Part 2. Information Technology
Chapter 3. IDRS Terminal Responses
Section 86. Command Code IRPOL
2.3.86 Command Code IRPOL
Manual Transmittal
February 15, 2024
Purpose
(1) This transmits revised IRM 2.3.86, Information Returns Processing Online (IRPOL) Command Code allows IDRS users to search, access, and display Affordable Care Act (ACA)forms - from insurance companies, employers, and ACA marketplaces - filed to the IRS in accord to the Patient Protection and Affordable Care Act (ACA) of 2010.
Material Changes
(1) Update of Internal Controls in 2.3.35.1 section of the IRM.
(2) Exhibit 2.3.86-1 - Document Code Availability Tax Year increased.
(3) Summary: Changes were made for TY2023. All Tax years reference TY2023 - TY2014 unless otherwise listed.
Effect on Other Documents
IRM 2.3.86 dated December 27, 2021, is superseded.
Audience
IDRS USERS, SB/SE.
Effective Date
(02-15-2024)
Rajiv Uppal
Chief Information Officer
Program Scope and Objectives
(1) Command Code (CC) Information Returns Processing Online (IRPOL) allows Integrated Data Retrieval System (IDRS) users to request on-line information from the Information Returns Database (IRDB).
(2) Audience: These procedures apply to IRS employees who use IDRS system to research information using PAYEE TIN, PAYEE TIN TYPE, PAYER TIN, TAX YEAR and DOCUMENT CODES.
(3) Policy Owner: Wage and Investment (W&I) Customer Account Services (SE:W:CAS).
(4) Program Owner: Information Returns Master File (IRMF) is a Non-major, high impact planned maintenance project that is part of the Information Returns Processing (IRP) Program. IRMF is categorized as a steady state legacy system that incorporates annual programming changes and legislative changes to maintain functionality.
(5) Primary Stakeholders: Stakeholders Impacted by system/application are Wage and Investment (W&I), Small Business/Self-Employed (SBSE),Tax Exempt & Government Entities (TE/GE), Large Business and International (LB&I) Division.
(6) Program Goals: This IRM provides the fundamental knowledge and procedural guidance for employees to search various Information Returns Documents by PAYEE TIN, PAYEE TIN TYPE, PAYER TIN, TAX YEAR and DOCUMENT CODES.
Background
(1) Information Returns Processing Online (IRPOL) allow tax examiners to research tax payers information to confirm data validity provided to the IRS.
Authority
(1) Command CODE IRPOL was developed to allow users to do research on the IDRS (Integrated Data Retrieval System) for Entity data.
Responsibilities
(1) The team manager is responsible for ensuring the program developer receive requirements from stakeholders for annual changes.
(2) The programmer is responsible for all changes and updates that are made based on requirements from internal and external stakeholders.
Program Management and Review
(1) The Program is managed utilizing IRMF Exam Transcripts processing to produce and sort transcript tapes for examination. These tapes will contain taxpayer IRP data which was extracted from IRMF. A Tickler is created for each taxpayer for whom IRP data was extracted from the IRMF. A Standard Transcript Summary report is created with the requested data.
Program Controls
(1) IDRS user access code and permissions required to access IRPOL information.
Terms/Acronyms/Definition
(1) Acronyms
Acronym | Definition |
ACA | Affordable Care Act |
CC | Command Code |
DOB | Date Of Birth |
IDRS | Integrated Data Retrieval System |
IRM | Internal Revenue Manual |
LB&I | Large Business and International |
IRDB | Information Returns Database |
IRPOL | Information Returns Processing Online |
TE/GE | Tax Exempt and Government Entities |
SB/SE | Small Business Self-Employed |
W&I | Wage & Investment |
TIN | Taxpayer Identification Number |
TY | Tax Year |
Important Dates For Command Code IRPOL
(1) TY2023 data should be accessible online on Monday, January 2, 2024.
Command Code IRPOL Valid Tax Years
(1) Tax years (TY2014, TY2015, TY2016, TY2017, TY2018, TY2019, TY2020, TY2021, TY2022, or TY2023) can be referenced in IRPOL currently.
IRPOL Help Screen
(1) The figure and table below show the validated fields for the IRPOL Help screen
TIN | Entry must be 9 numeric and unedited (no hyphens) for either an SSN or an EIN. TIN cannot be 000000000 or 999999999. |
TIN TYPE and VALIDITY | Entry must be 0, 1, or 3 to respectively specify Valid SSN, Invalid SSN, or EIN extraction of Information Return Documents for the TIN. |
TAX YEAR | Entry must be a valid Tax Year that is available on the Command Code IRPOL Valid Tax Years, IRM 2.3.86.3 for valid Tax Years. |
DOC CODE | Entry must be any DOC CODE specified by Exhibit 2.3.86-1. |
Document Code Availability by Tax Year
(1) Valid Document Codes and available tax years are listed in the table below.
DOCUMENT FORM | DOC CODE | TY2014 | TY2015 | TY2016 | TY2017 | TY2018 | TY2019 | TY2020 | TY2021 | TY2022 | TY2023 |
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1094-B | 11 | X | X | X | X | X | X | X | X | X | X |
1094-C | 12 | X | X | X | X | X | X | X | X | X | X |
1095-A | 07 | X | X | X | X | X | X | X | X | X | X |
1095-B | 56 | X | X | X | X | X | X | X | X | X | X |
1095-C | 60 | X | X | X | X | X | X | X | X | X | X |
IRPOLB DOB Search Screen
(1) IRPOLB search uses the first and last name, form type, tax year, DOB, state, or zip-code to search for ACA Forms 1095-A, 1095-B, and 1095C. When matching data is found the OVERVIEW Screen will appear.
(2) After IRPOLB parameters are entered, the results of the search returns an OVERVIEW screen and a valid IRPOLA command line is displayed. The IRPOLA command line may contain a ‘00’ in the document code position. The ‘00’ must be changed to a valid document code of 07,11,12,56, or 60. To retrieve the form enter the UNIQUE-ID.
LINE | POSITION | DESCRIPTION AND VALIDITY |
1.1 | 1 | COMMAND CD |
1.2 | 6 | COMMAND DEFINER CD- “B”. |
2.1 | 16 | Literal Title “ACA IR 1095A, 1095B, 1095C DOCUMENTS SEARCH” |
4.1 | 13 | Literal -REQUIRED FIELDS: LAST NAME, FORM TYPE, TAX YEAR AND |
5.1 | 8 | Literal-ONE OR MORE OPTIONAL FIELDS: DOB, STATE, ZIP CODE, FIRST NAME |
8.1 | 21 | Literal-LAST NAME |
10.1 | 21 | Literal-FIRST NAME |
12.1 | 21 | Literal-FORM TYPE |
14.1 | 21 | Literal-TAX YEAR |
16.1 | 21 | Literal-DOB |
18.1 | 21 | Literal-STATE |
20.1 | 21 | Literal-ZIP CODE |
IRPOL Overview Screen
LINE | POSITION | DESCRIPTION AND VALIDITY | PAPER FORM REFERENCE |
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1.1 | 1 | COMMAND CD |
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1.2 | 6 | COMMAND DEFINER CD- “A”NOTE: Errors are treated as if you had entered the default. |
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1.3 | 7 | REQUEST TIN - This Field recapitulates the requested TIN you entered |
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1.4 | 16 | VALIDITY CODE- This Field recapitulates the VALIDITY CODE you entered. |
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1.5 | 17 | TAX YEAR - Requested Tax Year, See IRM 2.3.86-1 for valid Tax Years. |
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1.6 | 21 | DOCUMENT CODE (00) “00” retrieves all documents |
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1.7 | 27 | Literal- UNIQUE-ID=> |
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1.8 | 38 | nnnnnnnnnnnn Enter the UNIQUE-ID and ensure the DOCUMENT CODE is not ‘00’ |
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2.1 | 24 | TAX YEAR See IRM 2.3.86-1 |
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2.2 | 62 | TIN (Requested TIN) |
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4.1 | 28 | TOTAL OF ALL DOCUMENTS |
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7.1 8.1 9.1 | 2 | DOCUMENT CODE |
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7.2 8.2 9.2 | 5 | FORM Form Type |
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7.3 8.3 9.3 | 11 | UNIQUE-ID |
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7.4 8.4 9.4 | 33 | ALE |
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7.5 8.5 9.5 | 35 | NAME FROM PART 1 OF FORM |
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7.6 8.6 9.6 | 66 | DATE On-File-date |
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7.7 8.7 9.7 | 74 | INFORMATION STATUS INDICATORVALUES |
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7.8 8.8 9.8 | 78 | DATA RECONCILIATION CODE | See Table Below |
DATA RECONCILIATION CODES | ||
Aggregated Group Indicator | ||
Rule | Description | Interpretation of Data |
A01 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as Yes and Aggregated Group Indicator has been marked for both monthly fields and "All 12 Months" and Other Members of Aggregated Group member list contains at least one entry, then consider Aggregated Group Indicator marked for "All 12 Months". | Consider Aggregated Group Indicator "All 12 Months" field marked |
A02 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as Yes and Aggregated Group Indicator has been unmarked for all fields and Other Members of Aggregated Group member list contains at least one entry, then consider Aggregated Group Indicator marked for "All 12 Months". | Consider Aggregated Group Indicator "All 12 Months" field marked |
A03 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as both Yes and No and Aggregated Group Indicator has been marked only for "All 12 Months" and Other Members of Aggregated Group member list contains at least one entry, then consider Aggregated ALE Group membership as Yes with Aggregated Group Indicator marked for "All 12 Months". | Consider Member of Aggregated ALE Group is marked as Yes with Aggregated Group Indicator "All 12 Months" marked |
A04 A05 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as both Yes and No and Aggregated Group Indicator has been marked for both monthly fields and "All 12 Months" and Other Members of Aggregated Group member list contains at least one entry, then consider Aggregated ALE Group membership as Yes with Aggregated Group Indicator marked for "All 12 Months". | Consider Member of Aggregated ALE Group is marked as Yes with Aggregated Group Indicator "All 12 Months" marked |
A06 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as both Yes and No and Aggregated Group Indicator has been marked for only monthly fields and Other Members of Aggregated Group member list contains at least one entry, then consider Aggregated ALE Group membership as Yes with Aggregated Group Indicator marked monthly. | Consider Member of Aggregated ALE Group is marked as Yes with Aggregated Group Indicator monthly fields marked |
A07 A37 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as both Yes and No and Aggregated Group Indicator has been unmarked for all fields and Other Members of Aggregated Group member list contains at least one entry, then consider Aggregated ALE Group membership as Yes with Aggregated Group Indicator marked for "All 12 Months". | Consider Member of Aggregated ALE Group is marked as Yes with Aggregated Group Indicator "All 12 Months" marked |
A08 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as both Yes and No and Aggregated Group Indicator has been marked only for "All 12 Months" and Other Members of Aggregated Group member list is empty, then consider Aggregated ALE Group membership as No. | Consider Member of Aggregated ALE Group is marked as No |
A09 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as both Yes and No and Aggregated Group Indicator has been marked for both monthly fields and "All 12 Months" and Other Members of Aggregated Group member list is empty, then consider Aggregated ALE Group membership as No. | Consider Member of Aggregated ALE Group is marked as No |
A10 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as both Yes and No and Aggregated Group Indicator has been marked only for monthly fields and Other Members of Aggregated Group member list is empty, then consider Aggregated ALE Group membership as No. | Consider Member of Aggregated ALE Group is marked as No |
A11 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as both Yes and No and Aggregated Group Indicator has been unmarked for all fields and Other Members of Aggregated Group member list is empty, then consider Aggregated ALE Group membership as No. | Consider Member of Aggregated ALE Group is marked as No |
A12 A13 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as No and Aggregated Group Indicator has been marked for both monthly field and "All 12 Months" and Other Members of Aggregated Group member list contains at least one entry, then consider Aggregated ALE Group membership as Yes with Aggregated Group Indicator marked for "All 12 Months". | Consider Member of Aggregated ALE Group is marked as Yes with Aggregated Group Indicator "All 12 Months" marked |
A14 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as No and Aggregated Group Indicator has been marked only for "All 12 Months" and Other Members of Aggregated Group member list contains at least one entry, then consider Aggregated ALE Group membership as Yes with Aggregated Group Indicator marked for "All 12 Months". | Consider Member of Aggregated ALE Group is marked as Yes with Aggregated Group Indicator "All 12 Months" marked |
A15 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as No and Aggregated Group Indicator has been marked only for monthly fields and Other Members of Aggregated Group member list contains at least one entry, then consider Aggregated ALE Group membership as Yes with Aggregated Group Indicator marked monthly. | Consider Member of Aggregated ALE Group is marked as Yes with Aggregated Group Indicator monthly fields marked |
A16 A17 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as No and Aggregated Group Indicator has been unmarked for all fields and Other Members of Aggregated Group member list contains at least one entry, then consider Aggregated ALE Group membership as Yes with Aggregated Group Indicator marked for "All 12 Months". | Consider Member of Aggregated ALE Group is marked as Yes with Aggregated Group Indicator "All 12 Months" marked |
A18 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as No and Aggregated Group Indicator has been marked only for "All 12 Months" and Other Members of Aggregated Group member list is empty, then consider Aggregated ALE Group membership as No. | Consider Member of Aggregated ALE Group is marked as No |
A19 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as No and Aggregated Group Indicator has been marked for both monthly fields and "All 12 Months" and Other Members of Aggregated Group member list is empty, then consider Aggregated ALE Group membership as No. | Consider Member of Aggregated ALE Group is marked as No |
A20 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as No and Aggregated Group Indicator has been marked only for monthly fields and Other Members of Aggregated Group member list is empty, then consider Aggregated ALE Group membership as No. | Consider Member of Aggregated ALE Group is marked as No |
A21 A22 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is unmarked and Aggregated Group Indicator has been marked for both monthly field and "All 12 Months" and Other Members of Aggregated Group member list contains at least one entry, then consider Aggregated ALE Group membership as Yes with Aggregated Group Indicator marked for "All 12 Months". | Consider Member of Aggregated ALE Group is marked as Yes with Aggregated Group Indicator "All 12 Months" marked |
A23 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is unmarked and Aggregated Group Indicator has been marked only for "All 12 Months" and Other Members of Aggregated Group member list contains at least one entry, then consider Aggregated ALE Group membership as Yes with Aggregated Group Indicator marked for "All 12 Months". | Consider Member of Aggregated ALE Group is marked as Yes with Aggregated Group Indicator "All 12 Months" marked |
A24 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is unmarked and Aggregated Group Indicator has been marked only for monthly fields and Other Members of Aggregated Group member list contains at least one entry, then consider Aggregated ALE Group membership as Yes with Aggregated Group Indicator marked monthly. | Consider Member of Aggregated ALE Group is marked as Yes with Aggregated Group Indicator monthly fields marked |
A25 A26 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is unmarked and Aggregated Group Indicator has been unmarked for all fields and Other Members of Aggregated Group member list contains at least one entry, then consider Aggregated ALE Group membership as Yes with Aggregated Group Indicator marked for "All 12 Months". | Consider Member of Aggregated ALE Group is marked as Yes with Aggregated Group Indicator "All 12 Months" marked |
A27 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is unmarked and Aggregated Group Indicator has been marked only for "All 12 Months" and Other Members of Aggregated Group member list is empty, then consider Aggregated ALE Group membership as No. | Consider Member of Aggregated ALE Group is marked as No |
A28 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is unmarked and Aggregated Group Indicator has been marked for both monthly fields and "All 12 Months" and Other Members of Aggregated Group member list is empty, then consider Aggregated ALE Group membership as No. | Consider Member of Aggregated ALE Group is marked as No |
A29 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is unmarked and Aggregated Group Indicator has been marked only for monthly fields and Other Members of Aggregated Group member list is empty, then consider Aggregated ALE Group membership as No. | Consider Member of Aggregated ALE Group is marked as No |
A30 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is unmarked and Aggregated Group Indicator has been unmarked for all fields and Other Members of Aggregated Group member list is empty, then consider Aggregated ALE Group membership as No. | Consider Member of Aggregated ALE Group is marked as No |
A31 | When Aggregated ALE Group membership is marked as Yes and Aggregated Group Indicator has been marked only for "All 12 Months" and Other Members of Aggregated Group member list has no entries, then consider Aggregated Group Indicator marked for "All 12 Months" and consider as Other ALE Members have 30 membersMonths" and Other Members of Aggregated Group member list has no entries, then consider Aggregated Group Indicator marked for "All 12 Months" and consider as Other ALE Members have 30 members. | Consider Aggregated Group Indicator "All 12 Months" marked and consider 30 members in metadata |
A32 A33 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as Yes and Aggregated Group Indicator has been marked for both monthly fields and "All 12 Months" and Other Members of Aggregated Group member list has no entries, then consider Aggregated Group Indicator marked for "All 12 Months" and consider as Other ALE Members have 30 members | Consider Aggregated Group Indicator "All 12 Months" marked and consider 30 members in metadata |
A34 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as Yes and Aggregated Group Indicator has been marked only for monthly fields and Other Members of Aggregated Group member list has no entries, then consider Aggregated Group Indicator marked monthly and consider as Other ALE Members have 30 members. | Consider Aggregated Group Indicator months marked and consider 30 members in metadata |
A35 A36 | When evaluating for data consistency of the 1094C form, when Aggregated ALE Group membership is marked as Yes and Aggregated Group Indicator has been unmarked for all monthly fields and "All 12 Months" and Other Members of Aggregated Group member list has no entries, then consider Aggregated Group Indicator marked for "All 12 Months" and consider as Other ALE Members have 30 members. | Consider Aggregated Group Indicator "All 12 Months" marked and leave unmarked for all monthly fields and consider 30 members in metadata |
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Minimum Essential Coverage (MEC) offer indicator | ||
Rule | Description | Interpretation of Data |
B01 | When evaluating for data consistency of the 1094C form, when Minimal Essential Coverage Offer Indicator (MEC) value for "All 12 Months" has been marked as either Yes or No and all monthly rows have been marked as either Yes or No, then consider all monthly MEC indicator rows. | Consider monthly MEC offer indicator |
B02 | When evaluating for data consistency of the 1094C form, when Minimal Essential Coverage Offer Indicator (MEC) value for "All 12 Months" has been unmarked and all monthly rows have been unmarked, then consider all monthly rows with MEC not offered and all values marked as No. | Consider all derived MEC monthly values as No |
B03 | When evaluating for data consistency of the 1094C form, when Minimal Essential Coverage Offer Indicator (MEC) value for "All 12 Months" has been marked as both Yes and No and all monthly rows have been marked as either Yes or No, then consider all monthly MEC indicator rows. | Consider monthly MEC offer indicator |
B04 | When evaluating for data consistency of the 1094C form, when Minimal Essential Coverage Offer Indicator (MEC) value for "All 12 Months" has been as both Yes and No and all monthly rows have been unmarked, then consider all monthly rows with MEC not offered and all values marked as No. | Consider MEC not offered yearly with value marked as No |
B05 B06 | When evaluating for data consistency of the 1094C form, when Minimal Essential Coverage Offer Indicator (MEC) value for "All 12 Months" has been marked as either Yes or No and some monthly rows have been marked as either Yes or No and other rows have been either left unmarked or marked as both Yes and No, then consider MEC offered by month with original values and for fields that were marked Yes and No simultaneously or left blank consider them marked as No. | Consider MEC offered by month with original values and for fields that were marked Yes and No simultaneously or left blank consider them marked as No |
B06 | When evaluating for data consistency of the 1094C form, when Minimal Essential Coverage Offer Indicator (MEC) value for "All 12 Months" has been unmarked and some monthly rows have been marked as either Yes or No and other rows have been either left unmarked or marked as both Yes and No, then consider MEC offered by month with original values and for fields that were marked Yes and No simultaneously or left blank consider them marked as No. | Consider MEC offered by month with original values and for fields that were marked Yes and No simultaneously or left blank consider them marked as No |
B07 B08 | When evaluating for data consistency of the 1094C form, when Minimal Essential Coverage Offer Indicator (MEC) value for "All 12 Months" has been marked as both Yes and No and some monthly rows have been marked as either Yes or No and other rows have been either left unmarked or marked as both Yes and No, then consider MEC offered by month with original values and for fields that were marked Yes and No simultaneously or left blank consider them marked as No. | Consider MEC offered by month with original values and for fields that were marked Yes and No simultaneously or left blank consider them marked as No |
B09 B10 | When evaluating for data consistency of the 1094C form, when Minimal Essential Coverage Offer Indicator (MEC) value for "All 12 Months" has been marked as either Yes or No and all monthly rows have been either unmarked or marked as both Yes and No, then consider all monthly rows with MEC not offered and all values marked as No. | Consider MEC offered by month with all values marked No |
B11 | When evaluating for data consistency of the 1094C form, when Minimal Essential Coverage Offer Indicator (MEC) value for "All 12 Months" has been unmarked and all monthly rows have been either unmarked or marked as both Yes and No, then consider all monthly rows with MEC not offered and all values marked as No. | Consider MEC offered by month with all values marked No |
B12 B13 | When evaluating for data consistency of the 1094C form, when Minimal Essential Coverage Offer Indicator (MEC) value for "All 12 Months" has been marked as both Yes and No and all monthly rows have been either unmarked or marked as both Yes and No, then consider all monthly rows with MEC not offered and all values marked as No. | Consider MEC offered by month with all values marked No |
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FTE - Part III column (b), Form 1094-C | ||
Rule | Description | Interpretation of Data |
C01 | When evaluating for data consistency of the 1094C form, when Full Time Employee (FTE) Count has a value zero or greater than zero for "All 12 Months" and all monthly rows have values greater than zero, then consider monthly values. | Consider FTE count by month and use monthly value. |
C02 | When evaluating for data consistency of the 1094C form, when Full Time Employee (FTE) Count has a value greater than zero for "All 12 Months" and all monthly rows have value zero, then consider FTE count of All 12 months value | Consider FTE count of All 12 months and replace all monthly rows with value zero to blank. |
C03 | When evaluating for data consistency of the 1094C form, when Full Time Employee (FTE) Count has a value greater than zero for "All 12 Months" and some monthly rows have value zero and the rest have blank, then consider FTE count of All 12 months value | Consider FTE count of All 12 months and replace all monthly rows with value zero to blank. |
C04 C05 | When evaluating for data consistency of the 1094C form, when Full Time Employee (FTE) Count has a value zero or greater than zero or blank for "All 12 Months" and some but not all monthly rows have values greater than zero, then consider monthly values as marked and consider highest monthly value for all empty monthly fields. | Consider highest monthly value to mark empty FTE fields and consider FTE count by month |
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FTE per Number of Total 1095-Cs filed (Line 20) on 1094-C | ||
Rule | Description | Interpretation of Data |
D01 D02 | When evaluating for data consistency of the 1094C form, if Box D on line 22 is not checked and Full Time Employee (FTE) Count has a value zero or blank for "All 12 Months" and all monthly rows have either zero or blank , then all monthly values will use the greater than zero value contained in Total Number of Forms 1095C filed by ALE Member. | Consider Total Number of Form 1095C filed by and/or on behalf of ALE Member count to update all monthly values and consider FTE count by month |
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FTE per Total number of 1095-Cs recorded in IRDB | ||
Rule | Description | Interpretation of Data |
E01 E02 | When evaluating for data consistency of the 1094C form, if Box D on line 22 is not checked and Full Time Employee (FTE) Count has a value zero or blank for "All 12 Months" and all monthly rows have either zero or blank and Total Number of Forms 1095C filed by ALE Member has a value zero or blank ,then use total number of Form1095C for the EIN from IRDB data tables count to update for all monthly values. | Consider the total number of Form 1095-C for that EIN from the IRDB data tables count to update all monthly values and consider FTE count by month |
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Transition Relief | ||
Rule | Description | Interpretation of Data |
F01 F02 | When evaluating for data consistency of the 1094C form, when transition relief code is valid for "All 12 Months" and valid for at least one monthly row, then consider valid monthly values and for any invalid codes mark value as blank. | Consider valid monthly values and for any invalid codes mark value as blank |
F03 F04 | When evaluating for data consistency of the 1094C form, when transition relief code is invalid for "All 12 Months" and valid for at least one monthly row, then consider valid monthly values and for any invalid codes mark value as blank. | Consider valid monthly values and for any invalid codes mark value as blank |
F05 | When evaluating for data consistency of the 1094C form, when transition relief code is blank for "All 12 Months" and valid for at least one monthly row, then consider valid monthly values and for any invalid codes mark value as blank. | Consider valid monthly values and for any invalid codes mark value as blank |
F06 F07 | When evaluating for data consistency of the 1094C form, when transition relief code is valid for "All 12 Months" and invalid for all monthly rows, then consider the "All 12 months" value as valid and for any invalid monthly codes mark value as blank. | Consider the valid All 12 months value and change invalid monthly values to blank |
F08 F09 | When evaluating for data consistency of the 1094C form, when transition relief code is invalid for "All 12 Months" and invalid for all monthly rows, then consider not qualified for 4980H relief and for any invalid codes mark value as blank. | Consider monthly relief fields as not valid and for any invalid codes mark value as blank |
F10 | When evaluating for data consistency of the 1094C form, when transition relief code is invalid for "All 12 Months" and blank for all monthly rows, then consider not qualified for 4980H relief and for any invalid codes mark value as blank. | Consider yearly relief field as not valid and for any invalid codes mark value as blank |
F11 | When evaluating for data consistency of the 1094C form, when transition relief code is blank for "All 12 Months" and invalid for all monthly rows, then consider not qualified for 4980H relief and for any invalid codes mark value as blank. | Consider monthly relief fields as not valid and for any invalid codes mark value as blank |
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MEC offer Code (Line 14), Form 1095-C | ||
Rule | Description | Interpretation of Data |
G01 G02 | When evaluating for data consistency of the 1095C form, when coverage code is valid for "All 12 Months" and valid for at least one monthly value, then consider valid monthly values and for any invalid codes mark value as blank. | Consider valid monthly values and for any invalid codes found change invalid value to blank Note: for this rule if a monthly value is changed to blank it is treated as if no offer was made. |
G03 G04 | When evaluating for data consistency of the 1095C form, when coverage code is invalid for "All 12 Months" and valid for at least one monthly value, then consider valid monthly values and for any invalid codes mark value as blank. | Consider valid monthly values and for any invalid codes found change invalid value to blank Note: for this rule if a monthly value is changed to blank it is treated as if no offer was made. |
G05 | When evaluating for data consistency of the 1095C form, when coverage code is blank for "All 12 Months" and valid for at least one monthly value, then consider valid monthly values and for any invalid codes mark value as blank. | Consider valid monthly values and for any invalid codes found change invalid value to blank Note: for this rule if a monthly value is changed to blank it is treated as if no offer was made. |
G06 G07 | When evaluating for data consistency of the 1095C form, when coverage code is valid for "All 12 Months" and invalid for all monthly values, then consider "All 12 months" value as valid and for any invalid monthly codes mark value as blank. | Consider the valid All 12 months value and change invalid monthly values to blank |
G08 G09 | When evaluating for data consistency of the 1095C form, when coverage code is invalid for "All 12 Months" and invalid for all monthly values, then consider coverage as not valid and for any invalid codes mark value as blank. | Consider monthly coverage fields as not valid and for any invalid codes found change invalid value to blank Note: for this rule if a monthly value is changed to blank it is treated as if no offer was made. |
G10 | When evaluating for data consistency of the 1095C form, when coverage code is invalid for "All 12 Months" and blank for all monthly values, then consider coverage as not valid and for any invalid codes mark value as blank. | Consider yearly coverage field as not valid and for any invalid codes found change invalid value to blank Note: for this rule if a monthly value is changed to blank it is treated as if no offer was made. |
G11 | When evaluating for data consistency of the 1095C form, when coverage code is blank for "All 12 Months" and invalid for all monthly values, then consider coverage as not valid and for any invalid codes mark value as blank. | Consider monthly coverage fields as not valid and for any invalid codes found change invalid value to blank Note: for this rule if a monthly value is changed to blank it is treated as if no offer was made. |
|
|
|
Safe Harbors and Other Relief (Line 16), Form 1095-C | ||
Rule | Description | Interpretation of Data |
H01 H02 | When evaluating for data consistency of the 1095C form, when relief code is valid for "All 12 Months" and valid for at least one monthly value, then consider valid monthly values and for any invalid codes mark value as blank. | Consider valid monthly values and for any invalid codes found change invalid value to blank |
H03 H04 | When evaluating for data consistency of the 1095C form, when relief code is invalid for "All 12 Months" and valid for at least one monthly value, then consider valid monthly values and for any invalid codes mark value as blank. | Consider valid monthly values and for any invalid codes found change invalid value to blank |
H05 | When evaluating for data consistency of the 1095C form, when relief code is blank for "All 12 Months" and valid for at least one monthly value, then consider valid monthly values and for any invalid codes mark value as blank. | Consider valid monthly values and for any invalid codes found change invalid value to blank |
H06 H07 | When evaluating for data consistency of the 1095C form, when relief code is valid for "All 12 Months" and invalid for all monthly values, then consider "All 12 months" value as valid and for any invalid monthly codes mark value as blank. | Consider the valid All 12 months value and change invalid monthly values to blank |
H08 H09 | When evaluating for data consistency of the 1095C form, when relief code is invalid for "All 12 Months" and invalid for all monthly values, then consider monthly relief code as not valid and for any invalid codes mark value as blank. | Consider monthly relief fields as not valid and for any invalid codes found change invalid value to blank |
H10 | When evaluating for data consistency of the 1095C form, when relief code is invalid for "All 12 Months" and blank for all monthly values, then consider yearly relief code as not valid and for any invalid codes mark value as blank. | Consider yearly relief field as not valid and for any invalid codes found change invalid value to blank |
H11 | When evaluating for data consistency of the 1095C form, when relief code is blank for "All 12 Months" and invalid for all monthly values, then consider monthly relief code as not valid and for any invalid codes mark value as blank. | Consider monthly relief fields as not valid and for any invalid codes found change invalid value to blank |
Document Display Screen: 1094-B (Doc Code 11)
(1) Form 1094-B Transmittal of Health Coverage Information Returns
LINE | POSITION | DESCRIPTION AND VALIDITY | PAPER FORM REFERENCE |
1.1 | 1 | COMMAND CD |
|
1.2 | 6 | COMMAND DEFINER CD- “A”NOTE: Errors are treated as if you had entered the default. |
|
1.3 | 7 | REQUEST TIN -This Field recapitulates the requested TIN you entered |
|
1.4 | 16 | VALIDITY CODE -This Field recapitulates the VALIDITY CODE you entered. |
|
1.5 | 17 | TAX YEAR - Requested Tax Year |
|
1.6 | 17 | DOCUMENT CODE |
|
1.7 | 31 | REQUESTED TAX YEAR |
|
2.1 | 16 | DOCUMENT CODE DC 11 |
|
3.1 | 17 | DOCUMENT TYPE(1094-B) |
|
3.2 | 43 | ON FILE DATE MM/DD/YYYY |
|
3.3 | 53 | TYPE OF SUBMISSION: |
|
4.1 | 2 | LITERAL NAMES: |
|
4.2 | 22 | FILER NINE-DIGIT (EIN) | Box 2 |
4.3 | 58 | SUBMITTED TO IRS |
|
5.1 | 2 | FILER’S DATA | Box 1 |
5.2 | 58 | LITERAL CONTACT INFO |
|
6.2 | 44 | CONTACT NAME | Box 3 |
7.2 | 45 | CONTACT TELEPHONE | Box 4 |
20.1 | 11 | TAX YEAR |
|
20.2 | 37 | FILED – RECEIVED ON |
|
21.1 | 38 | TOTAL 1095-B FORMS TRANSMITTED WITH FORM 1094-B. | Box 9 |
22.1 | 38 | TOTAL 1095-B FORMS PROCESSED |
|
24.1 | 35 | PAGE NUMBER OF TOTAL PAGES - The page number of the last document of the individual document display. |
|
Document Display Screen: 1094-C (Doc Code 12)
(1) Form 1094-C Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns
(2)
Note: In Paper Form Reference column, Box numbers, when they appear, refer to the boxes on the paper forms.
LINE | POSITION | DESCRIPTION AND VALIDITY | PAPER FORM REFERENCE |
1.1 | 1 | COMMAND CD |
|
1.2 | 6 | COMMAND DEFINER CD- “A”NOTE: Errors are treated as if you had entered the default. |
|
1.3 | 7 | REQUEST TIN -This Field recapitulates the requested TIN you entered |
|
1.4 | 16 | VALIDITY CODE -This Field recapitulates the VALIDITY CODE you entered. |
|
1.5 | 17 | TAX YEAR - Requested Tax Year |
|
1.6 | 21 | DOCUMENT CODE - |
|
1.7 | 31 | REQUESTED TAX YEAR |
|
2.1 | 16 | DOCUMENT CODE DC 12 |
|
3.1 | 17 | DOCUMENT TYPE(1094-C) |
|
3.2 | 42 | ON FILE DATE - MM/DD/YYYY |
|
3.3 | 53 | TYPE OF SUBMISSION: |
|
4.1 | 2 | LITERAL NAMES: |
|
4.2 | 22 | EMPLOYER NINE-DIGIT (EIN) | Box 2 |
4.3 | 58 | SUBMITTED TO IRS |
|
5.1 | 2 | ALE DATA | Box 1 |
5.2 | 58 | LITERAL: CONTACT INFO |
|
6.2 | 44 | CONTACT NAME | Box 7 |
7.2 | 45 | CONTACT TELEPHONE | Box 8 |
12.1 | 11 | GOVERNMENT ENTITY DATA |
|
12.2 | 27 | EIN(Employer Identification Number) | Box 10 |
13.1 | 2 | DESIGNATED GOVERNMENT ENTITY NAME, ADDRESS,CITY,STATE,ZIP CODE, COUNTRY | Box 9, 11-14 |
13.2 | 58 | LITERAL: CONTACT INFO |
|
14.1 | 2 | CONTACT NAME | Box 15 |
15.2 | 45 | CONTACT TELEPHONE | Box 16 |
20.1 | 11 | TAX YEAR |
|
20.2 | 37 | FILED – RECEIVED ON |
|
21.1 | 38 | TOTAL 1095-C FORMS TRANSMITTED | Box 18 |
22.1 | 38 | TOTAL 1095-C FORMS PROCESSED |
|
24.1 | 35 | PAGE NUMBER OF TOTAL PAGES - The page number of the last document of the individual document display. |
|
Document Display Screen: 1094-C PART II (Doc Code 12)
(1) Form 1094-C PART II Transmittal of Employer-Provided Health Insurance Offer
LINE | POSITION | DESCRIPTION AND VALIDITY | PAPER FORM REFERENCE |
1.1 | 1 | COMMAND CD |
|
1.2 | 6 | COMMAND DEFINER CD- “A”NOTE: Errors are treated as if you had entered the default. |
|
1.3 | 7 | REQUEST TIN -This Field recapitulates the requested TIN you entered |
|
1.4 | 16 | VALIDITY CODE -This Field recapitulates the VALIDITY CODE you entered. |
|
1.5 | 17 | TAX YEAR - Requested Tax Year |
|
1.6 | 21 | DOCUMENT CODE |
|
1.7 | 32 | REQUESTED TAX YEAR |
|
2.1 | 16 | DOCUMENT CODE DC 12 |
|
3.1 | 17 | DOCUMENT TYPE– (1094-C) |
|
3.2 | 43 | ON FILE DATE - MM/DD/YYYY |
|
3.3 | 54 | TYPE OF SUBMISSION: |
|
4.1 | 2 | LITERAL NAMES: |
|
4.2 | 22 | EIN | Box 2 |
4.3 | 58 | SUBMITTED TO IRS |
|
5.1 | 2 | EMPLOYER NAME | Box 1 |
12.1 | 42 | AUTHORITATIVE TRANSMITTAL FOR THIS ALE | Box19 |
13.1 | 47 | ALE MEMBER - A MEMBER OF AGGREGATED ALE GROUP | Box 21 |
14.1 | 2 | LITERAL: CERTIFICATIONS OF ELIGIBILITY |
|
15.1 | 32 | QUALIFYING OFFER METHOD | Box 22a |
16.1 | 50 | RESERVED | Box 22b |
17.1 | 37 | RESERVED | Box 22c |
18.1 | 22 | 98% OFFER METHOD | Box 22d |
21.1 | 38 | TOTAL 1095-C FORMS FILED FOR ALE MEMBER | Box 20 |
24.1 | 35 | PAGE NUMBER OF TOTAL PAGES - The page number of the last document of - the individual document display |
|
Document Display Screen: 1094-C PART III (Doc Code 12)
(1) Form 1094-C PART III Transmittal of Employer-Provided Health Insurance Offer
LINE | POSITION | DESCRIPTION AND VALIDITY | PAPER FORM REFERENCE |
1.1 | 1 | COMMAND CD |
|
1.2 | 6 | COMMAND DEFINER CD- “A”NOTE: Errors are treated as if you had entered the default. |
|
1.3 | 7 | REQUEST TIN -This Field recapitulates the requested TIN you entered |
|
1.4 | 16 | VALIDITY CODE -This Field recapitulates the VALIDITY CODE you entered. |
|
1.5 | 17 | TAX YEAR - Requested Tax Year |
|
1.6 | 21 | DOCUMENT CODE |
|
1.7 | 32 | REQUESTED TAX YEAR |
|
2.1 | 16 | DOCUMENT CODE DC 12 |
|
3.1 | 17 | DOCUMENT TYPE– (1094-C) |
|
3.2 | 43 | ON FILE DATE - MM/DD/YYYY |
|
3.3 | 54 | TYPE OF SUBMISSION: |
|
4.1 | 2 | LITERAL EMPLOYER DATA |
|
4.2 | 22 | EIN | Box 2 |
4.3 | 58 | SUBMITTED TO IRS |
|
5.1 | 2 | EMPLOYER NAME | Box 1 |
9.1 | 13 | MEC (MINIMUM ESSENTIAL COVERAGE OFFER INDICATOR) ALL MONTHS | Box 23a |
9.2 | 27 | AGG (AGGREGATED GROUP INDICATOR) ALL MONTHS | Box 23d |
9.3 | 37 | RELIEF (SECTION 4980H TRANSITION RELIEF INDICATOR) ALL MONTHS | Box 23e |
9.4 | 43 | FTE (FULL-TIME EMPLOYEE COUNT FOR ALE MEMBER) ALL MONTHS | Box 23b |
9.5 | 59 | TOT EMP COUNT (TOTAL EMPLOYEE COUNT FOR ALE MEMBER) ALL MONTHS | Box 23c |
10.1 | 13 | MEC (MINIMUM ESSENTIAL COVERAGE OFFER INDICATOR) JAN | Box 24a |
10.2 | 27 | AGG (AGGREGATED GROUP INDICATOR) JAN | Box 24d |
10.3 | 37 | RELIEF (SECTION 4980H TRANSITION RELIEF INDICATOR) JAN | Box 24e |
10.4 | 43 | FTE (FULL-TIME EMPLOYEE COUNT FOR ALE MEMBER) JAN | Box 24b |
10.5 | 59 | TOT EMP COUNT (TOTAL EMPLOYEE COUNT FOR ALE MEMBER) JAN | Box 24c |
11.1 | 13 | MEC (MINIMUM ESSENTIAL COVERAGE OFFER INDICATOR) FEB | Box 25a |
11.2 | 27 | AGG (AGGREGATED GROUP INDICATOR) FEB | Box 25d |
11.3 | 37 | RELIEF (SECTION 4980H TRANSITION RELIEF INDICATOR) FEB | Box 25e |
11.4 | 43 | FTE (FULL-TIME EMPLOYEE COUNT FOR ALE MEMBER) FEB | Box 25b |
11.5 | 59 | TOT EMP COUNT (TOTAL EMPLOYEE COUNT FOR ALE MEMBER) FEB | Box 25c |
12.1 | 13 | MEC (MINIMUM ESSENTIAL COVERAGE OFFER INDICATOR) MAR | Box 26a |
12.2 | 27 | AGG (AGGREGATED GROUP INDICATOR) MAR | Box 26d |
12.3 | 37 | RELIEF IND (SECTION 4980H TRANSITION RELIEF INDICATOR) MAR | Box 26e |
12.4 | 43 | FTE (FULL-TIME EMPLOYEE COUNT FOR ALE MEMBER) MAR | Box 26b |
12.5 | 59 | TOT EMP COUNT (TOTAL EMPLOYEE COUNT FOR ALE MEMBER) MAR | Box 26c |
13.1 | 13 | MEC (MINIMUM ESSENTIAL COVERAGE OFFER INDICATOR) APR | Box 27a |
13.2 | 27 | AGG (AGGREGATED GROUP INDICATOR) APR | Box 27d |
13.3 | 37 | RELIEF IND (SECTION 4980H TRANSITION RELIEF INDICATOR) APR | Box 27e |
13.4 | 43 | FTE (FULL-TIME EMPLOYEE COUNT FOR ALE MEMBER) APR | Box 27b |
13.5 | 59 | TOT EMP COUNT (TOTAL EMPLOYEE COUNT FOR ALE MEMBER) APR | Box 27c |
14.1 | 13 | MEC (MINIMUM ESSENTIAL COVERAGE OFFER INDICATOR) MAY | Box 28a |
14.2 | 27 | AGG (AGGREGATED GROUP INDICATOR) MAY | Box 28d |
14.3 | 37 | RELIEF IND (SECTION 4980H TRANSITION RELIEF INDICATOR) MAY | Box 28e |
14.4 | 43 | FTE (FULL-TIME EMPLOYEE COUNT FOR ALE MEMBER) MAY | Box 28b |
14.5 | 59 | TOT EMP COUNT (TOTAL EMPLOYEE COUNT FOR ALE MEMBER) MAY | Box 28c |
15.1 | 13 | MEC (MINIMUM ESSENTIAL COVERAGE OFFER INDICATOR) JUN | Box 29a |
15.2 | 27 | AGG (AGGREGATED GROUP INDICATOR) JUN | Box 29d |
15.3 | 37 | RELIEF IND (SECTION 4980H TRANSITION RELIEF INDICATOR) JUN | Box 29e |
15.4 | 43 | FTE (FULL-TIME EMPLOYEE COUNT FOR ALE MEMBER) JUN | Box 29b |
15.5 | 59 | TOT EMP COUNT (TOTAL EMPLOYEE COUNT FOR ALE MEMBER) JUN | Box 29c |
16.1 | 13 | MEC (MINIMUM ESSENTIAL COVERAGE OFFER INDICATOR) JUL | Box 30a |
16.2 | 27 | AGG (AGGREGATED GROUP INDICATOR) JUL | Box 30d |
16.3 | 37 | RELIEF IND (SECTION 4980H TRANSITION RELIEF INDICATOR) JUL | Box 30e |
16.4 | 43 | FTE (FULL-TIME EMPLOYEE COUNT FOR ALE MEMBER) JUL | Box 30b |
16.5 | 59 | TOT EMP COUNT (TOTAL EMPLOYEE COUNT FOR ALE MEMBER) JUL | Box 30c |
17.1 | 13 | MEC (MINIMUM ESSENTIAL COVERAGE OFFER INDICATOR) AUG | Box 31a |
17.2 | 27 | AGG (AGGREGATED GROUP INDICATOR) AUG | Box 31d |
17.3 | 37 | RELIEF IND (SECTION 4980H TRANSITION RELIEF INDICATOR) AUG | Box 31e |
17.4 | 43 | FTE (FULL-TIME EMPLOYEE COUNT FOR ALE MEMBER) AUG | Box 31b |
17.5 | 59 | TOT EMP COUNT (TOTAL EMPLOYEE COUNT FOR ALE MEMBER) AUG | Box 31c |
18.1 | 13 | MEC (MINIMUM ESSENTIAL COVERAGE OFFER INDICATOR) SEP | Box 32a |
18.2 | 27 | AGG (AGGREGATED GROUP INDICATOR) SEP | Box 32d |
18.3 | 37 | RELIEF IND (SECTION 4980H TRANSITION RELIEF INDICATOR) SEP | Box 32e |
18.4 | 43 | FTE (FULL-TIME EMPLOYEE COUNT FOR ALE MEMBER) SEP | Box 32b |
18.5 | 59 | TOT EMP COUNT (TOTAL EMPLOYEE COUNT FOR ALE MEMBER) SEP | Box 32c |
19.1 | 13 | MEC (MINIMUM ESSENTIAL COVERAGE OFFER INDICATOR) OCT | Box 33a |
19.2 | 27 | AGG (AGGREGATED GROUP INDICATOR) OCT | Box 33d |
19.3 | 37 | RELIEF IND (SECTION 4980H TRANSITION RELIEF INDICATOR) OCT | Box 33e |
19.4 | 43 | FTE (FULL-TIME EMPLOYEE COUNT FOR ALE MEMBER) OCT | Box 33b |
19.5 | 59 | TOT EMP COUNT (TOTAL EMPLOYEE COUNT FOR ALE MEMBER) OCT | Box 33c |
20.1 | 13 | MEC (MINIMUM ESSENTIAL COVERAGE OFFER INDICATOR) NOV | Box 34a |
20.2 | 27 | AGG (AGGREGATED GROUP INDICATOR) NOV | Box 34d |
20.3 | 37 | RELIEF IND (SECTION 4980H TRANSITION RELIEF INDICATOR) NOV | Box34e |
20.4 | 43 | FTE (FULL-TIME EMPLOYEE COUNT FOR ALE MEMBER) NOV | Box34b |
20.5 | 59 | TOT EMP COUNT (TOTAL EMPLOYEE COUNT FOR ALE MEMBER) NOV | Box 34c |
21.1 | 13 | MEC (MINIMUM ESSENTIAL COVERAGE OFFER INDICATOR) DEC | Box 35a |
21.2 | 27 | AGG (AGGREGATED GROUP INDICATOR) DEC | Box 35d |
21.3 | 37 | RELIEF IND (SECTION 4980H TRANSITION RELIEF INDICATOR) DEC | Box 35e |
21.4 | 43 | FTE (FULL-TIME EMPLOYEE COUNT FOR ALE MEMBER) DEC | Box 35b |
21.5 | 59 | TOT EMP COUNT (TOTAL EMPLOYEE COUNT FOR ALE MEMBER) DEC | Box 35c |
24.1 | 35 | PAGE NUMBER OF TOTAL PAGES - The page number of the last document of - the individual document display |
|
Document Display Screen: 1094-C PART IV (Doc Code 12)
(1) Form 1094-C PART IV Transmittal of Employer-Provided Health Insurance Offer
LINE | POSITION | DESCRIPTION AND VALIDITY | PAPER FORM REFERENCE |
1.1 | 1 | COMMAND CD |
|
1.2 | 6 | COMMAND DEFINER CD- “A”NOTE: Errors are treated as if you had entered the default. |
|
1.3 | 7 | REQUEST TIN -This Field recapitulates the requested TIN you entered |
|
1.4 | 16 | VALIDITY CODE -This Field recapitulates the VALIDITY CODE you entered. |
|
1.5 | 17 | TAX YEAR - Requested Tax Year |
|
1.6 | 21 | DOCUMENT CODE |
|
1.7 | 32 | REQUESTED TAX YEAR |
|
2.1 | 16 | DOCUMENT CODE DC 12 |
|
3.1 | 17 | DOCUMENT TYPE– (1094-C) |
|
3.2 | 43 | ON FILE DATE - MM/DD/YYYY |
|
3.3 | 54 | TYPE OF SUBMISSION: |
|
4.1 | 2 | LITERAL EMPLOYER DATA |
|
4.2 | 27 | EIN | Box 2 |
4.2 | 58 | SUBMITTED TO IRS |
|
5.1 | 2 | EMPLOYER NAME | Box 1 |
7.1 | 2 | LITERAL OTHER ALE MEMBERS OF ALE GROUP |
|
8.1, 8.2, 10.1, 10.2, 12.1, 12.2, 14.1, 14.2, 16.1, 16.2, 18.1, 18.2, 20.1, 20.2, 22.1, 22.2 | 2, 42 | OTHER ALE MEMBERS OF ALE GROUP | Box 36 - Box 65 |
9.1, 9.2, 11.1, 11.2, 13.1, 13.2, 15.1, 15.2, 17.1, 17.2, 19.1, 19.2, 21.1, 21.2, 23.1, 23.2 | 7, 47 | EIN | Box 36 - Box 65 |
24.1 | 35 | PAGE NUMBER OF TOTAL PAGES - The page number of the last document of - the individual document display |
|
Document Display Screen: 1094-C Data Reconciliation Code (Doc Code 12)
(1) Form 1094-C Data Reconciliation Code-Transmittal of Employer-Provided Health Insurance Offer.
LINE | POSITION | DESCRIPTION AND VALIDITY | PAPER FORM REFERENCE |
1.1 | 1 | COMMAND CD |
|
1.2 | 6 | COMMAND DEFINER CD- “A”NOTE: Errors are treated as if you had entered the default. |
|
1.3 | 7 | REQUEST TIN -This Field recapitulates the requested TIN you entered |
|
1.4 | 16 | VALIDITY CODE -This Field recapitulates the VALIDITY CODE you entered. |
|
1.5 | 17 | TAX YEAR - Requested Tax Year |
|
1.6 | 21 | DOCUMENT CODE |
|
1.7 | 32 | REQUESTED TAX YEAR |
|
2.1 | 16 | DOCUMENT CODE DC 12 |
|
3.1 | 17 | DOCUMENT TYPE– (1094-C) |
|
3.2 | 43 | ON FILE DATE - MM/DD/YYYY |
|
3.3 | 54 | TYPE OF SUBMISSION: |
|
6.1 | 2 | DATA RECONCILIATION CODES FOR AGGREGATED GROUP INDICATORS (Potentially codes A01 thru A26 can be listed) |
|
9.1 | 2 | DATA RECONCILATION CODES FOR MINIMUM ESSENTIAL COVERAGE (MEC) OFFER INDICATORS (Potentially code B04 can be listed) | Box 2 |
12.1 | 2 | DATA RECONCILIATION CODES FOR FTE – PART III COLUMN B, FORM 11094-C INDICATORS (Potentially codes C01 and/or C03 can be listed) |
|
15.1 | 2 | DATA RECONCILIATION CODES FOR FTE PER NUMBER OF TOTAL 1095-CS FILED (LINE 20) ON 1094-C (Potentially D01 code can be listed) |
|
18.1 | 2 | DATA RECONCILIATION CODES FOR FTE PER TOTAL NUMBER OF 1095-CS RECORDED IN IRDB (Potentially E01 code can be listed) |
|
21.1 | 2 | DATA RECONCILIATION CODES FOR TRANSITION RELIEF INDICATORS (Potentially codes F01, F06, F07 can be listed) |
|
23.1 | 2 | EXHIBIT 2.3.86.2 JOB AIDE EXHIBIT |
|
Document Display Screen: 1095-A (Doc Code 07)
(1) Form 1095-A PART I Health Insurance Marketplace Statement.
LINE | POSITION | DESCRIPTION AND VALIDITY | PAPER FORM REFERENCE |
1.1 | 1 | COMMAND CD |
|
1.2 | 6 | COMMAND DEFINER CD- “A”NOTE: Errors are treated as if you had entered the default. |
|
1.3 | 7 | REQUEST TIN -This Field recapitulates the requested TIN you entered |
|
1.4 | 16 | VALIDITY CODE -This Field recapitulates the VALIDITY CODE you entered. |
|
1.5 | 17 | TAX YEAR - Requested Tax Year |
|
1.6 | 21 | DOCUMENT CODE |
|
1.7 | 32 | REQUESTED TAX YEAR |
|
2.1 | 16 | DOCUMENT CODE DC 07 |
|
3.1 | 17 | DOCUMENT TYPE– (1095-A) |
|
3.2 | 43 | ON FILE DATE - MM/DD/YYYY |
|
3.3 | 54 | TYPE OF SUBMISSION: |
|
4.1 | 2 | LITERAL RECIPIENT DATA |
|
4.2 | 27 | SSN | Box 5 |
4.3 | 58 | SUBMITTED TO IRS |
|
5.1 | 2 | RECIPIENT’S DATA | BOXES 4, 12, 13, 14, 15 |
5.2 | 49 | RECIPIENT’S DATE OF BIRTH (DOB) | BOX 6 |
12 | 2 | LITERAL SPOUSE DATA |
|
12.2 | 27 | SSN | Box 8 |
13.1 | 2 | SPOUSE NAME | Box 7 |
13.2 | 49 | SPOUSE’S DATE OF BIRTH (DOB) | Box 9 |
15.1 | 26 | MARKETPLACE IDENTIFIER | Box 1 |
16.1 | 29 | ASSIGNED POLICY NUMBER | Box 2 |
17.1 | 25 | POLICY ISSUER | Box 3 |
18.1 | 24 | POLICY START-DATE | Box 10 |
19.1 | 30 | POLICY TERMINATION-DATE | Box 11 |
24 | 21 | PAGE NUMBER OF TOTAL PAGES - The page number of the last document of— the individual document display |
|
Document Display Screen: 1095-A PART II (Doc Code 07)
(1) Form 1095-A PART II Health Insurance Marketplace Statement.
LINE | POSITION | DESCRIPTION AND VALIDITY | PAPER FORM REFERENCE |
1.1 | 1 | COMMAND CD |
|
1.2 | 6 | COMMAND DEFINER CD- “A”NOTE: Errors are treated as if you had entered the default. |
|
1.3 | 7 | REQUEST TIN -This Field recapitulates the requested TIN you entered |
|
1.4 | 16 | VALIDITY CODE -This Field recapitulates the VALIDITY CODE you entered. |
|
1.5 | 17 | TAX YEAR - Requested Tax Year |
|
1.6 | 21 | DOCUMENT CODE |
|
1.7 | 32 | REQUESTED TAX YEAR |
|
2.1 | 16 | DOCUMENT CODE DC 07 |
|
3.1 | 17 | DOCUMENT TYPE– (1095-A) |
|
3.2 | 43 | ON FILE DATE - MM/DD/YYYY |
|
3.3 | 54 | TYPE OF SUBMISSION: |
|
4.1 | 2 | LITERAL RECIPIENT DATA |
|
4.2 | 27 | SSN | Box 5 |
4.3 | 58 | SUBMITTED TO IRS |
|
5.1 | 2 | RECIPIENT NAME | Box 4 |
5.2 | 47 | RECIPIENT DOB | Box 6 |
7.1 | 2 | LITERAL: COVERED INDIVIDUALS, SSN, DOB |
|
8.1, 10.1, 12.1, 14.1, 16.1, 18.1, 20.1 | 2 | COVERED INDIVIDUAL NAME | Box 16a-20a |
8.2, 10.2, 12.2, 14.2, 16.2, 18.2, 20.2 | 38 | COVERED INDIVIDUAL SSN | Box 16b-20b |
8.3, 10.3, 12.3, 14.3, 16.3, 18.3, 20.3 | 52 | COVERED INDIVIDUAL DOB | Box 16c-20c |
9.1, 11.1, 13.1, 15.1, 17.1, 19.1, 21.1 | 14 | COVERAGE START DATE | Boxes16D-20D |
9.2, 11.2, 13.2, 15.2, 17.2, 19.2, 21.2 | 44 | COVERAGE TERMINATION DATE | Boxes 16E-20E |
24 | 21 | PAGE NUMBER OF TOTAL PAGES - The page number of the last document of— the individual document display |
|
Document Display Screen: 1095-A PART III (Doc Code 07)
(1) Form 1095-A PART III Health Insurance Marketplace Statement
LINE | POSITION | DESCRIPTION AND VALIDITY | PAPER FORM REFERENCE |
1.1 | 1 | COMMAND CD |
|
1.2 | 6 | COMMAND DEFINER CD- “A”NOTE: Errors are treated as if you had entered the default. |
|
1.3 | 7 | REQUEST TIN -This Field recapitulates the requested TIN you entered |
|
1.4 | 16 | VALIDITY CODE -This Field recapitulates the VALIDITY CODE you entered. |
|
1.5 | 17 | TAX YEAR - Requested Tax Year |
|
1.6 | 21 | DOCUMENT CODE |
|
1.7 | 32 | REQUESTED TAX YEAR |
|
2.1 | 16 | DOCUMENT CODE DC 07 |
|
3.1 | 17 | DOCUMENT TYPE– (1095-A) |
|
3.2 | 43 | ON FILE DATE - MM/DD/YYYY |
|
3.3 | 54 | TYPE OF SUBMISSION: |
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4.1 | 2 | LITERAL NAME: RECIPIENT DATA |
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4.2 | 27 | SSN | Box 5 |
4.3 | 58 | SUBMITTED TO IRS |
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5.1 | 2 | RECIPIENT NAME | Box 4 |
5.2 | 49 | RECIPIENT DOB | Box 6 |
7.1 | 12 | LITERAL NAME: ENROLLMT |
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7.2 | 29 | LITERAL NAME: SLCSP |
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7.3 | 46 | LITERAL NAME: APCT |
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8.1 | 13 | LITERAL NAME: PREM |
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8.2 | 30 | LITERAL NAME: AMT |
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8.3 | 46 | LITERAL NAME:AMT |
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9.1 | 14 | JAN MONTHLY PREMIUM AMOUNT | Box 21a |
9.2 | 30 | JAN MONTHLY SECOND LOWEST COST SILVER PLAN (SLCSP) | Box 21b |
9.3 | 45 | JAN MONTHLY ADVANCE PAYMENT OF PREMIUM TAX CREDIT | Box 21c |
10.1 | 14 | FEB MONTHLY PREMIUM AMOUNT | Box 22a |
10.2 | 30 | FEB MONTHLY SECOND LOWEST COST SILVER PLAN (SLCSP) | Box 22b |
10.3 | 45 | FEB MONTHLY ADVANCE PAYMENT OF PREMIUM TAX CREDIT | Box 22c |
11.1 | 14 | MAR MONTHLY AMOUNT | Box 23a |
11.2 | 30 | MAR MONTHLY SECOND LOWEST COST SILVER PLAN (SLCSP) | Box 23b |
11.3 | 45 | MAR MONTHLY ADVANCE PAYMENT OF PREMIUM TAX CREDIT | Box 23c |
12.1 | 14 | APR MONTHLY PREMIUM AMOUNT | Box 24a |
12.2 | 30 | APR MONTHLY SECOND LOWEST COST SILVER PLAN (SLCSP) | Box 24b |
12.3 | 45 | APR MONTHLY ADVANCE PAYMENT OF PREMIUM TAX CREDIT | Box 24c |
13.1 | 14 | MAY MONTHLY PREMIUM AMOUNT | Box 25a |
13.2 | 30 | MAY MONTHLY SECOND LOWEST COST SILVER PLAN (SLCSP) | Box 25b |
13.3 | 45 | MAY MONTHLY ADVANCE PAYMENT OF PREMIUM TAX CREDIT | Box 25c |
14.1 | 14 | JUN MONTHLY PREMIUM AMOUNT | Box 26a |
14.2 | 30 | JUN MONTHLY SECOND LOWEST COST SILVER PLAN (SLCSP) | Box 26b |
14.3 | 45 | JUN MONTHLY ADVANCE PAYMENT OF PREMIUM TAX CREDIT | Box 26c |
15.1 | 14 | JUL MONTHLY PREMIUM AMOUNT | Box 27a |
15.2 | 30 | JUL MONTHLY SECOND LOWEST COST SILVER PLAN (SLCSP) | Box 27b |
15.3 | 45 | JUL MONTHLY ADVANCE PAYMENT OF PREMIUM TAX CREDIT | Box 27c |
16.1 | 14 | AUG MONTHLY PREMIUM AMOUNT | Box 28a |
16.2 | 30 | AUG MONTHLY SECOND LOWEST COST SILVER PLAN (SLCSP) | Box 28b |
16.3 | 45 | AUG MONTHLY ADVANCE PAYMENT OF PREMIUM TAX CREDIT | Box 28c |
17.1 | 14 | SEP MONTHLY PREMIUM AMOUNT | Box 29a |
17.2 | 30 | SEP MONTHLY SECOND LOWEST COST SILVER PLAN (SLCSP) | Box 29b |
17.3 | 45 | SEP MONTHLY ADVANCE PAYMENT OF PREMIUM TAX CREDIT | Box 29c |
18.1 | 14 | OCT MONTHLY PREMIUM AMOUNT | Box 30a |
18.2 | 30 | OCT MONTHLY SECOND LOWEST COST SILVER PLAN (SLCSP) | Box 30b |
18.3 | 45 | OCT MONTHLY ADVANCE PAYMENT OF PREMIUM TAX CREDIT | Box 30c |
19.1 | 14 | NOV MONTHLY PREMIUM AMOUNT | Box 31a |
19.2 | 30 | NOV MONTHLY SECOND LOWEST COST SILVER PLAN (SLCSP) | Box 31b |
19.3 | 45 | NOV MONTHLY ADVANCE PAYMENT OF PREMIUM TAX CREDIT | Box 31c |
20.1 | 14 | DEC MONTHLY PREMIUM AMOUNT | Box 32a |
20.2 | 30 | DEC MONTHLY SECOND LOWEST COST SILVER PLAN (SLCSP) | Box 32b |
20.3 | 45 | DEC MONTHLY ADVANCE PAYMENT OF PREMIUM TAX CREDIT | Box 32c |
22.1 | 10 | ANNUAL TOTAL MONTHLY PREMIUM AMOUNT | Box 33a |
22.2 | 26 | TOTAL MONTHLY SECOND LOWEST COST SILVER PLAN (SLCSP) | Box 33b |
22.3 | 41 | TOTAL MONTHLY ADVANCE PAYMENT OF PREMIUM TAX CREDIT | Box 33c |
24 | 21 | PAGE NUMBER OF TOTAL PAGES - The page number of the last document of— the individual document display |
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Document Display Screen: 1095-B (Doc Code 56)
(1) Form 1095-B Health Coverage (Responsible Individual)
LINE | POSITION | DESCRIPTION AND VALIDITY | PAPER FORM REFERENCE |
1.1 | 1 | COMMAND CD |
|
1.2 | 6 | COMMAND DEFINER CD- “A”NOTE: Errors are treated as if you had entered the default. |
|
1.3 | 7 | REQUEST TIN -This Field recapitulates the requested TIN you entered |
|
1.4 | 16 | VALIDITY CODE -This Field recapitulates the VALIDITY CODE you entered. |
|
1.5 | 17 | TAX YEAR - Requested Tax Year |
|
1.6 | 21 | DOCUMENT CODE |
|
1.7 | 32 | REQUESTED TAX YEAR |
|
2.1 | 16 | DOCUMENT CODE DC 56 |
|
3.1 | 17 | DOCUMENT TYPE– (1095-B) |
|
3.2 | 43 | ON FILE DATE - MM/DD/YYYY |
|
3.3 | 54 | TYPE OF SUBMISSION: |
|
4.1 | 2 | LITERAL RESPONSIBLE INDIVIDUAL DATA |
|
4.2 | 27 | SSN or TIN | Box 2 |
4.3 | 58 | SUBMITTED TO IRS |
|
5.1 | 2 | RESPONSIBLE INDIVIDUAL DATA |
|
5.2 | 49 | RESPONSIBLE INDIVIDUAL’S DOB | Box 3 |
12.1 | 2 | LITERAL EMPLOYER DATA |
|
12.2 | 27 | EIN(Employer Identification Number | Box 11 |
12.3 | 44 | LITERAL ISSUER/PROVIDER |
|
12.4 | 70 | ISSUER/PROVIDER (EIN) | Box 17 |
13.1, 14.1, 15.1, 16.1, 17.1, 18.1, 19.1, 19.219.3 | 2 | EMPLOYER | Box 10 |
13.2, 14.2, 15.2, 16.2, 17.2, 18.2, 19.4, 19.5, 19.6 | 44 | ISSUER/PROVIDER INFORMATION NAME, ADDRESS,CITY,STATE,ZIP CODE, COUNTRY | Box 16 |
20 | 53 | CONTACT TELEPHONE NUMBERTelephone number the individual seeking additional information may call. | Box 18 |
21 | 14 | SMALL BUSINESS HEALTH PROGRAM (S.H.O.P.) ID | Note: This line is reserved |
22 | 20 | ORIGIN OF POLICY | Box 8 |
24 | 21 | PAGE NUMBER OF TOTAL PAGES - The page number of the last document of— the individual document display |
|
Document Display Screen: 1095-B PART II (Doc Code 56)
(1) Form 1095-B Part II Health Coverage (Employee-Sponsored Coverage)
LINE | POSITION | DESCRIPTION AND VALIDITY | PAPER FORM REFERENCE |
1.1 | 1 | COMMAND CD |
|
1.2 | 6 | COMMAND DEFINER CD- “A”NOTE: Errors are treated as if you had entered the default. |
|
1.3 | 7 | REQUEST TIN -This Field recapitulates the requested TIN you entered |
|
1.4 | 16 | VALIDITY CODE -This Field recapitulates the VALIDITY CODE you entered. |
|
1.5 | 17 | TAX YEAR - Requested Tax Year |
|
1.6 | 21 | DOCUMENT CODE |
|
1.7 | 32 | REQUESTED TAX YEAR |
|
2.1 | 16 | DOCUMENT CODE DC 56 |
|
3.1 | 17 | DOCUMENT TYPE– (1095-B) |
|
3.2 | 43 | ON FILE DATE - MM/DD/YYYY |
|
3.3 | 54 | TYPE OF SUBMISSION: |
|
4.1 | 2 | LITERAL RESPONSIBLE INDIVIDUAL DATA |
|
4.2 | 27 | RESPONSIBLE INDIVIDUAL | Box 2 |
4.3 | 58 | SUBMITTED TO IRS |
|
5.1 | 2 | RESPONSIBLE INDIVIDUAL NAME | Box 1 |
5.2 | 47 | RESPONSIBLE INDIVIDUAL DOB | Box 3 |
7.1 | 2 | LITERAL COVERED INDIVIDUALS:, SSN, DOB |
|
8.1, 10.1, 12.1, 14.1, 16.1, 18.1, 20.1 | 2 | COVERED INDIVIDUAL NAME | Box 23a |
8.2, 10.2, 12.2, 14.2, 16.2, 18.2, 20.2 | 38 | SSN or TIN | Box 23b |
8.3, 10.3, 12.3, 14.3, 16.3, 18.3, 20.3 | 50 | DATE OF BIRTH (DOB) | Box 23c |
9.1, 11.1, 13.1, 15.1, 17.1, 19.1, 21.1 | 6 | ALL | Box 23d |
9.1, 11.1, 13.1, 15.1, 17.1, 19.1, 21.1 | 13,19,25,31,37, 43, 49, 55,61, 67, 73, 79 | MONTHS | Box 23e |
24 | 21 | PAGE NUMBER OF TOTAL PAGES - The page number of the last document of— the individual document display |
|
Document Display Screen: 1095-C (Doc Code 60)
(1) Form 1095-C Employer-Provided Health Insurance Offer and Coverage
LINE | POSITION | DESCRIPTION AND VALIDITY | PAPER FORM REFERENCE |
1.1 | 1 | COMMAND CD |
|
1.2 | 6 | COMMAND DEFINER CD- “A”NOTE: Errors are treated as if you had entered the default.. |
|
1.3 | 7 | REQUEST TIN -This Field recapitulates the requested TIN you entered |
|
1.4 | 16 | VALIDITY CODE -This Field recapitulates the VALIDITY CODE you entered. |
|
1.5 | 17 | TAX YEAR - Requested Tax Year |
|
1.6 | 21 | DOCUMENT CODE |
|
1.7 | 32 | REQUESTED TAX YEAR |
|
2.3 | 16 | DOCUMENT CODE DC 60 |
|
3.1 | 17 | DOCUMENT TYPE– (1095-C) |
|
3.2 | 43 | ON FILE DATE - MM/DD/YYYY |
|
3.3 | 54 | TYPE OF SUBMISSION: |
|
4.1 | 2 | LITERAL EMPLOYEE DATA |
|
4.2 | 27 | SOCIAL SECURITY NUMBER (SSN) | Box 2 |
4.3 | 58 | SUBMITTED TO IRS |
|
5.1 | 2 | EMPLOYEE DATA | Box 1 |
12.1 | 2 | LITERAL EMPLOYER DATA |
|
12.2 | 27 | EIN(Employer Identification Number) | Box 8 |
13.1 | 2 | EMPLOYER NAME | Box7 |
13.2 | 54 | CONTACT TELEPHONE | Box 10 |
19.4 | 57 | SELF-INSURED | Part III |
24 | 21 | PAGE NUMBER OF TOTAL PAGES - The page number of the last document of— the individual document display |
|
Document Display Screen: 1095-C PART II (Doc Code 60)
(1) Form 1095-C Part II Employer-Provided Health Insurance Offer and Coverage
LINE | POSITION | DESCRIPTION AND VALIDITY | PAPER FORM REFERENCE |
1.1 | 1 | COMMAND CD |
|
1.2 | 6 | COMMAND DEFINER CD- “A”NOTE: Errors are treated as if you had entered the default. |
|
1.3 | 7 | REQUEST TIN -This Field recapitulates the requested TIN you entered |
|
1.4 | 16 | VALIDITY CODE -This Field recapitulates the VALIDITY CODE you entered. |
|
1.5 | 17 | TAX YEAR - Requested Tax Year |
|
1.6 | 21 | DOCUMENT CODE |
|
1.7 | 32 | REQUESTED TAX YEAR |
|
2.2 | 16 | DOCUMENT CODE DC 60 |
|
3.1 | 17 | DOCUMENT TYPE– (1095-C) |
|
3.2 | 43 | ON FILE DATE - MM/DD/YYYY |
|
3.3 | 54 | TYPE OF SUBMISSION: |
|
4.1 | 2 | LITERAL EMPLOYEE DATA |
|
4.2 | 27 | EMPLOYEE SSN NUMBER | Box 2 |
4.3 | 58 | SUBMITTED TO IRS |
|
5.1 | 2 | EMPLOYEE NAME | Box 1 |
7.1 | 2 | LITERAL EMPLOYEE OFFER AND COVERAGE |
|
8.1 | 20 | PLAN START MONTH |
|
9.1 | 13, 33, 58 | LITERAL: OFFER COVERAGE, *LOWEST COST, EXCLUSION |
|
10.1Thru22.1 | 18 | OFFER COVERAGE | Part II Line 14 Instructions |
10.2Thru22.2 | 36 | *LOWEST COST | Part II Line 15 Instructions |
10.2Thru22.2 | 61 | EXCLUSION | Part II Line 16 Instructions |
24 | 21 | PAGE NUMBER OF TOTAL PAGES - The page number of the last document of— the individual document display |
|
Document Display Screen: 1095-C Part III (Doc Code 60)
(1) Form 1095-C Part III Employer-Provided Health Insurance Offer and Coverage
LINE | POSITION | DESCRIPTION AND VALIDITY | PAPER FORM REFERENCE |
1.1 | 1 | COMMAND CD |
|
1.2 | 6 | COMMAND DEFINER CD- “A”NOTE: Errors are treated as if you had entered the default. |
|
1.3 | 7 | REQUEST TIN -This Field recapitulates the requested TIN you entered |
|
1.4 | 16 | VALIDITY CODE -This Field recapitulates the VALIDITY CODE you entered. |
|
1.5 | 17 | TAX YEAR - Requested Tax Year |
|
1.6 | 21 | DOCUMENT CODE |
|
1.7 | 32 | REQUESTED TAX YEAR |
|
2.2 | 16 | DOCUMENT CODE DC 60 |
|
3.1 | 17 | DOCUMENT TYPE– (1095-C) |
|
3.2 | 43 | ON FILE DATE - MM/DD/YYYY |
|
3.3 | 54 | TYPE OF SUBMISSION: |
|
4.1 | 2 | LITERAL EMPLOYEE DATA |
|
4.2 | 27 | EMPLOYEE SSN | Box 2 |
4.3 | 58 | SUBMITTED TO IRS |
|
5.1 | 2 | EMPLOYEE NAME | Box 1 |
7.1 | 2 | LITERAL:COVERED INDIVIDUALS, SSN, DOB |
|
8.1, 10.1, 12.1, 14.1, 16.1, 18.1, 20.1 | 2 | COVERED INDIVIDUAL NAME | Box 23a |
8.2, 10.2, 12.2, 14.2, 16.2, 18.2, 20.2 | 38 | SOCIAL SECURITY NUMBER (SSN) | Box 23b |
8.3, 10.3, 12.3, 14.3, 16.3, 18.3, 20.3 | 50 | DATE OF BIRTH (DOB) | Box 23c |
9.1, 11.1, 13.1, 15.1, 17.1, 19.1, 21.1 | 6 | ALL | Box 23d |
9.1, 11.1, 13.1, 15.1, 17.1, 19.1, 21.1 | 13,19,25,31,37,43,49,55,61,67,73,79 | MONTHS | Box 23e |
24 | 21 | PAGE NUMBER OF TOTAL PAGES - The page number of the last document of— the individual document display |
|
Document Display Screen: 1095-C Data Reconciliation Code (Doc Code 60)
(1) Form 1095-C Data Reconciliation Code- Employer-Provided Health Insurance Offer and Coverage
LINE | POSITION | DESCRIPTION AND VALIDITY | PAPER FORM REFERENCE |
1.1 | 1 | COMMAND CD |
|
1.2 | 6 | COMMAND DEFINER CD- “A”NOTE: Errors are treated as if you had entered the default. |
|
1.3 | 7 | REQUEST TIN -This Field recapitulates the requested TIN you entered |
|
1.4 | 16 | VALIDITY CODE -This Field recapitulates the VALIDITY CODE you entered. |
|
1.5 | 17 | TAX YEAR - Requested Tax Year |
|
1.6 | 21 | DOCUMENT CODE |
|
1.7 | 32 | REQUESTED TAX YEAR |
|
2.1 | 16 | DOCUMENT CODE DC 60 |
|
3.1 | 17 | DOCUMENT TYPE– (1095-C) |
|
3.2 | 43 | ON FILE DATE - MM/DD/YYYY |
|
3.3 | 54 | TYPE OF SUBMISSION: |
|
6.1 | 2 | DATA RECONCILIATION CODES FOR OFFER OF COVERAGE CODE (LINE 14), FORM 1095-C INDICATORS (Potentially codes G01, G04,G05,G06 can be listed) |
|
9.1 | 2 | DATA RECONCILATION CODES FOR SAFE HARBOR AND OTHER RELIEF (LINE 16), FORM 1095-C INDICATORS (Potentially code H01, H04, H06 can be listed) | Box 2 |
23.1 | 2 | EXHIBIT 2.3.86.2 JOB AIDE EXHIBIT |
|