1095-C Code Calculator Released


Recent Blog:  Payroll Vendor Doing ACA Reporting … MUST be HIPAA Compliant


The most confusing portion of the entire Affordable Care Act employer reporting comes to bear when considering the lines 14, 15 and 16 for form 1095-C.


There are nearly 100 various logic combinations to create the codes necessary for the IRS reporting to be completed correctly.  To assist employers and organizations in checking the validity of the logic of these lines 14, 15 and 16 of form 1095-C, we have created a calculator.


Here is how it works … Simply select the codes below for lines 14 and 16 below and then press ‘search’.  You will then see the full logic as to why certain code combinations work or do not work.

Click here to load this Caspio Online Database.

ACA Reporting That ‘Creates The Codes’…

Due to the number of questions we still receive on this issue, we thought it would be helpful to post so that everyone knows our process for creating ACA reporting fully completes all of the codes necessary on form 1095-C lines 14 and 16 on behalf of our clients.  This is by far the most complex portion of the ACA reporting and yet many reporting vendors in the marketplace require the employer to create these codes.  If you have read through the IRS guidance on reporting, you understand that this is a problem due to the complexity and is the main reason ACA reporting vendors in the marketplace even exist.

Our approach to ACA reporting was born out of an intensive understanding on how employee benefits work.  We are not a payroll or other type vendor trying to ‘get up to speed’ on employee benefits.  Rather, we understand that the ACA reporting on forms 1094 and 1095 is mainly employee benefit reporting.  We built a process designed to collect the minimum necessary amount of information from employers, and then we take it from there!

Need help?  Feel free to contact us via customer support at the top of the page.

Municipalities, School Districts, Governmental Entities – ACA Reporting

Municipalities, School Districts, Governmental Entities – ACA Reporting

Across the country municipal government, cities, towns and school districts are beginning to learn their responsibilities for Affordable Care Act (ACA) reporting to the IRS under Internal Revenue Code 6055 and 6056.  We speak to these municipal groups every day, and this often is a complete shock to them.  What do you mean I have a self funded plan?

For municipal groups and school districts under the state health plan in their given state, they are being notified that they are actually on a self funded plan.  The reason for this is the manner in which the states generally arrange these plans and file with their department of insurance.  Since these plans are self funded, they have very specific reporting requirements under the ACA.  The largest shock for these groups is that the states are not performing the reporting on their behalf, but rather it is the responsibility of each individual municipality, school district and other governmental entity.

Due to these facts, it is imperative that these organizations understand what their requirements are, preferably in a simple and easy manner.  To assist with the learning curve, we have recorded a free webinar that can be accessed on demand.  The goal of this webinar is to tell you only what you need to know, and to do this in less than 45 minutes.  The feedback for this session has been excellent, so we hope you find it helpful.  Simply press play below to get started.


Session Overview Notes:

  • Overall Presentation 40 minutes (the last 10 minutes covered most frequently asked questions)
  • Session was a quick (non-attorney) overview of ACA Reporting
  • What did the Affordable Care Act Accomplish?
    • Individual mandate to have health insurance  (IRS 6055)
    • Employer pay or play rules (IRS 6056)
  • How will the IRS ensure individual and employer compliance?
  • What are employers options when it comes to ACA Reporting