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1094-c instructions PDF Form: What You Should Know

Enter the employee's date of birth (MM/DD/YYY). Line 4. Enter the information for the insurance coverage obtained through the employer (including the health insurance premium, any tax credits and any out-of-pocket expenses). Line 5. Enter the type of coverage obtained through the employer (Medicare, Medicaid, Trocar, Trocar Prime, a military or other benefit, TRI CARE Prime, Veterans Administration, VA Prescription drug program, Medicare Advantage, or COBRA plan). Line 6. Enter the name of the plan and whether it is a group plan (such as a family membership plan, a group coverage or a health maintenance organization). Line 7. Enter the number of individuals enrolled in the plan. Line 8. Enter the total number of individuals (excluding dependents under age 19 and those in the immediate family of the employee). Line 9. Enter the number of dependent children under age 19 (including one or more adopted children) and how many are covered under the plan. Line 10. Enter the cost for the employer-provided coverage obtained by the employee. Line 11. Enter any additional information about the employee (such as marital status, employer, marital status for the spouse of the employee and other information). Line 12. Enter the employee's taxpayer identification number (PIN). Line 13. Enter employer information. Line 14. Enter the tax year of employment. Line 15. Add the employer's filing status. If it's a partnership, enter “2.” The tax year is the calendar year. Line 16. Enter the total wages for the year and how much was paid in wages for self-only coverage and how much was paid in wages for family coverage. Line 17. Enter the total number of persons covered and how many were in each of the following categories: self-only and family coverage. Line 18. Enter the number of employees eligible for self-only coverage and how many were in the group. Line 19. Add the employee's premium (X). Line 20. Add the cost for self-only coverage obtained by the employee and the employer's cost for the same coverage. Line 21. Add the employee's co-pay (X). Line 22. Add the employee's cost for family coverage obtained by the employee. Line 23. Add the employee's co-pay (X). Line 24. Add the employee's additional payments (X). Line 25.

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Instructions and Help about Form 1094-c instructions PDF

Welcome to Express IRS forms your premier online tax solution for following your IRS information returns accurately and easily Express IRS forms is the answer to your Affordable Care Act II filing questions the easy-to-use program complete with bulk upload and error check features will help you finish your filing faster than you ever imagined to begin a filing form 1095-c log into your Express IRS forms account and click start new return then start your ACA forms by clicking start now first pick your organization name from the address book or add a new one by manually entering their information below and choose whether you'll be following this organization as an employer or insurer review the organization name in address details contact details and signing authority for the organization you are filing for then click Next is your group a member of an aggregated group select yes if you are a member of an aggregated group and into your aggregated group details if not just select no then click Next to help us decide on the appropriate form that needs to be found prthe type of insurance sponsored by the organization and into your full time employee count to determine as an applicable large employer we recommend you to use our worksheet for full-time employee calculation if you know which form to file click I know which form to file based on my injury our proceed to file form 1095-c as my organization has employed more than 50 employees click start 1 1095-c to continue now prnew employee details and employer offered coverage details here you can manually add employees and complete the details by clicking add employee or you can bulk upload all 50 plus employees using our custom Excel template just download the empty Excel template and...