Standard Report - 1094-C

Report Description

Form 1094-C and Form 1095-C are forms used to report required information about healthcare to the IRS. Following the Affordable Care Act (ACA), all applicable large employers (ALEs) need to report whether they’ve offered health coverage to each employee and whether those employees are enrolled in health coverage. Form 1094-C is the summary of this information for all employees. 

Parameters

Parameter Name	Options	Explanation
Form Batch ID	Employer & ACA Form Year	Select the Employer and ACA form year from the dropdown menu

Report Fields

• Available Config Options

Field Name	Explanation
Name of ALE Member	Enter employer's name. The employer is the ALE Member.
Employer Identification Number	Enter the ALE Member’s EIN. Do not enter an SSN. Enter the 9-digit EIN, including the dash.
Street Address	Employer's Street Address
City or Town	Employer's City or Town
State or Province	Employer's State or Province
Country & Zip or Foreign Postal Code	Employer's Country & Zip or Foreign Postal Code
Name of Person to Contact	Name of Contact Person
Contact Telephone Number	Contact's Telephone Number
Total Number of Forms 1095-C Filed by ALE Member	The total number of Forms 1095-C submitted with this Form 1094-C transmittal.
Is ALE Member a member of an Aggregated ALE Group?	Yes/No
Certifications of Eligibility	If the ALE Member meets the eligibility requirements and is using one of the Offer Methods, it must check the applicable box.