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1095-C - General Information

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Certain pieces of information are needed to produce 1095-Cs in Avionté.

 

1095-C Production

Per the IRS Instructions, a 1095-C is required for any employee who was ACA full-time at any point throughout the reporting year. So, any employee who hit an average of 30 hours per week across a measurement period would receive a 1095-C. A 1095-C is also required for any employee enrolled in a self-insured plan throughout the reporting year. 

For more information see, IRS.gov - Instructions for Forms 1094-C and 1095-C.

Avionté will produce a 1095-C for any employee who falls under the below criteria per the data in the Avionté system: 

  • An employee that reaches ACA full-time status is indicated by their ACA Eligibility being set to "Yes" throughout the reporting year. Because an employee might go from a "Yes" to "Undetermined" within the same year, the system looks at the audit of the employee's ACA Eligibility to determine if they were ever set to "Yes" within the reporting year. If this is the case, a 1095-C will be produced for the employee.

  • An employee that has a healthcare offer of coverage from the ACA Companion application during the reporting year AND the property "GSACA_FEINisSelfInsured" set to "True" (the employee is enrolled in self-insured coverage).

 

 

1095-C Part I

Part I of the 1095-C displays basic Employee and Employer information. The Employee and Employer information for this section pulls from the details in the core application. 


 


Employee Information: 

Field Information Sources From
Name Employee > Detail
Social Security Number
Address Primary address on record.

 


Employer Information: 

Field Information Sources From
Name Companion application > Employer details tab

 

 

FEIN
Address
Contact name
Contact phone number
Contact email

 

 

1095-C Part II

Part II of the 1095-C displays information about the employee's employment, healthcare offerings, and insurance enrollment throughout the reporting year. 


 


Line 14 Logic

Displays the full months that an offer of coverage was made. 

 

Code Description
1A-1G

Populates if:

  • A healthcare offer of coverage from the ACA Companion application touches the Employee's record for the full month.

  • The specific code used is populated based on the ACA Companion application's Employee plan details tab
1H Populates if: 
  • No healthcare offers of coverage from the ACA Companion application touch the employee's record that month
    OR
  • The healthcare offer of coverage from the ACA Companion application does not cover the full month.

 

 

Line 15 Logic

Displays the lowest cost monthly premium offered to the employee in months that an offer was made.

 

Code Description
$XX.XX
  • Will populate when a value populates if an offer of coverage is shown in Line 14 and if Line 14 does not equal 1H).

  • Dollar amount is determined by the ACA Companion application's Insurance plan setup tab > Monthly employee only minimum contribution value.

  • If the ACA Companion application's Insurance plan setup tab > Monthly employee only minimum contribution value is set to a percentage, the value will equal the percentage multiplied by the employee's gross wages for the month.
Blank This will be blank if Line 14 shows 1A, 1F, 1G or 1H. Line 15 is not required in combination with these codes. 

 

 

Line 16 Logic

Displays the information about months of employment, months enrolled in coverage, and if an affordability safe harbor was used when an offer of coverage was made.

 

Code Description
2A
  • Employee does not have an assignment touching that month

    OR

  • The assignment has a performance code that is marked as "False" for the Config Choice Property, "CountAsAssigned."
2B
  • Employee is considered non-full-time for that month and/or was terminated during that month. 

  • For 2015 ONLY: 2B will populate in January if the offer of coverage from the ACA Companion application starts on or before the first payroll of the year.
2C
  • A healthcare offer of coverage from the ACA Companion application touches that employee's record for the full month.
2D
  • Employee is in their limited non-assessment period, such as their initial measurement and/or admin periods. 

  • This will take the earliest EID on the employee's record in the reporting year.
2E - 2I
  • This will populate if the value is input for ACA Companion application's Insurance plan setup tab > Safe harbor code when none of the above conditions are met.
Blank
  • None of the above conditions for Line 16 are met

    AND/OR

  • The value for ACA Companion application's Insurance plan setup tab > Safe harbor code is blank.

 


1095-C Part III

Part III will only be completed if the employee was enrolled in self-insured coverage throughout the reporting year. Therefore, Part III will only populate data if the Supplier property "IsFEINSelfInsured" is set to "True" and the employee has a 2C for any month in Line 16. 

The dependent information populated in Part III sources from the ACA Companion application on the Employee Plan Details tab.

 

The employee will be listed in Part III as a covered individual in addition to any dependents on their plan. The dates of coverage for the employee and their dependents pulls from the start and end dates of the healthcare offer of coverage from the ACA Companion application.

If the coverage dates for the dependents are different from the employee's coverage dates, you may add an additional $0.00 healthcare deduction to the employee's file with the start and end dates that the dependent was covered. Then, enter the appropriate dependent information into the Notes field of this new deduction. 


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