Form Basics
- Distribution deadline is normally: JANUARY 31 (if not extended) by which Forms 1095-C & 1095-B must be given to full-time (benefit-eligible) employees.
- Filing deadline: MARCH 1 (if filing by paper) or MARCH 31 (if filing electronically).
- Refer to the form instructions to determine whether you need to file electronically.
- Employers are required to submit transmittal and summary forms together, just as with W-2s and the W-3.
Registration
- All employers must be registered to electronically file 1095s. You are responsible for registering and obtaining a Transmitter Control Code (TCC) from the IRS to complete the filing.
Program Updates
- It is imperative that you have received the latest Payroll and W-2 programs, which contain the reporting year form / filing changes for 1099s and W-2s, as well as the forms for ACA reporting. If you have older programs, then amounts/data may print in the wrong boxes, or not print at all.
- Please refer to the Product Announcements to ensure the version of programs that contain the forms for the reporting year.
- If you signed up for RDA's Print Service, you should wait until the mid-January program release before running forms. Print Service instructions will be made available at that time.
- The electronic filing will be included in a release in early to mid-January.
- To verify the Compile and Release Dates and Version number, go to System Administration → Version Control → Program Update Status.
Tracking Hours Worked
- Throughout the year, you should have been tracking hours worked by employees in payroll, so that full-time employees can be identified, and benefit-eligible employee counts can be reported on Form 1094-C.
- Reports that are available to track hours are the Job Pay Rate Units (Payroll module → Reports → General Payroll info → Job Pay Reports → Job Pay Rate Units) and Calendar Job Rate Monthly Summary (Reports → Calendar and Fiscal Year → By Calendar Period).
- If units were not properly tracked on particular employees, adjustments to units can be made under Maintenance → Adjustments → Change Payroll Earnings Amounts. Please submit a help desk ticket for guidance if you think you need to make adjustments.
- Submit a help desk ticket if you need direction on how to track employees' hours in future payrolls.
Personnel Demographics
- Personnel Demographics → Benefits tab
- In order for the 1095 reporting to be accurate, specific fields must be populated.
- The fields in the table below must be populated for each employee as applicable.
| FIELDS | Opt. | Rec. | Req. | Description |
|---|
| Group Health Insurance Eligibility Date | — | — | ♦ | Enter the date on which the employee became eligible for group health insurance. This date is for reference purposes only; the system does not key on this date as an effective start date. It keys on the Eligible boolean being flagged (see below). |
| Group Health Insurance Eligible | — | — | ♦ | Flag this boolean if the employee is eligible for group health insurance. This flag (not the Eligible Date field) is what triggers the system to flag the months in the Health Insurance Eligible column when Update Payroll History is run. |
| Group Health Insurance Participating | — | — | ♦ | Flag this boolean if the employee is participating in group health insurance. This flag is what triggers the system to flag the months in the Health Insurance Participating column when Update Payroll History is run. |
| Coverage Code | — | — | ♦ | Enter the Coverage Code that is applicable for the employee; This denotes the offer or non-offer of group health insurance to the employee; EVERY eligible employee who will get a 1095 MUST have a Coverage Code; If the employee was not offered coverage at any time during the year, and will subsequently not receive a 1095, then no Coverage Code needs to be selected. |
| Safe Harbor Code | — | — | ♦ | Enter the Safe Harbor Code that is applicable for the employee. This denotes the employee's insurance coverage. Note that a selection of NA will result in a blank (i.e., no code) on the 1095-B/1095-C. |
| Group Health Insurance Termination Date | — | — | ♦ | Enter the date that the employee's insurance ended. This date is for reference purposes only; the system does not key on this date as an effective end date. When an employee's insurance coverage ends, the Participating boolean should be un-flagged, which will cause the months in the Health Insurance Particpating column to no longer get flagged when Update Payroll History is run going forward. |
| Opt. = Optional Rec. = Recommended Req. = Required |
Personnel Dependents
- Self-insured organizations must report information about employees' covered dependents. This information must be entered so that it can appear in Part III on Form 1095-C, and in Part IV on Form 1095-B for organizations that are either self-insured or have > 50 employees.
- In order for the box in Part III of Form 1095-C to be checked, and for dependents to be listed on the 1095-C and 1095-B, the “Self-Insured Organization” GSV must be flagged under Setup → Setup Variables → Generic Setup Variables. Please contact RDA if you see that this GSV is not already flagged.
- Non-Enterprise customers that are self-insured or have > 50 employees need to have the Dependent Bundle turned on in order to have access to the Personnel Dependents Maintain Screen, where dependent information and eligibility must be tracked. Please contact RDA if you're a self-insured organization and don't already have access to this screen. We will turn on the Dependent Bundle at no charge.
- Personnel Demographics → Personnel → Dependents
- Enter required dependent information and eligibility for coverage; refer to table below:
| FIELDS | Opt. | Rec. | Req. | Description |
|---|
| Dependent Number | — | — | ♦ | Leave as 0 for the next available number to be assigned. |
| Dependent Name | — | — | ♦ | Enter dependent's full name. |
| Relationship | — | — | ♦ | Enter the dependent's relationship to the employee (ex., spouse, child). |
| Social Security Number | — | — | ♦ | Enter the dependent's SSN. Either the SSN or DOB should be entered, as one should appear on the form. |
| Date of Birth | — | — | ♦ | Enter the dependent's DOB, if available. Either the SSN or DOB should be entered, as one should appear on the form. |
| Eligible for Health Coverage | — | — | ♦ | Flag this field if the dependent is eligible for the employee's group health insurance; leave blank if he/she is not eligible for coverage |
| Opt. = Optional Rec. = Recommended Req. = Required |
- Click Save on the Dependents Maintain Screen, and click Dependent Calendar.
- Click + (Add), and populate the fields described below:
| FIELDS | Opt. | Rec. | Req. | Description |
|---|
| Calendar Year | — | — | ♦ | Enter the year. |
| Covered: January - December | — | — | ♦ | Flag each month during which the dependent was covered. |
| Make All Months Covered | — | — | ♦ | Selecting this boolean will flag all months (i.e., January through December) in the Covered column; individual months can be deselected if appropriate for the dependent's situation. |
| Opt. = Optional Rec. = Recommended Req. = Required |
Personnel Calendar Summary
- Personnel Demographics → Payroll → Calendar Year → select year → Group Health Insurance tab
- Refer to the "Notes on Retirees" section below for instructions on manually adding a Personnel Calendar Summary for retirees that were not paid in the calendar year.
- Once employees' Eligibility and Participating flags, Coverage Codes and Safe Harbor Codes are set on the Benefits tab in Personnel Demographics, those flags and codes will automatically populate for each month on the employees' Personnel Calendar Summary Maintain Screen. This occurs when the Update Payroll History process is run as part of the payroll process.
- Note that Undo Update Payroll History will not undo Coverage Code, Safe Harbor Codes, Eligibility or Participating flags.
- You will need to manually populate the month columns that could not be automatically updated due to the fact that the employees' Benefits tab fields were not populated at the time Update Payroll History was run, or due to the fact that the employees weren't paid in a particular month.
- Options to manually populate the month columns: (Option 1): Go to each individual employee's Personnel Calendar Summary Maintain Screen to flag and populate fields (see definitions below) for each month as applicable, or (Option 2): Use one or more in-mass processes to populate one or multiple fields for groups of employees at once.
| FIELDS | Opt. | Rec. | Req. | Description |
|---|
| Health Insurance Eligible: January - December | — | — | ♦ | Each month that the employee was eligible for group health insurance should be flagged; If this field is flagged at any time during the calendar year, the system will produce a 1095 for the employee. |
| Health Insurance Participating: January - December | — | — | ♦ | Each month that the employee participated in group health insurance should be flagged. |
| Make All Months Eligible | — | — | ♦ | Selecting this boolean will flag all months (i.e., January through December) in the Health Insurance Eligible column; individual months can be deselected if appropriate for the employee's situation. |
| Make All Months Participating | — | — | ♦ | Selecting this boolean will flag all months (i.e., January through December) in the Health Insurance Participating column; individual months can be deselected if appropriate for the employee's situation. |
| Coverage Code: January - December | — | — | ♦ | The Coverage Code that describes the employee's offer/non-offer for each month should be populated; If the employee was eligible for coverage at any point during the year, and will subsequently get a 1095, then a Coverage Code for each month should be populated; For any months in which she wasn't offered coverage, 1H should be selected. |
| Safe Harbor Code: January - December | — | — | ♦ | The Safe Harbor Code that describes the employee's coverage/non-coverage for each month should be populated. |
| Opt. = Optional Rec. = Recommended Req. = Required |
Notes on Retirees
- Forms must be given to ALL EMPLOYEES, including RETIREES that were eligible for your group health insurance in the calendar year. In the case of retirees that did not work during the year, you will need to perform the following steps:
- If a Personnel Demographicrecord doesn't already exist for the employee:
- Add him/her via the Add Personnel screen as normal, with only the standard, required fields populated
- Leave the Current Employee boolean un-flagged
- Flag the Group Health Insurance Eligible field on the Benefits tab
- After saving the demographic record, there is not need to click the buttons at the bottom of the screen (Hire Employee, Add Standard Deductions, etc.)
- Add a Personnel Calendar Summaryfor the year:
- From the saved demographic record, go to Payroll -> Calendar Year, click + (Add) on the Personnel Calendar Summary Browse screen, and add and save a record for the applicable Calendar Year
- Add a FEDERAL Deduction Masterto the employee:
- From the saved demographic record, go to Payroll -> Deductions, click + (Add), and select, activate and save the FEDERAL deduction
- With the saved FEDERAL Deduction Master selected, go to Deduction Summary -> Calendar, click + (Add), and add and save a record for the applicable Calendar Year
Notes on Multiple Federal Deductions
If there are two Federal Deductions such as FEDERAL and FEDERAL 25% or FEDERAL and FEDERAL2020, the employee's Deduction Master Maintain screen for the FEDERAL 25 or old FEDERAL deduction must be marked as ACA Secondary Deduction at the top to avoid printing each dependent twice. The employees and dependents are associated with an Employer ID by the Federal deduction, and two deductions indicate two Employer IDs.
In-Mass Process to Populate Flags/Codes
- Maintenance → Set, Change or Clear
- You may use one or more of these processes to set flags and fields for groups of employees.
- Read the instructions on the Report Description tabs, and RANGE CAREFULLY. There is no Undo that will reverse what is set with these in-mass processes.
- Set ACA Using Employment Type: This process allows for the GHI-related fields and booleans in Personnel Demographic to be set in mass by ranging on Employment Type. The most common range is on Pay Group; for example, one option is to range on your SUBSTITUTES Pay Group to assign Coverage Code 1H to all subs. This is a process exceptions report, which means you can select individual employees from the list in order to override their ACA fields as necessary.
- Set ACA Using Deduction Type: This process allows for GHI-related fields in Personnel Demographics to be set in mass based on the employees' Deduction Description's Coverage Code. Populating the Coverage Code field on the Deduction Descriptions is a prerequisite step. Note that this process will not set the Safe Harbor Code field, and it is not a process exceptions report, although a report will generate for review before flags get set.
- Mass Backload GHI Codes: This process allows codes and flags to be set for all months in the Personnel Calendar Summary based on how they're set in Personnel Demographics. The key to this process is finding a way to range on employees. The backload process can be used to fill in blank fields, but not to change fields that have already been populated, so be careful when running the backload. This is a process exceptions report, which means you can select individual employees from the list in order to override their ACA fields as necessary. An active non deleted job master is required as well as the Personnel Calendar Year Summary for the reporting year must exist for employees to be included in this process
Verify Personnel Calendar Summaries
- Reports → Calendar and Fiscal Year → By Calendar Period → Personnel Calendar Pay By Month
- Before running 1095 forms, run this report for the reporting year to verify that each employee's GHI and Safe Harbor codes are correct and populated for all months.
- Make sure that terminated employees have their GHI Termination Date field populated and their Eligibility and Participating booleans un-flagged. The Terminate Employees process (in the Other menu) allows those and other fields to be set in mass for the employee at termination.
Print Forms
- Printed forms must be distributed to employees, except employees that consent to receive the statement in an electronic format (i.e., as an email attachment or a document uploaded to ESS).
- Other → 1095 Setup
This consent must be an original created by yourself, or copied from a public domain or similar free resource (see OpenRDA Wiki:Copyrights for details). Do not submit copyrighted work without permission! Summary:
- 1095-B Report and Form: Populate the Resources tab as described in the table below:
| FIELDS | Opt. | Rec. | Req. | Description |
|---|
| Employer Identification | — | — | ♦ | Enter exactly what appears in the Employer ID field (NOT YOUR EIN) in the Employer Master under Setup (you may copy and paste it); This is NOT your EIN number. By entering it exactly, the system will pull the EIN, Name and Address from the Employer Master, and print it on the form. |
| Contact Phone Number | — | — | ♦ | Enter a phone number of the person whom employees should contact with questions related to the form. |
| Policy Origin | — | — | ♦ | Select the appropriate option (A-F) to print in Line 8; To determine which option to populate, refer to the form instructions. |
| Opt. = Optional Rec. = Recommended Req. = Required |
- Various range and select criteria are available on the Range and Select tabs, so that you can print forms for only certain employees if desired.
- Only employees that have an Eligible flag (in any month) in the Personnel Calendar Summary will be included.
- Note that there are sort options available, including a Sort by Location, as there are for W-2s. If you are distributing 1095s at the same time as W-2s, it is imperative that you choose the same sort order on this process that was used when setting Control Numbers for W-2s.
- Customers that are using pre-printed forms: You should print the form in landscape, even though the instructions (on the back) are in portrait.
- No Device Window will display. Click Cancel in the OK Acknowledgement window, at which point, the 1095s will be available in E-Documents to view/print.
- 1095-C Report and Form: Populate the Resources tab as described in the table below:
| FIELDS | Opt. | Rec. | Req. | Description |
|---|
| Employer Identification | — | — | ♦ | Enter exactly what appears in the Employer ID field (NOT YOUR EIN) in the Employer Master under Setup (you may copy and paste it); By entering it exactly, the system will pull the EIN, Name and Address from the Employer Master, and print it on the form |
| Contact Phone Number | — | — | ♦ | Enter a phone number of the person whom employees should contact with questions related to the form. |
| 2 Digit Plan Start Month | ♦ | — | – | This is now mandatory beginning with the 2016 Form 1095-C; To complete the box, 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 (or would be offered coverage if the employee were eligible to participate in the plan); If more than one plan year could apply (for instance, if the employer changes the plan year during the year), enter the earliest applicable month; If there is no health plan under which coverage is offered to the employee, enter 00. |
| Lowest Cost Health Insurance Offered: January - December | — | — | ♦ | Enter the employee share of the lowest-cost monthly premium for self-only minimum essential coverage that is offered, even if the employees do not elect the lowest cost plan. |
| Opt. = Optional Rec. = Recommended Req. = Required |
- Note that there are sort options available, including a Sort by Location, as there are for W-2s.
- Customers that are using pre-printed forms: You should print the form in landscape, even though the instructions (on the back) are in portrait.
- If you are using forms purchased from RDA with instructions pre-printed on the back, check box to Skip Instructions Page.
- No Device Window will display. Click Cancel in the OK Acknowledgement window, at which point, the 1095s will be available in E-Documents to view/print.
Archive Forms
- The Archive Forms process will archive each employee's 1095 in their Personnel Documents.
- Forms will automatically archive to E-Documents, which will enable you to reprint individual forms if necessary.
- Please note that you will not be able to work in OpenRDA while this process is running, and it takes approximately 45 minutes, so plan accordingly.
- Other → 1095 Setup → Archive 1095-B and C Report and Forms
- Populate the Resources tab the same way you did for the 1095B/C Report and Form.
- Various range and select criteria are available on the Range and Select tabs, so that you can archive forms for only certain employees if desired.
Email Forms
- Other → 1095 Setup → Archive 1095-B and C Report and Forms
- This process will email archived forms.
Employee Self Serve
Prerequisites
- Your organization's Employee Self Serve (ESS) site must be active.
- 1095s must be archived, via the Archive 1095 process.
- In order for the 1095 archives to be available (in the Document Type drop-down list) to be uploaded to ESS, the 1095 Document Type needs to be flagged as being a Document Type that is able to be uploaded. In the Personnel module, go to Setup -> Document Types: select the 1095 Document Type, and make sure "Upload to ESS" is flagged.
Upload Documents to Employee Self Serve (ESS)
- Go to HR → Personnel → Maintenance → Open Self Serve → Uploads → Upload Documents)
- Range on Document Type of 1095 FORM to 1095 FORM.
- Ranging on Last Notification Date is also recommended. This date corresponds to the date the 1095s were archived and can be found on any employee's 1095 Personnel Document.
- Click Run/Print Report.
- Once upload process is completed, the documents will be available to view/print in ESS.
- Employees can find their 1095 in pdf format, in Attachments/Documents with the name (YEAR) FORM 1095.
- A 1095 can be viewed by clicking the Download link.
- A downloaded 1095 can be printed by clicking the printer icon in the upper-left corner of the screen.
1094 Forms
- Paper forms are not currently available in OpenRDA, however, there are links for the 1094-B Form and 1094-C Form under Other → 1095 Setup. The links take you to the forms on the IRS website.
Print Services
The following instructions are only for those customers that have paid for Print Services through RDA. Once you have all your contracted data (W-2, 1095 and/or 1099) ready for printing, follow the steps outlined in the "OpenRDA W/2, 1095 and 1099 Print Service Guide" attachment emailed to you by Mimi. The instructions specific to 1095s are to:
- Create the 1095-C print file, using the same sort order that was used when setting Control Numbers for W-2s, populating the Resources tab, and ranging as desired (if at all).
- Send an email back to Mimi with the subject line "W2s Ready for Printing" or "W2s and 1095s Ready for Printing", depending on which forms you contracted to have RDA print.
Electronic File
- RDA will not be electronically filing these forms for you.
- RDA has provided a way for you to create the electronic file yourself.
- You are responsible for registering and obtaining a Transmitter Control Code (TCC) from the IRS to complete the filing. Note that this is different from your W-2 TCC.
- The electronic filing for ACA will be included in a future program release
- Instructions for running your ACA electronic file
