1095-C 2019

IRS Release Status: FINAL

Sample Excel Import File:

What's New for 2019

Updated 2019 Verbiage added to Instructions.
No new form changes.

Import Form Fields:

Field Name	Size	Type	Description	Notes	Part
See Form Filer Common Fields			Filer fields common to all form types.
See Recipient Common Fields			Recipient fields common to all form types.
Record Type	1	Text	Record Type is a required field and it indicates if a record is the Responsible Individual/Employee.	Use E for Employee/Responsible Individual & C for Covered Individual
Box 1 - 6 Employee		Character	Employee	Filer Info	Part I
Box 7-13 ALE MEMBER (Employer)		Character	Applicable Large Employer Member	Recipient Info	Part I
Box 1 Name	40	Text	Box 1: Name of employee		Part I
Box 2 TIN	11	TIN	Box 2: Social security number (ssn)		Part I
Box 3 Address Deliv/Street	40	Character	Box 3: employee address	Recipient address line 1	Part I
Box 4 City	40	Character	Box 4: employee city	Recipient city	Part I
Box 5 State	2	Character	Box 5: employee State or province	Recipient US state or Canadian province (Use state abbreviation)	Part I
Box 6 Zip	10	Character	Box 6: employee zip	Recipient US zip or Canadian postal code	Part I
Box 7 Name	40	Character	Box 7: Name of employer	Filer Name or company name	Part I
Box 8 TIN	11	Character	Box 8: Employer identification number (EIN)	Filer TIN (EIN or SSN)	Part I
Box 9 Address Deliv/Street	40	Character	Box 9: Employer street address (including room or suite)	Filer address line 1	Part I
Box 10 Contact	20	Character	Box 10: Contact telephone number	Filer contact phone number	Part I
Box 11 City	40	Character	Box 13: Employer city	Filer city	Part I
Box 12 State	2	Character	Box 14: Employer State	Filer US state or Canadian province (Use state abbreviation)	Part I
Box 13 Zip	10	Character	Box 13: Employer Zip	Filer US zip or Canadian postal code	Part I
Box 14 Offer coverage	2	Code	Box 14: Offer of Coverage (enter required code)	1A / 1B / 1C / 1D / 1E / 1F / 1G / 1H / 1J / 1K (All12Months or Jan - Dec)	Part II
Box 15 Month Premium	12	Amount	Box 15: Employee Share of lowest cost monthly premium....	All12Months or Jan - Dec	Part II
Box 16 Safe harbor	2	Code	Box 16: Applicable Section 408H Safe Harbor....	2A / 2B / 2C / 2D / 2E / 2F / 2G / 2H / (All12Months or Jan - Dec)	Part II
Box 17- 34 Covered Individuals		Character	Covered Individuals	Employee Dependents	Part III
Last Name/Company	40	Character	Covered Individual last name		Part III
Middle Initial	12	Character	Covered Individual Middle initial		Part III
First Name	40	Character	Covered Individual first name		Part III
Suffix	2	Character	Covered Individual suffix	Jr , Sr	Part III
Name Line 2	40	Character	Covered Individual name line 2	Additional name line	Part III
Social Security Number	11	TIN	Covered Individual SSN		Part III
Date of Birth	10	Date	Covered Individual DOB (if SSN is not available)	MM/DD/YYYY or M/D/YYYY	Part III
Covered All 12 Months	1	Checkbox	Covered Individual covered all 12 months	X / Y / T / 1 = Checked	Part III
January Coverage	1	Checkbox	January Coverage	X / Y / T / 1 = Checked	Part III
February Coverage	1	Checkbox	February Coverage	X / Y / T / 1 = Checked	Part III
March Coverage	1	Checkbox	March Coverage	X / Y / T / 1 = Checked	Part III
April Coverage	1	Checkbox	April Coverage	X / Y / T / 1 = Checked	Part III
May Coverage	1	Checkbox	May Coverage	X / Y / T / 1 = Checked	Part III
June Coverage	1	Checkbox	June Coverage	X / Y / T / 1 = Checked	Part III
July Coverage	1	Checkbox	July Coverage	X / Y / T / 1 = Checked	Part III
August Coverage	1	Checkbox	August Coverage	X / Y / T / 1 = Checked	Part III
September Coverage	1	Checkbox	September Coverage	X / Y / T / 1 = Checked	Part III
October Coverage	1	Checkbox	October Coverage	X / Y / T / 1 = Checked	Part III
November Coverage	1	Checkbox	November Coverage	X / Y / T / 1 = Checked	Part III
December Coverage	1	Checkbox	December Coverage	X / Y / T / 1 = Checked	Part III
See Form Common Fields			Form fields common to all form types.

IRS Release Status: FINAL

Sample Excel Import File:

Import Form Fields:

1095-C Form:

IRS 1095-C Form: 2019 1095-C Form

IRS 1095-C Instructions: 2019 1095-C Instructions