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An employee was hired on February 1st and became eligible for coverage on March 1st. Having completed the waiting period in March, he chose to waive coverage. However, the employee got divorced on May 15th, which is considered a qualifying event, and chose to enroll himself and his children in the company’s self-funded plan effective June 1st. What codes should be used on Form 1095-C?

Part-II of Form 1095-C should be coded as follows:

  • Line 14- Code 1H (No Offer of Coverage) should be used during the months the employee was not employed/not eligible for coverage. Use Code 1E throughout the months that the employee was eligible for coverage & MEC coverage providing MV was offered to the employee, spouse & dependents.
  • Line 15- The employee's monthly share of the lowest-cost self-only coverage offered is only required to be entered for the months when the employee was eligible.
  • Line 16- Enter Code 2A for the months that the employee was not employed. Code 2D is applied for the month(s) that the employee was in a waiting period. Code 2H (Rate of Pay Safe Harbor) is used for the months that the employee waived coverage. Code 2C is used for the months that the employee was enrolled in coverage.

Generating ACA codes for complex scenarios can sometimes be tricky and challenging, but it’s not always the case when you partner with our sister product, ACAwise. If you need help generating ACA codes on Part-II of the 1095-C form, please contact our ACAwise, an end-to-end ACA Reporting Service provider that offers: 

  • ACA 1095 Codes Generation
  • 1094 and 1095 Form Generation
  • IRS and State E-filing
  • Employee Copy Distribution

In addition to this, ACAwise also handles reporting for special cases like ICHRA, COBRA coverage, age band, rehires, etc.

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