1095-B : Health Coverage

 

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:

 

OFX / Types / Tax1095B_V100
#TagType
1 SRVRTID ServerIdType
2 TAXYEAR YearType
3 VOID BooleanType
4 CORRECTED BooleanType
5 RESPONSIBLEINDIV anonymous complex type
6 ORIGINOFPOLICYCD anonymous simple type
7 SHOPIDENTIFIER GenericNameType
8 EMPLOYERSPONSORED Employer
9 ISSUERORPROVIDER Employer
10 CONTACTPERSONPHONE PhoneType
11 COVEREDINDIVIDUAL CoveredIndivGrpType
Usages:

 

FIRE

This form is not reported in the IRS FIRE system.

TXF

The TXF standard does not support this form.

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