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IRS Release Status: FINAL
Sample Excel Import File: 1095-B 2016.xlsx
Import Form Fields:
Field Name | Size | Type | Description | Notes |
---|---|---|---|---|
See Form Filer Common Fields | ||||
See Recipient Common Fields | ||||
Rcp Email | 65 | Text | ||
Rcp IMB | 65 | Text | ||
Tax State | 2 | Text | ||
Emp TIN | 11 | Numeric | Part II: Employer EIN | |
Emp TIN Type | 1 | Numeric | Part II: Employer TIN Type | EIN=1, SSN=2, Unknown type=0 or blank |
Emp Address Type | 1 | Text | Part II: Employer Address Type | |
Emp Country Code | 2 | Text | Part II: Country Code | |
Emp Country Key | 1 | Numeric | Part II: Country Key | |
Emp Name 1 | 40 | Text | Part II: Employer Name 1 | |
Emp Name 2 | 40 | Text | Part II: Employer Name 2 | |
Emp Address 1 | 40 | Text | Part II: Employer Street Address | |
Emp Address 2 | 40 | Text | Part II: Employer Suite/Apt | |
Emp City | 40 | Text | Part II: City | |
Emp State | 23 | Text | Part II: Employer State/Province | |
Emp Zip | 15 | Text | Part II: Employer Zip/Postal Code | |
Rcp Date of Birth | 8 | Date | Recipient date of birth | MM/DD/YYYY or M/D/YYYY |
Policy Origin Code | 2 | Text | Letter identifying the origin of the policy | |
Ind All Coverage Chk | 1 | Checkbox | Individual: Covered all 12 months checkbox | X / Y / T / 1 = Checked |
Ind Apr Coverage Chk | 1 | Checkbox | Individual: Covered for April checkbox | X / Y / T / 1 = Checked |
Ind Aug Coverage Chk | 1 | Checkbox | Individual: Covered for August checkbox | X / Y / T / 1 = Checked |
Ind Dec Coverage Chk | 1 | Checkbox | Individual: Covered for December checkbox | X / Y / T / 1 = Checked |
Ind Feb Coverage Chk | 1 | Checkbox | Individual: Covered for February checkbox | X / Y / T / 1 = Checked |
Ind Jan Coverage Chk | 1 | Checkbox | Individual: Covered for January checkbox | X / Y / T / 1 = Checked |
Ind Jul Coverage Chk | 1 | Checkbox | Individual: Covered for July checkbox | X / Y / T / 1 = Checked |
Ind Jun Coverage Chk | 1 | Checkbox | Individual: Covered for June checkbox | X / Y / T / 1 = Checked |
Ind Mar Coverage Chk | 1 | Checkbox | Individual: Covered for March checkbox | X / Y / T / 1 = Checked |
Ind May Coverage Chk | 1 | Checkbox | Individual: Covered for May checkbox | X / Y / T / 1 = Checked |
Ind Nov Coverage Chk | 1 | Checkbox | Individual: Covered for November checkbox | X / Y / T / 1 = Checked |
Ind Oct Coverage Chk | 1 | Checkbox | Individual: Covered for October checkbox | X / Y / T / 1 = Checked |
Ind Sep Coverage Chk | 1 | Checkbox | Individual: Covered for September checkbox | X / Y / T / 1 = Checked |
1095-B Form:
IRS 1095-B Form: 1095-B Form
IRS 1095-B Instructions: 1095-B Instructions
Overview
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