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ACA Webinar #2: October 28, 2009 1095C: Configuring the Applicable Large Employer (ALE) Laura Smith, PHR training checkpoint hr. Company O LLHRMSBENEFITSAgenda Establish PACA Reporting Settings Configure

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How to fill out 1095-c configuring form applicable

01

Obtain the 1095-C configuring form applicable from your employer or the IRS website.

02

Fill out the 'Employer Information' section, providing your employer's name, address, and employer identification number (EIN).

03

In the 'Employee Information' section, provide your personal details such as your name, social security number (SSN), and address.

04

Complete Part II - 'Offer of Coverage' by indicating the type of coverage offered, the months it was offered, and the employee's share of the lowest-cost monthly premium.

05

If you or any family members were enrolled in self-insured coverage, complete Part III - 'Covered Individuals' by providing their names and SSNs.

06

Review the completed form for accuracy and double-check all the information provided.

07

Submit the form to the appropriate recipient as per the instructions provided by your employer or the IRS.

Who needs 1095-c configuring form applicable?

01

Employers with 50 or more full-time equivalent employees during the previous year.

02

Applicable Large Employers (ALEs) who are required by the Affordable Care Act (ACA) to provide health insurance to their employees.

03

Employees who are enrolled in employer-sponsored health coverage, including self-insured coverage.

04

Individuals who need to report their health coverage to the IRS for tax purposes.

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