ACA Forms Instructions ver .92

2016 

ACA IRS Compliance 

Kenneth F. Phillips 

Benefit Corporation of America, LLC. 

www.benefitscape.com 

508.655.3307

Introduction 

Thank you for providing the necessary data needed to prepare your ACA IRS filing for 2015.We 

are confident that the codes we have calculated for the IRS Form 1095C accurately reflect the 

data you have provided. 

The next step is for you to review the results that we have determined based on your data. By 

“review” we propose that you look over the data for accuracy and completeness. 

What we need you to do next 

There are PDF forms in your Sharefile 1 with the information to review. You should 

download the PDF forms and look them over. Instructions are on the next page. 

What we have done to insure accuracy and completeness 

Step 1. 

Discovery 

We have taken all of the plan rules, company data and applied the ACA 

IRS rules to your Organization. 

Step 2. 

Processing your 

Data 

We have taken your employee data, tested its accuracy and processed all 

of the data to determine which employees are to be reported to the IRS. 

Step 3. 

Producing your 

Reports 

The employee data is then processed by our systems to produce the 

‘results’ required by the IRS. These results are printed onto the Form 

1095C and prepared for publishing and mailing to each employee. 

These are the FORMS that you have to review 

After you have reviewed the forms you should communicate your 

comments to us. We will make the necessary corrections (if any are 

needed) and Print and Mail the Forms to your employees. 

Congratulations! Your compliance effort for 2015 is complete. 

1 If you do not know how to get access to your Share Folders please send us an email and we can help. y 

2 | Page Confidential 2016 BCA

How to review your forms 

The first item to review for accuracy is that the Company information is correct. 

Next step, please review the various codes. 

Step 1. Forms 

Review 

This is a 2 step 

process 

1. Check the 

Company 

Information. 

Make sure the 

phone number is 

correct! 

2. Review the 

OFFER codes for 

each employee. 

These are the possible OFFER Codes: 

 

 

1A or 1E means an offer of coverage was made 

1H means no offer of coverage was made 

The Safe Harbor codes are the reasons or the result for a certain offer. 

We determined these codes based on your employee data and plan rules. 

Additional common codes are: 

2C indicated the employee took the OFFER and has coverage in the 

months shown. 

2F, 2G 2H indicate employee waived the offer and has no coverage in the 

months shown. 

2A indicates the employee was not hired at the company. 

A complete listing of all the Codes that are available and their explanations are 

included in the Appendix attached to this document. 


For Self Funded Plans (Not Fully Insured)It is necessary to show coverage for 

each individual by month, check to see if the data appears correct. 

If any corrections are needed 

In addition to the above; we have provided you with a Spreadsheet with all of the Codes 

calculated for each employee (including any dependent information for each employee, 

if that information was required.)If you have any corrections you can highlight the errors 

on this Spreadsheet and put it back into the Sharefile. Then send us an email and we 

will set up a webinar or phone call. 

Remember: If the data contains personal information i.e. SSN do not send via email. 

Save and upload on the Secure Citrix Sharefile. 

If it’s all OK 

Send us an email and let us know you are ready for us to publish the Forms.We will 

then - 

Print the Forms for each person, 

Mail them to each employee’s address provided in the data 

The follow up…After the forms are mailed, some may come back for bad address, 

or there may be questions on the information. 

The best way to handle this is by email (if no personal information is involved). 

If you have certain information that is confidential please place it in the Secure Citrix 

Sharefile and send us an email explaining the situation. 


Appendix 

IRS Form 1095-C - Line 14 - Offer of Coverage Codes Lines 14, 15, and 16 

Offer of coverage codes should not be confused with the whether the employee 

accepted the coverage. The code indicates that you as the employer provided an “offer 

of health coverage to the employee” and is not affected by the employee acceptance of 

the offer or if the employee rejects the offer (a waiver). 

We have entered an offer of coverage for all 12 months if the employee was a 

full-time employee for one or more months during the year. 

VERY IMPORTANT - Regarding using codes 1A through 1F, the coverage offered must 

be applied to every day of the month. If the offer is less than for a full month codes 

1A/1E should NOT be used. If the employee only worked part of the month, then the 

only codes that should be used is 1H (No Offer). 

Situation 

MEC providing MV offer made to employee, 

dependents, and spouse. 

MEC providing MC offer made to employee only. 

MEC providing MC offer made to employee and 

dependents (not spouse). 

MEC providing MC offer made to employee and spouse 

(not dependents). 

MEC providing MC offer made to employee, 

dependents, and spouse, but cost is more than 9.5% of 

poverty line. 

MEC providing MC offer made to employee, 

dependents, and spouse, but no minimum essential 

value. 

MEC providing MC offer made to employee who was not 

a full-time employee for any month during the year and 

enrolled in coverage for one or more months. 

No offer of coverage. 

Quality Offer Transition Relief - Employee and spouse 

or dependents received no offer of coverage, received 

an offer that is not a qualifying offer, or received a 

qualifying offer for less than 12 months. 

Offer of Coverage Code 

1A 

Common 

1B 

Uncommon 

1C 

Uncommon 

1D 

Uncommon 

1E 

Common 

1F 

Uncommon 

1G 

Uncommon 

1H 

Common 

1I 

Uncommon 

MEC = Minimum essential coverage 

MV = Minimum value 

Other Situations: Employee terminated and offered COBRA coverage - Use 1H 


IRS Form 1095-C - Line 15 - Employee Share of Lowest Cost Monthly Premium, 

for Self- Only, Minimum Value Coverage 

Complete Line 15 only if code 1B, 1C, 1D, or 1E is entered on Line 14. The amount entered 

is the cost you would charge the employee for self-only coverage providing minimum 

essential coverage providing minimum value. This amount may NOT be the amount the 

employee is actually paying for coverage, for example, if the employee enrolled in family 

coverage and is paying $ 110 a month, but the amount that would be charged for selfcoverage 

only is $ 90, you would enter $ 90 on line 15. 

VERY IMPORTANT - An entry on line 16 is optional. We enter the appropriate 

code to fully describe the enrollment to the employee. Balnks tend to confuse 

and look like errors. 

Situation 

Employee not employed during month 

Employee not a full-time employee for 

the month and did not enroll in 

coverage offered or employee was a 

full-time employee and coverage ended 

before the end of the month because 

the employee terminated employment. 

Employee enrolled in coverage offered. 

Employee in an assessment period and 

not eligible for coverage. 

4980H Safe Harbor 

Code 

2A 

2B 

2C 

2D 

Use 

employees not yet 

employed 

Common 

Uncommon 

employees who take 

coverage 

Common 

in waiting period 

Common 

Multi employer interim rule relief. 2E Uncommon 

W-2 earnings used to determine 

affordability - code must be used for all 

months that the employee was offered 

coverage. 

Federal poverty line used to determine 

affordability. 

2F 

– Line 14 will 

probably be 1E 

2G 

- Line 14 will be 1A 

For waiver 

Common 


Common 

Rate of pay used to determine 

affordability. 

Non-calendar year transition relief. 

2H 

- Line 14 will be 1E 

2I 


Common 

Non calendar plans 

Uncommon

ACA Forms Instructions ver .92

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