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
4employerNameAddressPhoneNameAddressPhoneBoxes 7, 9-13, Employer name, address and phone (deprecated for rename to employerNameAddress, removing in FDX v5.0)
5employerNameAddressNameAddressPhoneBoxes 7, 9-13, Employer name, address and phone
6employerIdstringBox 8, Employer identification number (EIN) (deprecated for rename to employerTin, removing in FDX v5.0)
7employerTinstringBox 8, Employer identification number (EIN)
8selfInsuredCoveragebooleanSelf Insured Coverage
9offersOfCoverageArray of OfferOfHealthInsuranceCoverageBoxes 14-16, Employee Offer of Coverage
10employeeAgeintegerEmployee's Age on January 1
11planStartMonthintegerPlan Start Month
12coveredIndividualsArray 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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