Tax Documents

 

Tax1095A

 

FDX Data Structure as JSON
{
  "taxYear" : 0,
  "corrected" : true,
  "accountId" : "",
  "taxFormId" : "",
  "taxFormDate" : "2020-07-01",
  "description" : "string",
  "additionalInformation" : "string",
  "taxFormType" : "BusinessIncomeStatement",
  "attributes" : [ {
    "name" : "string",
    "value" : "string",
    "boxNumber" : "string",
    "code" : "string"
  } ],
  "error" : {
    "code" : "string",
    "message" : "string"
  },
  "marketplaceId" : "string",
  "marketplacePolicyNumber" : "string",
  "policyIssuerName" : "string",
  "recipientName" : "string",
  "recipientTin" : "string",
  "recipientDateOfBirth" : "2020-07-01",
  "spouseName" : "string",
  "spouseTin" : "string",
  "spouseDateOfBirth" : "2020-07-01",
  "policyStartDate" : "2020-07-01",
  "policyTerminationDate" : "2020-07-01",
  "recipientAddress" : {
    "line1" : "String64",
    "line2" : "String64",
    "line3" : "String64",
    "city" : "String64",
    "state" : "String64",
    "postalCode" : "string",
    "country" : "AD"
  },
  "coveredIndividuals" : [ {
    "name" : "string",
    "tin" : "string",
    "dateOfBirth" : "2020-07-01",
    "policyStartDate" : "2020-07-01",
    "policyTerminationDate" : "2020-07-01"
  } ],
  "coverages" : [ {
    "enrollmentPremium" : 0.0,
    "slcspPremium" : 0.0,
    "advancePremiumTaxCreditPayment" : 0.0,
    "month" : "ANNUAL"
  } ]
}
FDX / Data Structures / Tax1095A
Form 1095-A, Health Insurance Marketplace Statement
Extends and inherits all fields from Tax  
Tax1095A Properties
#IdTypeDescription
1marketplaceIdstringBox 1, Marketplace identifier
2marketplacePolicyNumberstringBox 2, Marketplace-assigned policy number
3policyIssuerNamestringBox 3, Policy issuer's name
4recipientNamestringBox 4, Recipient's name
5recipientTinstringBox 5, Recipient's SSN
6recipientDateOfBirthDateStringBox 6, Recipient's date of birth
7spouseNamestringBox 7, Recipient's spouse's name
8spouseTinstringBox 8, Recipient's spouse's SSN
9spouseDateOfBirthDateStringBox 9, Recipient's spouse's date of birth
10policyStartDateDateStringBox 10, Policy start date
11policyTerminationDateDateStringBox 11, Policy termination date
12recipientAddressAddressBoxes 12-15, Recipient address
13coveredIndividualsArray of HealthInsuranceMarketplaceCoveredIndividualBoxes 16+, Covered Individuals
14coveragesArray of HealthInsuranceCoverageBoxes 21-33, Coverage Information
Tax1095A Usage:
Example Form JSON

Download

{
  "tax1095A" : {
    "taxYear" : 2020,
    "taxFormId" : "e5d4ee73bd1-9295-480f-a426-1095-A",
    "taxFormDate" : "2021-02-01",
    "additionalInformation" : "FDX v4.6",
    "taxFormType" : "Tax1095A",
    "marketplaceId" : "10001",
    "marketplacePolicyNumber" : "20000002",
    "policyIssuerName" : "American People Health",
    "recipientName" : "Kris Q. Public",
    "recipientTin" : "xxx-xx-1234",
    "recipientDateOfBirth" : "1995-06-06",
    "spouseName" : "Tracy R. Public",
    "spouseTin" : "xxx-xxx-4321",
    "spouseDateOfBirth" : "1995-09-09",
    "policyStartDate" : "2020-01-01",
    "policyTerminationDate" : "2020-12-31",
    "recipientAddress" : {
      "line1" : "1 Main St",
      "city" : "Melrose",
      "state" : "NY",
      "postalCode" : "12121"
    },
    "coveredIndividuals" : [ {
      "name" : "Kris Q. Public",
      "tin" : "xxx-xx-1234",
      "dateOfBirth" : "1995-06-06",
      "policyStartDate" : "2020-01-01",
      "policyTerminationDate" : "2020-12-31"
    }, {
      "name" : "Tracy R. Public",
      "tin" : "xxx-xxx-4321",
      "dateOfBirth" : "1995-09-09",
      "policyStartDate" : "2020-01-01",
      "policyTerminationDate" : "2020-12-31"
    } ],
    "coverages" : [ {
      "enrollmentPremium" : 21.14,
      "slcspPremium" : 21.14,
      "advancePremiumTaxCreditPayment" : 21.14,
      "month" : "JANUARY"
    }, {
      "enrollmentPremium" : 22.14,
      "slcspPremium" : 22.14,
      "advancePremiumTaxCreditPayment" : 22.14,
      "month" : "FEBRUARY"
    }, {
      "enrollmentPremium" : 23.14,
      "slcspPremium" : 23.14,
      "advancePremiumTaxCreditPayment" : 23.14,
      "month" : "MARCH"
    }, {
      "enrollmentPremium" : 24.14,
      "slcspPremium" : 24.14,
      "advancePremiumTaxCreditPayment" : 24.14,
      "month" : "APRIL"
    }, {
      "enrollmentPremium" : 25.14,
      "slcspPremium" : 25.14,
      "advancePremiumTaxCreditPayment" : 25.14,
      "month" : "MAY"
    }, {
      "enrollmentPremium" : 26.14,
      "slcspPremium" : 26.14,
      "advancePremiumTaxCreditPayment" : 26.14,
      "month" : "JUNE"
    }, {
      "enrollmentPremium" : 27.14,
      "slcspPremium" : 27.14,
      "advancePremiumTaxCreditPayment" : 27.14,
      "month" : "JULY"
    }, {
      "enrollmentPremium" : 28.14,
      "slcspPremium" : 28.14,
      "advancePremiumTaxCreditPayment" : 28.14,
      "month" : "AUGUST"
    }, {
      "enrollmentPremium" : 29.14,
      "slcspPremium" : 29.14,
      "advancePremiumTaxCreditPayment" : 29.14,
      "month" : "SEPTEMBER"
    }, {
      "enrollmentPremium" : 30.14,
      "slcspPremium" : 30.14,
      "advancePremiumTaxCreditPayment" : 30.14,
      "month" : "OCTOBER"
    }, {
      "enrollmentPremium" : 31.14,
      "slcspPremium" : 31.14,
      "advancePremiumTaxCreditPayment" : 31.14,
      "month" : "NOVEMBER"
    }, {
      "enrollmentPremium" : 32.14,
      "slcspPremium" : 32.14,
      "advancePremiumTaxCreditPayment" : 32.14,
      "month" : "DECEMBER"
    }, {
      "enrollmentPremium" : 319.68,
      "slcspPremium" : 319.68,
      "advancePremiumTaxCreditPayment" : 319.68,
      "month" : "ANNUAL"
    } ]
  }
}
Example Form JSON as QR Code

Download

 

 

Example Form JSON for QR Code Purposes

Download

© Copyright 2021. All Rights Reserved.