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
# | Id | Type | Description |
---|---|---|---|
1 | marketplaceId | string | Box 1, Marketplace identifier |
2 | marketplacePolicyNumber | string | Box 2, Marketplace-assigned policy number |
3 | policyIssuerName | string | Box 3, Policy issuer's name |
4 | recipientName | string | Box 4, Recipient's name |
5 | recipientTin | string | Box 5, Recipient's SSN |
6 | recipientDateOfBirth | DateString | Box 6, Recipient's date of birth |
7 | spouseName | string | Box 7, Recipient's spouse's name |
8 | spouseTin | string | Box 8, Recipient's spouse's SSN |
9 | spouseDateOfBirth | DateString | Box 9, Recipient's spouse's date of birth |
10 | policyStartDate | DateString | Box 10, Policy start date |
11 | policyTerminationDate | DateString | Box 11, Policy termination date |
12 | recipientAddress | Address | Boxes 12-15, Recipient address |
13 | coveredIndividuals | Array of HealthInsuranceMarketplaceCoveredIndividual | Boxes 16+, Covered Individuals |
14 | coverages | Array of HealthInsuranceCoverage | Boxes 21-33, Coverage Information |
Tax1095A Usage:
- TaxData tax1095A
Example Form JSON
{ "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

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