For 2021, the due date to furnish recipient copies is March 2, 2022. Filers should note that with these Regulations, they will no longer be able to request an additional 30 days to furnish recipient statements. These Proposed Regulations provide for a one-time automatic 30-day extension every year – and eliminate the option for the IRS to grant any additional relief to a Filer beyond that initial 30 days. Due dates for Filing with the IRS do not change. Remember, Forms 1095-B and 1095-C must be filed with the IRS no later than February 28 annually if filing on paper, and no later than March 31, 2022 if filing electronically. Nothing in these Proposed Regulations changes those due dates. More information can be found her: https://sovos.com/blog/trr/irs-grants-permanent-relief-for-aca-recipient-forms-1095-b-c/ |
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 | Recipient info | Part I | |
| Rcp Account | 25 | Character | Recipient Account Number | ||
| Last Name/Company | 40 | Character | Employee last name/Company Name | ||
| First Name | 40 | Character | Employee First name | ||
| Rcp TIN | 11 | TIN | Recipient Tax ID Number | ||
| Address Deliv/Street | 40 | Character | Employee Delivery address | ||
| Address Apt/Suite | 40 | Character | Employee Apartment Suite | ||
| City | 40 | Character | Employee City | ||
| State | 23 | Character | Employee State | ||
| Zip | 15 | Character | Employee Zip | ||
| Box 14-17 Employer Offer and Coverage | Character | Employer Offer and Coverage | Filer Info | Part II | |
| Emp Age Jan 1st | 3 | Numeric | If the employee was offered an individual coverage HRA, enter the employee’s age on January 1, 2020 | Age range 1 to 120 | Part II |
| Plan Start Month | 2 | Numeric | Enter the two-digit number (01 through 12) indicating the calendar month during which the plan year begins of the health plan in which the employee is offered coverage | (Required Field) If there is no health plan under which coverage is offered to the employee, enter “00.” | Part II |
| All Months 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 |
Jan 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) | |
| Feb 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) | |
| Mar 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) | |
| Apr 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) | |
| May 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) | |
| Jun 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) | |
| Jul 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) | |
| Aug 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) | |
| Sep 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) | |
| Oct 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) | |
| Nov 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) | |
| Dec 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) | |
| All Months Premium | 12 | Amount | Box 15: Employee Share of lowest cost monthly premium.... | All12Months or Jan - Dec | Part II |
| Jan Emp Cost Share | 12 | Amount | Box 15: Employee Share of lowest cost monthly premium.... | All12Months or Jan - Dec | |
| Feb Emp Cost Share | 12 | Amount | Box 15: Employee Share of lowest cost monthly premium.... | All12Months or Jan - Dec | |
| Mar Emp Cost Share | 12 | Amount | Box 15: Employee Share of lowest cost monthly premium.... | All12Months or Jan - Dec | |
| Apr Emp Cost Share | 12 | Amount | Box 15: Employee Share of lowest cost monthly premium.... | All12Months or Jan - Dec | |
| May Emp Cost Share | 12 | Amount | Box 15: Employee Share of lowest cost monthly premium.... | All12Months or Jan - Dec | |
| Jun Emp Cost Share | 12 | Amount | Box 15: Employee Share of lowest cost monthly premium.... | All12Months or Jan - Dec | |
| Jul Emp Cost Share | 12 | Amount | Box 15: Employee Share of lowest cost monthly premium.... | All12Months or Jan - Dec | |
| Aug Emp Cost Share | 12 | Amount | Box 15: Employee Share of lowest cost monthly premium.... | All12Months or Jan - Dec | |
| Sep Emp Cost Share | 12 | Amount | Box 15: Employee Share of lowest cost monthly premium.... | All12Months or Jan - Dec | |
| Oct Emp Cost Share | 12 | Amount | Box 15: Employee Share of lowest cost monthly premium.... | All12Months or Jan - Dec | |
| Nov Emp Cost Share | 12 | Amount | Box 15: Employee Share of lowest cost monthly premium.... | All12Months or Jan - Dec | |
| Dec Emp Cost Share | 12 | Amount | Box 15: Employee Share of lowest cost monthly premium.... | All12Months or Jan - Dec | |
| All Months Safe Hbr | 2 | Code | Box 16: Applicable Section 408H Safe Harbor.... | 2A / 2B / 2C / 2D / 2E / 2F / 2G / 2H / (All12Months or Jan - Dec) | Part II |
| Jan Safe Harbor Code | 2 | Code | Box 16: Applicable Section 408H Safe Harbor.... | 2A / 2B / 2C / 2D / 2E / 2F / 2G / 2H / (All12Months or Jan - Dec) | |
| Feb Safe Harbor Code | 2 | Code | Box 16: Applicable Section 408H Safe Harbor.... | 2A / 2B / 2C / 2D / 2E / 2F / 2G / 2H / (All12Months or Jan - Dec) | |
| Mar Safe Harbor Code | 2 | Code | Box 16: Applicable Section 408H Safe Harbor.... | 2A / 2B / 2C / 2D / 2E / 2F / 2G / 2H / (All12Months or Jan - Dec) | |
| Apr Safe Harbor Code | 2 | Code | Box 16: Applicable Section 408H Safe Harbor.... | 2A / 2B / 2C / 2D / 2E / 2F / 2G / 2H / (All12Months or Jan - Dec) | |
| May Safe Harbor Code | 2 | Code | Box 16: Applicable Section 408H Safe Harbor.... | 2A / 2B / 2C / 2D / 2E / 2F / 2G / 2H / (All12Months or Jan - Dec) | |
| Jun Safe Harbor Code | 2 | Code | Box 16: Applicable Section 408H Safe Harbor.... | 2A / 2B / 2C / 2D / 2E / 2F / 2G / 2H / (All12Months or Jan - Dec) | |
| Jul Safe Harbor Code | 2 | Code | Box 16: Applicable Section 408H Safe Harbor.... | 2A / 2B / 2C / 2D / 2E / 2F / 2G / 2H / (All12Months or Jan - Dec) | |
| Aug Safe Harbor Code | 2 | Code | Box 16: Applicable Section 408H Safe Harbor.... | 2A / 2B / 2C / 2D / 2E / 2F / 2G / 2H / (All12Months or Jan - Dec) | |
| Sep Safe Harbor Code | 2 | Code | Box 16: Applicable Section 408H Safe Harbor.... | 2A / 2B / 2C / 2D / 2E / 2F / 2G / 2H / (All12Months or Jan - Dec) | |
| Oct Safe Harbor Code | 2 | Code | Box 16: Applicable Section 408H Safe Harbor.... | 2A / 2B / 2C / 2D / 2E / 2F / 2G / 2H / (All12Months or Jan - Dec) | |
| Nov Safe Harbor Code | 2 | Code | Box 16: Applicable Section 408H Safe Harbor.... | 2A / 2B / 2C / 2D / 2E / 2F / 2G / 2H / (All12Months or Jan - Dec) | |
| Dec Safe Harbor Code | 2 | Code | Box 16: Applicable Section 408H Safe Harbor.... | 2A / 2B / 2C / 2D / 2E / 2F / 2G / 2H / (All12Months or Jan - Dec) | |
| All Months Zip Code | 5 | Code | Box 17: Zip Code | Used by employers to determine affordability | Part II |
| Jan Zip Code | 5 | Code | Box 17: Zip Code | Used by employers to determine affordability | |
| Feb Zip Code | 5 | Code | Box 17: Zip Code | Used by employers to determine affordability | |
| Mar Zip Code | 5 | Code | Box 17: Zip Code | Used by employers to determine affordability | |
| Apr Zip Code | 5 | Code | Box 17: Zip Code | Used by employers to determine affordability | |
| May Zip Code | 5 | Code | Box 17: Zip Code | Used by employers to determine affordability | |
| Jun Zip Code | 5 | Code | Box 17: Zip Code | Used by employers to determine affordability | |
| Jul Zip Code | 5 | Code | Box 17: Zip Code | Used by employers to determine affordability | |
| Aug Zip Code | 5 | Code | Box 17: Zip Code | Used by employers to determine affordability | |
| Sep Zip Code | 5 | Code | Box 17: Zip Code | Used by employers to determine affordability | |
| Oct Zip Code | 5 | Code | Box 17: Zip Code | Used by employers to determine affordability | |
| Nov Zip Code | 5 | Code | Box 17: Zip Code | Used by employers to determine affordability | |
| Dec Zip Code | 5 | Code | Box 17: Zip Code | Used by employers to determine affordability | |
| Box 17- 34 Covered Individuals | Character | Covered Individuals | Employee Dependents | Part III | |
| Emp Self Insured Chk | 1 | Character | Employee Self Insured Checkbox | X / Y / T / 1 = Checked | |
| Last Name/Company | 40 | Character | Covered Individual last name | Part III | |
| First Name | 40 | Character | Covered Individual first name | Part III | |
| RCP TIN | 11 | TIN | Covered Individual SSN | Part III | |
| RCP Date of Birth | 10 | Date | Covered Individual DOB (if SSN is not available) | MM/DD/YYYY or M/D/YYYY | Part III |
| Ind All Coverage Chk | 1 | Checkbox | Covered Individual covered all 12 months | X / Y / T / 1 = Checked | Part III |
Ind Jan Coverage Chk | 1 | Checkbox | January Coverage | X / Y / T / 1 = Checked | Part III |
| Ind Feb Coverage Chk | 1 | Checkbox | February Coverage | X / Y / T / 1 = Checked | Part III |
| Ind Mar Coverage Chk | 1 | Checkbox | March Coverage | X / Y / T / 1 = Checked | Part III |
| Ind Apr Coverage Chk | 1 | Checkbox | April Coverage | X / Y / T / 1 = Checked | Part III |
| Ind May Coverage Chk | 1 | Checkbox | May Coverage | X / Y / T / 1 = Checked | Part III |
| Ind Jun Coverage Chk | 1 | Checkbox | June Coverage | X / Y / T / 1 = Checked | Part III |
| Ind Jul Coverage Chk | 1 | Checkbox | July Coverage | X / Y / T / 1 = Checked | Part III |
| Ind Aug Coverage Chk | 1 | Checkbox | August Coverage | X / Y / T / 1 = Checked | Part III |
| Ind Sep Coverage Chk | 1 | Checkbox | September Coverage | X / Y / T / 1 = Checked | Part III |
| Ind Oct Coverage Chk | 1 | Checkbox | October Coverage | X / Y / T / 1 = Checked | Part III |
| Ind Nov Coverage Chk | 1 | Checkbox | November Coverage | X / Y / T / 1 = Checked | Part III |
| Ind Dec Coverage Chk | 1 | Checkbox | December Coverage | X / Y / T / 1 = Checked | Part III |
| See Form Common Fields | Form fields common to all form types. |
