Form 1095-C Information Requirements

Form 1095-C is a pretty important form. It’s the form that all Applicable Large Employers (ALEs) use to report the health care coverage they offer their full-time employees each year.

So before you sit down to complete these important forms, you need to be sure to have all the information required. A lot of the data you’ll need can be gotten easily from your current payroll system but you’ll also be required to supply data on the coverage you offered each of your full-time employees.




To help get you prepared, here’s a list that breaks down all the information you need to complete Form 1095-C:

• Employee data. For each employee, you’ll need to have their
• Name,
• Social security number, and
• Address
• Applicable Large Employer data. That’s you. You’ll need your business’s
• Name
• Employer Identification Number (EIN)
• Address, and
• Telephone number
• Offer of coverage information. This is the part where you tell about the (at least) minimum essential coverage you offered your full-time employees. You’ll need
• The plan start month,
• An offer of coverage code for each month that identifies the type of coverage offered,
• The employee’s required monthly contribution to their coverage, and
• Any Section 4980H Safe Harbor information that applies, indicated by the safe harbor codes.
• Covered individuals’ information. If your coverage offer extends to the employee’s spouse and/or dependent(s), you’ll need the following information on them:
• Name,
• Social security number or date of birth, and
• Which months coverage was offered.

Once you have all the information you need, you can feel confident as you begin your Affordable Care Act filing.


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