Tax1095A_V100

OFX / Types / Tax1095A_V100
#TagType
1 SRVRTID ServerIdType
2 TAXYEAR YearType
3 VOID BooleanType
4 CORRECTED BooleanType
5 MARKETPLACEIDENTIFIER GenericNameType
6 MARKETASSIGNEDPOLICYNUM GenericNameType
7 POLICYISSUERNAME GenericNameType
8 RECIPIENTINFO RecipientInfo
9 POLICYSTARTDATE DateTimeType
10 POLICYTERMINATIONDATE DateTimeType
11 COVERAGEHOUSEHOLD CoverageHouseholdType
12 HOUSEHOLDINFO HouseholdInformationType
13 TOTALPLANPREMIUMAMT AmountType
14 TOTALPREMIUMSLCSPAMT AmountType
15 TOTALADVANCEPTCAMT AmountType
Usages:
XSD
	<xsd:complexType name="Tax1095A_V100">
		<xsd:annotation>
			<xsd:documentation>The OFX element "TAX1095A_v100" is of type "Tax1095A_V100"</xsd:documentation>
		</xsd:annotation>
		<xsd:complexContent>
			<xsd:extension base="ofx:AbstractTaxForm1095">
				<xsd:sequence>
					<xsd:element name="MARKETPLACEIDENTIFIER" type="ofx:GenericNameType">
						<xsd:annotation>
							<xsd:documentation>Marketplace identifier</xsd:documentation>
						</xsd:annotation>
					</xsd:element>
					<xsd:element name="MARKETASSIGNEDPOLICYNUM" type="ofx:GenericNameType">
						<xsd:annotation>
							<xsd:documentation>Marketplace assigned policy number</xsd:documentation>
						</xsd:annotation>
					</xsd:element>
					<xsd:element name="POLICYISSUERNAME" type="ofx:GenericNameType">
						<xsd:annotation>
							<xsd:documentation>Name of the exchange providing the 1095-A</xsd:documentation>
						</xsd:annotation>
					</xsd:element>
					<xsd:element name="RECIPIENTINFO" type="ofx:RecipientInfo">
						<xsd:annotation>
							<xsd:documentation>Recipient and Recipient Spouse(if applicable) info</xsd:documentation>
						</xsd:annotation>
					</xsd:element>
					<xsd:element name="POLICYSTARTDATE" type="ofx:DateTimeType">
						<xsd:annotation>
							<xsd:documentation>Date policy coverage began</xsd:documentation>
						</xsd:annotation>
					</xsd:element>
					<xsd:element name="POLICYTERMINATIONDATE" type="ofx:DateTimeType" minOccurs="0">
						<xsd:annotation>
							<xsd:documentation>Date policy coverage ended</xsd:documentation>
						</xsd:annotation>
					</xsd:element>
					<xsd:element name="COVERAGEHOUSEHOLD" type="ofx:CoverageHouseholdType" maxOccurs="unbounded">
						<xsd:annotation>
							<xsd:documentation>Covered Individual Information Group</xsd:documentation>
						</xsd:annotation>
					</xsd:element>
					<xsd:element name="HOUSEHOLDINFO" type="ofx:HouseholdInformationType" maxOccurs="12">
						<xsd:annotation>
							<xsd:documentation>Monthly premium anounts. </xsd:documentation>
						</xsd:annotation>
					</xsd:element>
					<xsd:element name="TOTALPLANPREMIUMAMT" type="ofx:AmountType">
						<xsd:annotation>
							<xsd:documentation>Total Monthly Premium Amount</xsd:documentation>
						</xsd:annotation>
					</xsd:element>
					<xsd:element name="TOTALPREMIUMSLCSPAMT" type="ofx:AmountType">
						<xsd:annotation>
							<xsd:documentation>Total monthly SLCSP Amount</xsd:documentation>
						</xsd:annotation>
					</xsd:element>
					<xsd:element name="TOTALADVANCEPTCAMT" type="ofx:AmountType">
						<xsd:annotation>
							<xsd:documentation>Total Monthly Advanced PTC Amount</xsd:documentation>
						</xsd:annotation>
					</xsd:element>
				</xsd:sequence>
			</xsd:extension>
		</xsd:complexContent>
	</xsd:complexType>

FDX 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"
    } ]
  }
}

OFX XML

<?xml version="1.0" encoding="UTF-8" standalone="no"?>
<?OFX OFXHEADER="200" VERSION="202" SECURITY="NONE" OLDFILEUID="NONE" NEWFILEUID="NONE"?>

<OFX>
    <SIGNONMSGSRSV1>
        <SONRS>
            <STATUS>
                <CODE>0</CODE>
                <SEVERITY>INFO</SEVERITY>
                <MESSAGE>Successful Login</MESSAGE>
            </STATUS>
            <DTSERVER>39210131000000</DTSERVER>
            <LANGUAGE>ENG</LANGUAGE>
            <FI>
                <ORG>fiName</ORG>
                <FID>fiId</FID>
            </FI>
        </SONRS>
    </SIGNONMSGSRSV1>
    <TAX1095MSGSRSV1>
        <TAX1095TRNRS>
            <TRNUID>_GUID_</TRNUID>
            <STATUS>
                <CODE>0</CODE>
                <SEVERITY>INFO</SEVERITY>
                <MESSAGE>SUCCESS</MESSAGE>
            </STATUS>
            <TAX1095RS>
                <TAX1095A_V100>
                    <SRVRTID>e5d4ee73bd1-9295-480f-a426-1095-A</SRVRTID>
                    <TAXYEAR>2020</TAXYEAR>
                    <MARKETPLACEIDENTIFIER>10001</MARKETPLACEIDENTIFIER>
                    <MARKETASSIGNEDPOLICYNUM>20000002</MARKETASSIGNEDPOLICYNUM>
                    <POLICYISSUERNAME>American People Health</POLICYISSUERNAME>
                    <RECIPIENTINFO>
                        <RECIPIENTNAME>Kris Q. Public</RECIPIENTNAME>
                        <SSN>xxx-xx-1234</SSN>
                        <DOB>19950606</DOB>
                        <SPOUSENAME>Tracy R. Public</SPOUSENAME>
                        <SPOUSESSN>xxx-xxx-4321</SPOUSESSN>
                        <SPOUSEDOB>19950909</SPOUSEDOB>
                        <ADDR1>1 Main St</ADDR1>
                        <CITY>Melrose</CITY>
                        <STATE>NY</STATE>
                        <POSTALCODE>12121</POSTALCODE>
                    </RECIPIENTINFO>
                    <POLICYSTARTDATE>20200101</POLICYSTARTDATE>
                    <POLICYTERMINATIONDATE>20201231</POLICYTERMINATIONDATE>
                    <COVERAGEHOUSEHOLD>
                        <COVEREDINDIVNAME>Kris Q. Public</COVEREDINDIVNAME>
                        <COVEREDINDIVSSN>xxx-xx-1234</COVEREDINDIVSSN>
                        <COVEREDINDIVBIRTHDT>19950606</COVEREDINDIVBIRTHDT>
                        <COVEREDINDIVSTARTDT>20200101</COVEREDINDIVSTARTDT>
                        <COVEREDINDIVENDDT>20201231</COVEREDINDIVENDDT>
                    </COVERAGEHOUSEHOLD>
                    <COVERAGEHOUSEHOLD>
                        <COVEREDINDIVNAME>Tracy R. Public</COVEREDINDIVNAME>
                        <COVEREDINDIVSSN>xxx-xxx-4321</COVEREDINDIVSSN>
                        <COVEREDINDIVBIRTHDT>19950909</COVEREDINDIVBIRTHDT>
                        <COVEREDINDIVSTARTDT>20200101</COVEREDINDIVSTARTDT>
                        <COVEREDINDIVENDDT>20201231</COVEREDINDIVENDDT>
                    </COVERAGEHOUSEHOLD>
                    <HOUSEHOLDINFO>
                        <MONTHCD>JAN</MONTHCD>
                        <MONTHLYPLANPREMIUMAMT>21.14</MONTHLYPLANPREMIUMAMT>
                        <MONTHLYPREMIUMSLCSPAMT>21.14</MONTHLYPREMIUMSLCSPAMT>
                        <MONTHLYADVANCEPTCAMT>21.14</MONTHLYADVANCEPTCAMT>
                    </HOUSEHOLDINFO>
                    <HOUSEHOLDINFO>
                        <MONTHCD>FEB</MONTHCD>
                        <MONTHLYPLANPREMIUMAMT>22.14</MONTHLYPLANPREMIUMAMT>
                        <MONTHLYPREMIUMSLCSPAMT>22.14</MONTHLYPREMIUMSLCSPAMT>
                        <MONTHLYADVANCEPTCAMT>22.14</MONTHLYADVANCEPTCAMT>
                    </HOUSEHOLDINFO>
                    <HOUSEHOLDINFO>
                        <MONTHCD>MAR</MONTHCD>
                        <MONTHLYPLANPREMIUMAMT>23.14</MONTHLYPLANPREMIUMAMT>
                        <MONTHLYPREMIUMSLCSPAMT>23.14</MONTHLYPREMIUMSLCSPAMT>
                        <MONTHLYADVANCEPTCAMT>23.14</MONTHLYADVANCEPTCAMT>
                    </HOUSEHOLDINFO>
                    <HOUSEHOLDINFO>
                        <MONTHCD>APR</MONTHCD>
                        <MONTHLYPLANPREMIUMAMT>24.14</MONTHLYPLANPREMIUMAMT>
                        <MONTHLYPREMIUMSLCSPAMT>24.14</MONTHLYPREMIUMSLCSPAMT>
                        <MONTHLYADVANCEPTCAMT>24.14</MONTHLYADVANCEPTCAMT>
                    </HOUSEHOLDINFO>
                    <HOUSEHOLDINFO>
                        <MONTHCD>MAY</MONTHCD>
                        <MONTHLYPLANPREMIUMAMT>25.14</MONTHLYPLANPREMIUMAMT>
                        <MONTHLYPREMIUMSLCSPAMT>25.14</MONTHLYPREMIUMSLCSPAMT>
                        <MONTHLYADVANCEPTCAMT>25.14</MONTHLYADVANCEPTCAMT>
                    </HOUSEHOLDINFO>
                    <HOUSEHOLDINFO>
                        <MONTHCD>JUN</MONTHCD>
                        <MONTHLYPLANPREMIUMAMT>26.14</MONTHLYPLANPREMIUMAMT>
                        <MONTHLYPREMIUMSLCSPAMT>26.14</MONTHLYPREMIUMSLCSPAMT>
                        <MONTHLYADVANCEPTCAMT>26.14</MONTHLYADVANCEPTCAMT>
                    </HOUSEHOLDINFO>
                    <HOUSEHOLDINFO>
                        <MONTHCD>JUL</MONTHCD>
                        <MONTHLYPLANPREMIUMAMT>27.14</MONTHLYPLANPREMIUMAMT>
                        <MONTHLYPREMIUMSLCSPAMT>27.14</MONTHLYPREMIUMSLCSPAMT>
                        <MONTHLYADVANCEPTCAMT>27.14</MONTHLYADVANCEPTCAMT>
                    </HOUSEHOLDINFO>
                    <HOUSEHOLDINFO>
                        <MONTHCD>AUG</MONTHCD>
                        <MONTHLYPLANPREMIUMAMT>28.14</MONTHLYPLANPREMIUMAMT>
                        <MONTHLYPREMIUMSLCSPAMT>28.14</MONTHLYPREMIUMSLCSPAMT>
                        <MONTHLYADVANCEPTCAMT>28.14</MONTHLYADVANCEPTCAMT>
                    </HOUSEHOLDINFO>
                    <HOUSEHOLDINFO>
                        <MONTHCD>SEP</MONTHCD>
                        <MONTHLYPLANPREMIUMAMT>29.14</MONTHLYPLANPREMIUMAMT>
                        <MONTHLYPREMIUMSLCSPAMT>29.14</MONTHLYPREMIUMSLCSPAMT>
                        <MONTHLYADVANCEPTCAMT>29.14</MONTHLYADVANCEPTCAMT>
                    </HOUSEHOLDINFO>
                    <HOUSEHOLDINFO>
                        <MONTHCD>OCT</MONTHCD>
                        <MONTHLYPLANPREMIUMAMT>30.14</MONTHLYPLANPREMIUMAMT>
                        <MONTHLYPREMIUMSLCSPAMT>30.14</MONTHLYPREMIUMSLCSPAMT>
                        <MONTHLYADVANCEPTCAMT>30.14</MONTHLYADVANCEPTCAMT>
                    </HOUSEHOLDINFO>
                    <HOUSEHOLDINFO>
                        <MONTHCD>NOV</MONTHCD>
                        <MONTHLYPLANPREMIUMAMT>31.14</MONTHLYPLANPREMIUMAMT>
                        <MONTHLYPREMIUMSLCSPAMT>31.14</MONTHLYPREMIUMSLCSPAMT>
                        <MONTHLYADVANCEPTCAMT>31.14</MONTHLYADVANCEPTCAMT>
                    </HOUSEHOLDINFO>
                    <HOUSEHOLDINFO>
                        <MONTHCD>DEC</MONTHCD>
                        <MONTHLYPLANPREMIUMAMT>32.14</MONTHLYPLANPREMIUMAMT>
                        <MONTHLYPREMIUMSLCSPAMT>32.14</MONTHLYPREMIUMSLCSPAMT>
                        <MONTHLYADVANCEPTCAMT>32.14</MONTHLYADVANCEPTCAMT>
                    </HOUSEHOLDINFO>
                    <TOTALPLANPREMIUMAMT>319.68</TOTALPLANPREMIUMAMT>
                    <TOTALPREMIUMSLCSPAMT>319.68</TOTALPREMIUMSLCSPAMT>
                    <TOTALADVANCEPTCAMT>319.68</TOTALADVANCEPTCAMT>
                </TAX1095A_V100>
            </TAX1095RS>
        </TAX1095TRNRS>
    </TAX1095MSGSRSV1>
</OFX>

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