTE)

Overview

Form 1095-C is used by Applicable Large Employers (ALEs) to report information to the IRS and employees about health insurance coverage offers and enrollment. This form satisfies both the Section 6056 employer reporting requirements and Section 6055 minimum essential coverage reporting for self-insured plans.

ALEs must file this form for each full-time employee (working 30+ hours per week or 130 hours per month) for any month of the calendar year, regardless of whether the employee accepted coverage. The information is used to determine employer shared responsibility payment obligations under Section 4980H and employee eligibility for premium tax credits.

Who Must File

Required Filers (ALE Members)

•Employers with 50+ full-time equivalent employees in the prior year
•Each member of an aggregated ALE group (under common control)
•Government employers meeting the size threshold
•Self-insured plan sponsors (for coverage reporting)

Key Requirements

→Must file for EVERY full-time employee, even if they declined coverage
→Report all 12 months of the year for each employee
→Electronic filing mandatory for 250+ forms
→Must also file Form 1094-C as transmittal

Form Structure & Instructions

Form 1095-C has three main parts. Here's what information is required in each section:

Part I: Employee & Employer Information

Basic information about the employee and the Applicable Large Employer

Employee Name

Full legal name of the full-time employee

SSN

Employee's SSN (required)

3-6

Employee Address

Street address, city, state, and ZIP code

Employer Name

Name of the ALE Member (employer)

Employer EIN

Employer Identification Number of the ALE Member

9-13

Employer Contact & Address

Phone number and complete mailing address of employer

Plan Start Month

Month the plan year begins (optional for non-calendar year plans)

Part II: Employee Offer of Coverage

Monthly details about coverage offers to the employee and cost information

Offer of Coverage Codes

For each month (Jan-Dec), enter code indicating type of coverage offered (1A-1J for offers, 2A-2I for safe harbors)

Employee Required Contribution

Monthly cost for employee-only lowest-cost minimum value coverage (leave blank if not applicable)

Section 4980H Safe Harbor

Code indicating if safe harbor relief applies (2A-2I)

Age on January 1

Employee's age at the start of the calendar year (for HRA affordability calculations)

Part III: Covered Individuals

List individuals enrolled in employer-sponsored self-insured coverage (if applicable)

Column (a)

Name

Full name of each covered individual (employee, spouse, dependents)

Column (b)

SSN or TIN

Social Security Number or taxpayer identification number

Column (c)

Date of Birth

DOB in MM/DD/YYYY format

Column (d)

Covered All 12 Months

Check if individual was covered for the entire year

Column (e)

Months of Coverage

If not full year, enter each month covered using Jan, Feb, Mar format

Common Coverage Offer Codes (Line 14)

Offer Codes (Series 1)

1A - Qualifying offer (employee + spouse + dependents)
1B - Employee only minimum essential coverage
1C - Employee + spouse (not dependents)
1D - Employee + dependent(s) (not spouse)
1E - Employee, spouse, and dependents
1H - No offer of coverage

Safe Harbor Codes (Series 2)

2A - Employee not employed during month
2C - Employee enrolled in coverage
2D - Employee in limited non-assessment period
2E - Multiemployer interim rule relief
2F - Section 4980H affordability - Federal poverty line
2G - Section 4980H affordability - rate of pay
2H - Section 4980H affordability - Form W-2 wages

Important Filing Notes

Authoritative Transmittal Required

Use Form 1094-C as the authoritative transmittal. If filing multiple 1094-Cs, designate one as authoritative by checking the box on line 19.

Monthly Reporting Required

Must report information for all 12 months of the year for each full-time employee, even months where no coverage was offered.

Corrected Returns

To correct a Form 1095-C, check the 'CORRECTED' box and enter the correct information. File the corrected form with a new Form 1094-C.

Alternative Furnishing Methods

Qualifying Offer Method allows simplified employee furnishing. Must still file complete forms with IRS but can provide shortened statement to employees.