120118 1094-C Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns Form Department of the Treasury Internal Revenue Service Part I Go OMB No. 1545-2251 CORRECTED to www.irs.gov/Form1094C for instructions and the latest information. Applicable Large Employer Member ALE Member 1 Name of ALE Member Employer 2 Employer identification number EIN 3 Street address including room or suite no. Signature For Privacy Act and Paperwork Reduction Act Notice see separate...instructions. Title Cat. No. 61571A Date Form 1094-C 2017 Page 2 a Minimum Essential Coverage Offer Indicator b Section 4980H Full-Time Employee Count for ALE Member c Total Employee Count for ALE Member d Aggregated Group Indicator All 12 Months Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec 120316 Page 3 Other ALE Members of Aggregated ALE Group Enter the names and EINs of Other ALE Members of the Aggregated ALE Group who were members at any time during the calendar year. 4 City or town 5...State or province 6 Country and ZIP or foreign postal code 7 Name of person to contact 8 Contact telephone number 9 Name of Designated Government Entity only if applicable For Official Use Only 17 Reserved. 18 Total number of Forms 1095-C submitted with this transmittal 19 Is this the authoritative transmittal for this ALE Member If Yes check the box and continue. If No see instructions ALE Member Information 21 Is ALE Member a member of an Aggregated ALE Group Yes No If No do not complete...Part IV. 22 Certifications of Eligibility select all that apply A. Qualifying Offer Method B. Reserved D. 98 Offer Method Under penalties of perjury I declare that I have examined this return and accompanying documents and to the best of my knowledge and belief they are true correct and complete. 4 City or town 5 State or province 6 Country and ZIP or foreign postal code 7 Name of person to contact 8 Contact telephone number 9 Name of Designated Government Entity only if applicable For Official...Use Only 17 Reserved. 18 Total number of Forms 1095-C submitted with this transmittal 19 Is this the authoritative transmittal for this ALE Member If Yes check the box and continue. 18 Total number of Forms 1095-C submitted with this transmittal 19 Is this the authoritative transmittal for this ALE Member If Yes check the box and continue. If No see instructions ALE Member Information 21 Is ALE Member a member of an Aggregated ALE Group Yes No If No do not complete Part IV. If No see...instructions ALE Member Information 21 Is ALE Member a member of an Aggregated ALE Group Yes No If No do not complete Part IV. 22 Certifications of Eligibility select all that apply A. Qualifying Offer Method B. Reserved D. 98 Offer Method Under penalties of perjury I declare that I have examined this return and accompanying documents and to the best of my knowledge and belief they are true correct and complete. 4 City or town 5 State or province 6 Country and ZIP or foreign postal code 7 Name...of person to contact 8 Contact telephone number 9 Name of Designated Government Entity only if applicable For Official Use Only 17 Reserved. 18 Total number of Forms 1095-C submitted with this transmittal 19 Is this the authoritative transmittal for this ALE Member If Yes check the box and continue. If No see instructions ALE Member Information 21 Is ALE Member a member of an Aggregated ALE Group Yes No If No do not complete Part IV.
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How to fill out IRS 1094-C
Instructions and Help about IRS 1094-C
How to edit IRS 1094-C
Editing IRS 1094-C can be crucial for ensuring that all information is accurate before submission. You can easily edit the form using pdfFiller’s tools, which allow you to input your data, correct mistakes, and ensure compliance with regulations. Make sure to review all areas of the form for any necessary updates.
How to fill out IRS 1094-C
Filling out IRS 1094-C involves a series of steps that require careful attention to detail. To complete the form, follow these steps:
01
Gather your organization’s information, including Employer Identification Number (EIN) and contact details.
02
Review the IRS 1094-C instructions to understand the requirements for your specific filing situation.
03
Complete each section of the form accurately, ensuring that data such as the number of full-time employees is correctly reflected.
04
Double-check all entries for accuracy before finalizing the form.
About IRS 1094-C 2020 previous version
What is IRS 1094-C?
IRS 1094-C is an annual information return form that large employers must file to report their compliance with the Affordable Care Act (ACA). This form serves as a transmittal document for individual identification and reporting information provided on IRS Forms 1095-C for employees.
Who needs the form?
IRS 1094-C must be filed by Applicable Large Employers (ALEs), which are employers with 50 or more full-time employees or equivalents. If your organization meets this criterion, you are required to submit this form alongside the corresponding 1095-Cs to report coverage offered to your employees.
Components of the form
IRS 1094-C comprises several key components including the following sections: employer information, total number of employees, employees with minimum essential coverage, and details regarding the type of health insurance offered. Each component is crucial in demonstrating your compliance with ACA requirements.
What information do you need when you file the form?
To file IRS 1094-C, you'll need your organization’s EIN, the name and address of the employer, and information about the health coverage provided to employees. Additionally, you should have demographic data regarding your full-time employees ready to accurately fill out the sections regarding coverage.
Where do I send the form?
The completed IRS 1094-C can be sent to the appropriate IRS service center based on where your business is located. It's vital to check the IRS guidelines for the exact mailing address and ensure your forms are submitted to the correct location to avoid processing delays.
What is the purpose of this form?
The primary purpose of IRS 1094-C is to provide the IRS with data about the health coverage offered to employees. This helps the IRS verify that applicable large employers are meeting the ACA's employer shared responsibility provisions. Accurate reporting can assist in preventing any potential penalties for non-compliance.
When am I exempt from filling out this form?
Employers that do not meet the 50 full-time employee threshold are exempt from filing IRS 1094-C. Additionally, certain small employers that qualify for specific relief under the ACA do not have to file this form. It's essential to consult the IRS guidelines to confirm your exemption status.
What are the penalties for not issuing the form?
Failure to file IRS 1094-C can result in substantial penalties. Employers may face fines if they do not report required information or if filings are inaccurate or late. The penalties can accumulate quickly, emphasizing the importance of timely and accurate submissions.
Is the form accompanied by other forms?
IRS 1094-C must be accompanied by Forms 1095-C for each full-time employee. The 1095-C form details the health insurance coverage provided to each employee and must be accurately filled out to align with the information reported on the 1094-C.
FAQ about IRS 1094-C
What should I do if I discover an error after filing my IRS 1094-C?
If you find an error on your IRS 1094-C after filing, it’s essential to correct it by submitting an amended form. Make sure to check the IRS guidelines to ensure compliance and use the correct corrected form. For tracking the correction, maintain records and be aware of possible delays in processing.
How can I verify if my IRS 1094-C has been received and processed?
To verify the receipt and processing of your IRS 1094-C, you can check the status through the IRS's e-file system. If you filed via e-file, you may also receive confirmation of receipt. Keep an eye on any rejection codes that may indicate issues with your submission.
What privacy or data security measures should I consider when filing my IRS 1094-C?
When filing your IRS 1094-C, ensure the protection of sensitive data by using secured software or platforms compliant with IRS regulations. It's crucial to protect personal information to prevent unauthorized access and maintain privacy. Follow best practices for data security even after filing.
What common mistakes should I avoid when submitting my IRS 1094-C?
Common mistakes include misreporting employee counts and incorrect employer details. Review each section carefully, as inaccuracies can lead to penalties or delays. Double-checking your entries against IRS guidelines can help ensure a smoother filing process and minimize errors.
Use this catalog to find any type of IRS forms. We've gathered all of them under this section uncategorized to help you to find a proper form faster. Once you spot it on this list, have a look at the versions and schedules you might need as attachments. All returns are available for 2016 and for previous fiscal years.
