1095-C : Employer-Provided Health Insurance Offer and Coverage

 

FDX / Data Structures / Tax1095C
Form 1095-C, Employer-Provided Health Insurance Offer and Coverage
Extends and inherits all fields from Tax  
Tax1095C Properties
#IdTypeDescription
1employeeNameIndividualNameBox 1, Employee name
2tinstringBox 2, Social security number (SSN)
3employeeAddressAddressBoxes 3-6, Employee address
4employerNameAddressNameAddressPhoneBoxes 7, 9-13, Employer name, address and phone
5employerTinstringBox 8, Employer identification number (EIN)
6selfInsuredCoveragebooleanSelf Insured Coverage
7offersOfCoverageArray of OfferOfHealthInsuranceCoverageBoxes 14-16, Employee Offer of Coverage
8employeeAgeintegerEmployee's Age on January 1
9planStartMonthintegerPlan Start Month
10coveredIndividualsArray of HealthInsuranceCoveredIndividualBoxes 17+, Covered Individuals
Tax1095C Usage:

 

OFX / Types / Tax1095C_V100
#TagType
1 SRVRTID ServerIdType
2 TAXYEAR YearType
3 VOID BooleanType
4 CORRECTED BooleanType
5 ALECONTACTPHONE PhoneType
6 EMPLOYER Employer
7 EMPLOYEEINFO EmployeeInfo
8 EMPLOYEEAGE AgeType
9 PLANSTARTMONTH anonymous simple type
10 ANNUALCOVERAGE anonymous complex type
11 MONTHLYCOVERAGE PartIIGrpType
12 SELFINSURED BooleanType
13 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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