Tax Documents

 

Tax1095B

 

FDX Data Structure as JSON
{
  "tax1095B" : {
    "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"
    },
    "responsibleName" : {
      "first" : "string",
      "middle" : "string",
      "last" : "string",
      "suffix" : "string"
    },
    "responsibleTin" : "string",
    "responsibleDateOfBirth" : "2020-07-01",
    "responsibleAddress" : {
      "line1" : "String64",
      "line2" : "String64",
      "line3" : "String64",
      "city" : "String64",
      "state" : "String64",
      "postalCode" : "string",
      "country" : "AD"
    },
    "originOfHealthCoverageCode" : "string",
    "employerNameAddress" : {
      "line1" : "String64",
      "line2" : "String64",
      "line3" : "String64",
      "city" : "String64",
      "state" : "String64",
      "postalCode" : "string",
      "country" : "AD",
      "name1" : "String64",
      "name2" : "String64"
    },
    "employerId" : "string",
    "employerTin" : "string",
    "issuerNameAddressPhone" : {
      "line1" : "String64",
      "line2" : "String64",
      "line3" : "String64",
      "city" : "String64",
      "state" : "String64",
      "postalCode" : "string",
      "country" : "AD",
      "name1" : "String64",
      "name2" : "String64",
      "phone" : {
        "type" : "HOME",
        "country" : "string",
        "number" : "string",
        "extension" : "string"
      }
    },
    "issuerNameAddress" : {
      "line1" : "String64",
      "line2" : "String64",
      "line3" : "String64",
      "city" : "String64",
      "state" : "String64",
      "postalCode" : "string",
      "country" : "AD",
      "name1" : "String64",
      "name2" : "String64",
      "phone" : {
        "type" : "HOME",
        "country" : "string",
        "number" : "string",
        "extension" : "string"
      }
    },
    "issuerId" : "string",
    "issuerTin" : "string",
    "coveredIndividuals" : [ {
      "name" : {
        "first" : "string",
        "middle" : "string",
        "last" : "string",
        "suffix" : "string"
      },
      "tin" : "string",
      "dateOfBirth" : "2020-07-01",
      "coveredAt12Months" : true,
      "coveredMonths" : [ "JAN" ]
    } ]
  }
}
FDX / Data Structures / Tax1095B
Form 1095-B, Health Coverage
Extends and inherits all fields from Tax  
Tax1095B Properties
#IdTypeDescription
1responsibleNameIndividualNameBox 1, Name of responsible individual
2responsibleTinstringBox 2, Social security number (SSN or other TIN)
3responsibleDateOfBirthDateStringBox 3, Date of birth (if SSN or other TIN is not available)
4responsibleAddressAddressBoxes 4-7, Address of responsible individual
5originOfHealthCoverageCodestringBox 8, Enter letter identifying Origin of the Health Coverage
6employerNameAddressNameAddressBoxes 10, 12-15, Employer name and address
7employerIdstringBox 11, Employer identification number (EIN) (deprecated for rename to employerTin, removing in FDX v5.0)
8employerTinstringBox 11, Employer identification number (EIN)
9issuerNameAddressPhoneNameAddressPhoneBoxes 16, 18-22, Issuer name, address, and phone (deprecated for rename to issuerNameAddress, removing in FDX v5.0)
10issuerNameAddressNameAddressPhoneBoxes 16, 18-22, Issuer name, address, and phone
11issuerIdstringBox 17, Employer identification number (EIN) (deprecated for rename to issuerTin, removing in FDX v5.0)
12issuerTinstringBox 17, Employer identification number (EIN)
13coveredIndividualsArray of HealthInsuranceCoveredIndividualBoxes 23+, Covered Individuals
Tax1095B Usage:
Example Form JSON
{
  "tax1095B" : {
    "taxYear" : 2020,
    "taxFormId" : "e5d4ee73bd1-9295-480f-a426-1095-B",
    "taxFormDate" : "2021-02-01",
    "taxFormType" : "Tax1095B",
    "responsibleName" : {
      "first" : "Kris",
      "middle" : "Q",
      "last" : "Public"
    },
    "responsibleTin" : "xxx-xx-1234",
    "responsibleDateOfBirth" : "1995-03-03",
    "responsibleAddress" : {
      "line1" : "1 Main St",
      "city" : "Melrose",
      "state" : "NY",
      "postalCode" : "12121",
      "country" : "US"
    },
    "originOfHealthCoverageCode" : "B",
    "employerNameAddress" : {
      "line1" : "12020 Sunrise Valley Dr",
      "line2" : "Suite 230",
      "city" : "Reston",
      "state" : "VA",
      "postalCode" : "20191",
      "country" : "US",
      "name1" : "Financial Data Exchange"
    },
    "employerTin" : "12-3456789",
    "issuerNameAddress" : {
      "line1" : "1718-1/2 Oak Blvd",
      "city" : "Austin",
      "state" : "TX",
      "postalCode" : "78735",
      "country" : "US",
      "name1" : "American People Health",
      "phone" : {
        "number" : "8885551212"
      }
    },
    "issuerTin" : "99-0011223",
    "coveredIndividuals" : [ {
      "name" : {
        "first" : "Kris",
        "middle" : "Q",
        "last" : "Public"
      },
      "tin" : "xxx-xx-1234",
      "dateOfBirth" : "1995-03-13",
      "coveredAt12Months" : true,
      "coveredMonths" : [ "JAN", "FEB", "MAR", "APR", "MAY", "JUN", "JUL", "AUG", "SEP", "OCT", "NOV", "DEC" ]
    }, {
      "name" : {
        "first" : "Tracy",
        "middle" : "R",
        "last" : "Public"
      },
      "tin" : "xxx-xx-4321",
      "dateOfBirth" : "1995-04-13",
      "coveredAt12Months" : true,
      "coveredMonths" : [ "JAN", "FEB", "MAR", "APR", "MAY", "JUN", "JUL", "AUG", "SEP", "OCT", "NOV", "DEC" ]
    } ]
  }
}
Example Form JSON as QR Code

 

 

© Copyright 2020. All Rights Reserved.