Standard AQ - Get employee 1095-C info

Report Description

Get 1095-C fields that will appear on the 1095-C form.

Parameters

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

Report Fields

Series 1 Code: Line 14

Employee Share: Line 15

Series 2 Code: Line 16

• Information on 1095C codes

Field	Description
All12MonthsColumnEmployeeShare	Employee Share $ for the year Note: This option only is used if all 12 months are the same.
All12MonthsColumnSeries1Code	Offer Code for Insurance for the year Note: This option only is used if all 12 months are the same.
All12MonthsColumnSeries2Code	Safe Harbor Section Code for the year Note: This option only is used if all 12 months are the same.
City	City from Employee’s Primary Address
Electronic1095C	Classic/Back Office: the Config Choice system name is Electronic1095C and the choice code is Electronic 1095-C for  Category, EmployeeInterview.  Integrated/BOLD: Dev has not released anything yet so not sure what it will be shown on Bold interface.
FirstName	Employee's First Name
FullName	Employee's Full Name
IsCorrected	Checked if the 1095-C has been corrected
IsSelfInsuredCoverageOffered	Checked if Self Insurance Coverage selected
IsVoided	Checked if the 1095-C has been voided
LastName	Employee's Last Name
MiddleName	Employee's Middle Name
PlanStartMonth	00 - 12:
SSN	Employee's Social Security Number
State	State from Employee’s Primary Address
Street	Street 1 from Employee’s Primary Address
ZipCode	Zip code from Employee’s Primary Address
JanuaryColumnEmployeeShare	Employee Share $ for the month
JanuaryColumnSeries1Code	Offer Code for Insurance for the month
JanuaryColumnSeries2Code	Safe Harbor Section Code for the month
FebruaryColumnEmployeeShare	Employee Share $ for the month
FebruaryColumnSeries1Code	Offer Code for Insurance for the month
FebruaryColumnSeries2Code	Safe Harbor Section Code for the month
MarchColumnEmployeeShare	Employee Share $ for the month
MarchColumnSeries1Code	Offer Code for Insurance for the month
MarchColumnSeries2Code	Safe Harbor Section Code for the month
AprilColumnEmployeeShare	Employee Share $ for the month
AprilColumnSeries1Code	Offer Code for Insurance for the month
AprilColumnSeries2Code	Safe Harbor Section Code for the month
MayColumnEmployeeShare	Employee Share $ for the month
MayColumnSeries1Code	Offer Code for Insurance for the month
MayColumnSeries2Code	Safe Harbor Section Code for the month
JuneColumnEmployeeShare	Employee Share $ for the month
JuneColumnSeries1Code	Offer Code for Insurance for the month
JuneColumnSeries2Code	Safe Harbor Section Code for the month
JulyColumnEmployeeShare	Employee Share $ for the month
JulyColumnSeries1Code	Offer Code for Insurance for the month
JulyColumnSeries2Code	Safe Harbor Section Code for the month
AugustColumnEmployeeShare	Employee Share $ for the month
AugustColumnSeries1Code	Offer Code for Insurance for the month
AugustColumnSeries2Code	Safe Harbor Section Code for the month
SeptemberColumnEmployeeShare	Employee Share $ for the month
SeptemberColumnSeries1Code	Offer Code for Insurance for the month
SeptemberColumnSeries2Code	Safe Harbor Section Code for the month
OctoberColumnEmployeeShare	Employee Share $ for the month
OctoberColumnSeries1Code	Offer Code for Insurance for the month
OctoberColumnSeries2Code	Safe Harbor Section Code for the month
NovemberColumnEmployeeShare	Employee Share $ for the month
NovemberColumnSeries1Code	Offer Code for Insurance for the month
NovemberColumnSeries2Code	Safe Harbor Section Code for the month
DecemberColumnEmployeeShare	Employee Share $ for the month
DecemberColumnSeries1Code	Offer Code for Insurance for the month
DecemberColumnSeries2Code	Safe Harbor Section Code for the month