Standard AQ - Get employee 1095-C info

Report Description

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

 

 

Parameters

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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

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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

 

 

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