to select, the taxable entity (ALE Member) for which the 1094-C record is being entered. The following Address values must be assigned to the taxable entity in the Configure Company Settings screen in order to be entered here:Use this screen after you generate 1094-C records through the Create 1094-C and 1095-C Data screen. Thoroughly review the data on this screen before you create the 1094-C reports on the Print 1094-Cs screen and Create 1094-C Electronic File screen. You can also enter and change 1094-C information on this screen.
Enter, or click to select, the taxable entity (ALE Member) for which the 1094-C record is being entered. The following Address values must be assigned to the taxable entity in the Configure Company Settings screen in order to be entered here:
Address Line 1
City
State/Province
Country
Postal Code
This is the calendar year for which the 1094-C is being created.
Select this check box if you are correcting information on a Form 1094-C that was previously files with the IRS.
If correcting information on the Authoritative Transmittal (identified on Part I, line 19, as the Authoritative Transmittal, which must be filed for each employer reporting aggregate employer-level data for all full-time employees of the employer), file a standalone fully completed Form 1094-C including the correct information and enter an “X” in the Corrected check box.
Do not file a return correcting information on a Form 1094-C that is not the Authoritative Transmittal.
This field displays the sequence number of the 1094-C for the specified Calendar Year / Taxable Entity combination. If the 1094-C does not yet exist in the Manage 1094-C Data table, then a Sequence Number of 1 (one) will be assigned. The sequence number will be incremented by one for any correcting 1094-Cs entered for the same Calendar Year / Taxable Entity combination.
This check box displays as selected when you process this record on the Create 1094-C and 1095-C Electronic File screen using the Confirm Records as Accepted by the IRS processing option. The record is disabled and is no longer editable if this check box is selected.
This field displays the data file generation key created when an electronic file is generated for 1094-C and 1095-C transmission. This ID is used when you process the record on the Create 1094-C and 1095-C Electronic File screen using the Confirm Records as Accepted by the IRS processing option.
This field displays the name of the employer for which the 1094-C record is being entered. This field loads the taxable entity name assigned to the taxable entity on the Configure Company Information screen.
This field displays the Employer Identification Number (EIN) of the employer for which the 1094-C record is being entered. This field loads the tax ID assigned to the taxable entity on the Configure Company Information screen.
This field displays the street address (including room or suite number)of the employer for which the 1095-C record is being entered. This field loads the Address Line 1, Address Line 2, and Address Line 3 assigned to the taxable entity on the Configure Company Information screen.
This field displays the city or town of the taxable entity for which the 1094-C record is being entered. This field loads the city assigned to the taxable entity on the Configure Company Information screen.
This field displays the state/province of the taxable entity for which the 1094-C record is being entered. This field loads the state/province assigned to the taxable entity on the Configure Company Information screen.
This field displays the country and ZIP or foreign postal code of the taxable entity for which the 1094-C record is being entered. This field loads the country and postal code assigned to the taxable entity on the Configure Company Information screen.
Enter, click to select, the contact person who is responsible for answering any questions regarding the 1094-C. The name of the person displays in the adjacent unlabeled field.
Enter the contact telephone number of the taxable entity for which the 1094-C record is being entered. This field loads the telephone number assigned to the taxable entity on the Configure Company Information screen.
Enter, or click to select, the designated governmental taxable entity which is filing on behalf of the employer for which the 1094-C record is being entered. The following Address values must be assigned to the taxable entity in the Configure Company Information screen in order to be entered here:
Address Line 1
City
State/Province
Country
Postal Code
This field displays the name of the Designated Government Entity (DGE) which is filing on behalf of the employer. This field loads the taxable entity name assigned to the DGE on the Configure Company Information screen.
This field displays the Employer Identification Number (EIN) of the DGE which is filing on behalf of the employer. This field loads the tax ID assigned to the DGE on the Configure Company Information screen.
This field displays the street address (including room or suite number) of the DGE which is filing on behalf of the employer. This field loads the Address Line 1, Address Line 2, and Address Line 3 assigned to the DGE on the Configure Company Information screen.
This field displays the city or town of the DGE which is filing on behalf of the employer. This field loads the city assigned to the DGE on the Configure Company Information screen.
This field displays the state/province of the DGE which is filing on behalf of the employer. This field loads the state/province assigned to the DGE on the Configure Company Information screen.
This field displays the country and ZIP or postal code of the DGE which is filing on behalf of the employer. This field loads the country and ZIP or postal code assigned to the DGE on the Configure Company Information screen.
Enter, or click to select, the contact person who is responsible for answering any questions regarding the 1094-C.
This field can be used to enter the contact telephone number of the DGE which is filing on behalf of the employer. This field loads the telephone number assigned to the DGE on the Configure Company Information screen.
Enter the total number of Forms 1095-C submitted with this Form 1094-C transmittal.
If this Form 1094-C transmittal is the Authoritative Transmittal that reports aggregate employer-level data for the employer, Select this check box and complete Parts II, III, and IV, to the extent applicable. Otherwise, complete the signature portion of Form 1094-C and leave the remainder of the form (lines 20-22 of Part II, and all of Parts III and IV) blank.
Enter the total number of Forms 1095-C that will be filed by and/or on behalf of the employer. This includes all Forms 1095-C that are filed with this transmittal including those filed for any individuals who enrolled in the employer-sponsored self-insured plan, and for any Forms 1095-C filed with a separate transmittal filed by or on behalf of the employer.
Select this check box if the employer was a member of an Aggregated ALE Group during any month of the calendar year. If you select this check box, you need to:
Complete the d) Aggregated Group Indicator column in Part III - ALE Member Information, and then;
List the other members of the Aggregated ALE Group in the Part IV - Other ALE Member of the Aggregated ALE Group subtask.
Clear this check box if the employer was not a member of an Aggregated ALE Group for all 12 months of the calendar year. If this is the case, do not complete Part III - column (d), or Part IV.
Select this check box if the employer is eligible to use and is using the Qualifying Offer Method to report the information on Form 1095–C for one or more full-time employees.
According to the IRS instructions, to be eligible to use the Qualifying Offer Method, the employer must certify that it made a Qualifying Offer to one or more of its full-time employees for all months during the year in which the employee was a full-time employee for whom an employer shared responsibility payment could apply.
If the employer reports using this method, it must not complete on Form 1095-C, Part II, line 15, for any month for which a Qualifying Offer is made. Instead, it must enter the Qualifying Offer code 1A on Form 1095-C, line 14, to indicate that the employee received a Qualifying Offer for all 12 months (in which case the employer must not, for any month, report the dollar amount on line 15). An employer is not required to use the Qualifying Offer Method, even if it is eligible and instead may enter on line 14 the applicable offer code and on line 15 the dollar amount required as an employee contribution for the lowest-cost employee-only coverage providing minimum value for that month.
If the employer is eligible to use the Qualifying Offer Method, it may report on Form 1095–C by entering the Qualifying Offer code 1A on Form 1095–C, line 14, for any month for which it made a Qualifying Offer to an employee, even if the employee did not receive a Qualifying Offer for all 12 calendar months. However, if employee receives a Qualifying Offer for less than all 12 months, the employer must furnish a copy of Form 1095-C to the employee unless the Qualifying Offer Method Transition Relief described later applies for 2015.
Select this check box if the employer is eligible for and is using the Qualifying Offer Method Transition Relief for the 2015 calendar year to report information on Form 1095-C for one or more full-time employees.
According to IRS instructions, to be eligible to use the Qualifying Offer Method Transition Relief, the employer must certify that it made a Qualifying Offer for one or more months of calendar year 2015 to at least 95% of its full-time employees. For this purpose, an employee in a Limited Non-Assessment Period is not included in the 95% calculation.
If an employer reports using this method, it must not complete Form 1095-C, Part II, line 15, for any month for which a Qualifying Offer is made or for which Qualifying Offer Method Transition Relief applies. An employer that reports using this method must enter on Form 1095–C, line 14, either the Qualifying Offer code 1A for any months for which the employee received a Qualifying Offer, or the Qualifying Offer Method Transition Relief code 1I for any months for which the employee did not receive a Qualifying Offer. An employer is not required to use this method, even if it is eligible and the employer may report on line 14 the applicable offer code and on line 15 the dollar amount required as an employee contribution for the lowest-cost employee-only coverage providing minimum value for that month. An employer may not, for any month, use code 1A or code 1I and also report the dollar amount on line 15.
Select this check box if the employer is eligible for section 4980H Transition Relief under either:
2015 Section 4980H Transition Relief for ALEs with Fewer Than 100 Full-Time Employees, Including Full-Time Equivalent Employees (50-99 Transition Relief); or
2015 Transition Relief for Calculation of Assessable Payments Under Section 4980H(a) for ALEs with 100 or More Full-Time Employees, Including Full-Time Equivalent Employees (100 or More Transition Relief).
For a description of the relief, including which employers are eligible for the relief, see Section 4980H Transition Relief for 2015 of the IRS Instructions for Forms 1094-C and 1095-C . If you select this check box, you must also complete Form 1094-C, Part III, column (e), Section 4980H Transition Relief Indicator, to indicate the type of section 4980H transition relief for which it is eligible.
Check this box if the employer is eligible for and is using the 98% Offer Method.
According to the IRS instructions, to be eligible to use the 98% Offer Method, an employer must certify that taking into account all months during which the individuals were employees of the employer and were not in a Limited Non-Assessment Period, the employer offered, affordable health coverage providing minimum value to at least 98% of its employees for whom it is filing a Form 1095-C employee statement, and offered minimum essential coverage to those employees’ dependents. The employer is not required to identify which of the employees for whom it is filing were full-time employees, but the employer is still required, under the general reporting rules, to file Forms 1095-C on behalf of all its full-time employees who were full-time employees for one or more months of the calendar year. To ensure compliance with the general reporting rules, an employer should confirm for any employee for whom it fails to file a Form 1095-C that the employee was not a full-time employee for any month of the calendar year. (For this purpose, the health coverage is affordable if the employer meets one of the section 4980H affordability safe harbors.)
Example of Employer Eligible for 98% Offer Method
From the drop-down list, select Yes or No to specify whether or not minimal essential coverage was offered to at least 95% of full-time employees/dependents for entire year.
The following are the criteria for Column (a) Minimum Essential Coverage Offer Indicator in Form 1094-C:
If the employer offered minimum essential coverage to at least 95% of its full-time employees and their dependents for the entire calendar year, enter X in the Yes check box on line 23 for All 12 Months or for each of the 12 calendar months.
If the employer offered minimum essential coverage to at least 95% of its full-time employees and their dependents only for certain calendar months, enter X in the Yes check box for each applicable month. For the months, if any, for which the employer did not offer minimum essential coverage to at least 95% of its full-time employees and their dependents, enter X in the No check box for each applicable month.
If the employer did not offer minimum essential coverage to at least 95% of its full-time employees and their dependents for any of the 12 months, enter X in the No check box for All 12 Months for each of the 12 calendar months.
However, an employer that did not offer minimum essential coverage to at least 95% of its full-time employees and their dependents but is eligible for certain transition relief described in the instructions later under Section 4980H Transition Relief for 2015 should enter an X in the Yes check box for Part III, line 23, column (a), as applicable. See the instructions later under Section 4980H Transition Relief for 2015.
Enter the number of full-time employees for each month, but do not count any employee in a Limited Non-Assessment Period. (If the number of full-time employees (excluding employees in a Limited Non-Assessment Period) for a month is zero, enter 0.)
Enter the total number of all of your employees, including full-time employees and non-full-time employees and employees in a Limited Non-Assessment Period, for each calendar month.
An employer must choose to use one of the following days of the month to determine the number of employees per month and must use that day for all months of the year:
The first day of each month;
The last day of each month;
The 12th day of each month;
The first day of the first payroll period that starts during each month; or
The last day of the first payroll period that starts during each month (provided that for each month that last day falls within the calendar month in which the payroll period starts).
If the total number of employees was the same for every month of the entire calendar year, enter that number in line 23, column (c) All 12 Months or in the boxes for each month of the calendar year. If the number of employees for any month is zero, enter 0.
From the drop-down list, select Yes or No to specify whether or not the taxable entity was a member of an Aggregated ALE Group.
An employer must complete this column if it checked Yes on line 21, indicating that, during any month of the calendar year, it was a member of an Aggregated ALE Group. If the employer was a member of an Aggregated ALE Group during each month of the calendar year, enter X in the All 12 Months box or in the boxes for each of the 12 calendar months. If the employer was not a member of an Aggregated ALE Group for all 12 months but was a member of an Aggregated ALE Group for one or more month(s), enter X in each month for which it was a member of an Aggregated ALE Group. If an employer enters X in one or more months in this column, it must also complete Part IV.
Select the applicable code if the employer certified Section 4980H Transition Relief eligibility in all 12 months. Valid options are:
A: 50-99 - Select this code if the employer certifies, by selecting box C (Section 4980H Transition Relief check box) on line 22, that it is eligible for Section 4980H Transition Relief and is eligible for the 50 to 99 Relief.
B: 100 or More Relief - Select this code if the employer certifies, by selecting box C (Section 4980H Transition Relief check box) on line 22, that it is eligible for Section 4980H Transition Relief and is eligible for the 100 or More Relief.
An employer will not be eligible for both types of relief.
Use lines 24 Jan to 35 Dec to specify information for each month of the calendar year. Each monthly line has the following columns:
From the drop-down list, select Yes or No to specify whether or not minimal essential coverage was offered to at least 95% of full-time employees/dependents for the calendar month.
Enter the number of full-time employees for the calendar month. Do not count any employee in a Limited Non-Assessment Period.
Enter the total number of all of your employees, including full-time employees and non-full-time employees and employees in a Limited Non-Assessment Period, for the calendar month.
From the drop-down list, select Yes or No to specify whether or not the taxable entity was a member of an Aggregated ALE Group.
Select the applicable code if the employer certified Section 4980H Transition Relief eligibility in the calendar month. Valid options are:
A: 50-99 - Select this code if the employer certifies, by selecting box C (Section 4980H Transition Relief check box) on line 22, that it is eligible for Section 4980H Transition Relief and is eligible for the 50 to 99 Relief.
B: 100 or More Relief - Select this code if the employer certifies, by selecting box C (Section 4980H Transition Relief check box) on line 22, that it is eligible for Section 4980H Transition Relief and is eligible for the 100 or More Relief.
An employer will not be eligible for both types of relief.
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Subtask |
Description |
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Part IV - Other ALE Members of Aggregated ALE Group |
Select this link to enter information for other ALE members of aggregated ALE group. |