The six 1095 and 1094 forms and what each does

What’s a 1095? Which do I need?

It’s ACA reporting season again, and forms are rolling out.

Here’s a friendly reminder of the SIX different forms and what their respective purposes are:

1094 - Plan Or Issuer Transmittal - think of it like a fax cover sheet (if you’re old enough to remember those, or work in a doctor’s office where the machines are still unexplainably very active).

1095 - Individual Information Forms

A - Exchange Based Coverage

B - Proof of Enrollment

C - Proof of Applicable Large Employer Offer and Enrollment Outcome. Also Proof of Enrollment for Self-Funded Plans

Only the IRS needs the 1094, and that is really to account for the 1095s submitted by an entity.

Individuals use the 1095 for tax purposes when:

- they have received an Advanced Premium Tax Credit (APTC) for exchange coverage (1095-A).

- they need to show compliance with the individual mandate (1095-B, 1095-C for self-funded plans).

- they need to validate that their employer offer did not disqualify them from an APTC (1095-C).

The don’t actually have to be filed with an individual tax return, but should be kept as proof in the event of an audit.