Generating and Validating 1095-B Forms

1. From the Payroll screen, select the Government Reporting menu and then Affordable Care Act (ACA) B Forms.

Note: The Affordable Care Act (ACA) B Forms option is only enabled if a calendar year is defined within the Affordable Care Act (ACA) Reporting Setup option with Self-insured (Fully Self-funded) specified in the Plan Type field and the Large Employer (or Small Employer Treated as Large) field not selected.

2. The ACA B Forms Search screen will appear listing all the applicable calendar years (those defined within the Affordable Care Act (ACA) Reporting Setup option with Self-insured (Fully Self-funded) specified in the Plan Type field and the Large Employer (or Small Employer Treated as Large) field not selected). Double-click the desired calendar year for which to generate and validate the 1095-B forms.

3. At the Affordable Care Act (ACA) B Forms screen, click the General tab, if it is not already selected.

4. Complete the Employer Information section with the information to print on the 1094-B form.

Enter the name of your organization in the Employer Name field. The name can be up to 100 characters long.

Note: Initially, the organization name as shown in the System File will appear as the default (and can be changed), but thereafter, the default will be the information last saved in this field.

Enter the address (up to two lines) for your organization in the Address 1 and Address 2 fields. Each address can be alphanumeric and up to 50 characters long.

Note: Initially, the address entered in the Address 1 and Address 2 fields in the System File will appear as the default (and can be changed), but thereafter, the default will be the information last saved in this field.

Enter the city where your organization is located in the City field. The city can be alphanumeric and up to 30 characters long.

Note: Initially, the city entered in the City field in the System File will appear as the default (and can be changed), but thereafter, the default will be the information last saved in this field.

Enter the appropriate state abbreviation for your organization in the State field, or click the down-arrow button to select the correct one.

Note: Initially, the state abbreviation entered in the State field in the System File will appear as the default (and can be changed), but thereafter, the default will be the information last saved in this field.

Enter the zip code for your organization in the Zip Code field. The zip code can be alphanumeric and up to 20 characters long. The system will automatically add the dash in the zip code if 9 digits are entered, using the format of ##### - ####.

Note: Initially, the zip code entered in the Zip Code field in the System File will appear as the default (and can be changed), but thereafter, the default will be the information last saved in this field.

Enter the first name of the person who should be contacted with questions regarding the electronic submission in the Contact First Name field. The name can be up to 30 characters long.
If desired, enter the middle name or the middle initial of the person who should be contacted with questions regarding the electronic submission in the Contact Middle Name field. The name can be up to 30 characters long.
Enter the last name of the person who should be contacted with questions regarding the electronic submission in the Contact Last Name field. The name can be up to 40 characters long.
If applicable, enter the suffix (such as Jr. or Sr.) for the contact person in the Contact Suffix field, or click the down-arrow button to select the correct one.
If desired, enter the phone number for the contact person in the Contact Phone Number field. The phone number can be up to 30 digits long. The system will automatically add the dashes for the phone number (if entered with numbers only) using the following formats: 1) ### - #### if 7 digits are entered; 2) ### - #### x ## if 8 or 9 digits are entered; 3) ### - ### - #### if 10 digits are entered; or 4) ### - ### - #### x ## if 11 or more digits are entered.

Note: Initially, the phone number entered in the Primary Phone Number field in the System File will appear as the default (and can be changed), but thereafter, the default will be the information last saved in this field.

The federal ID number for your organization (as entered in the System File) appears in the Employer Identification Number (EIN) field and cannot be changed. If needed, change the federal ID number in the System File to update the information in this field.

5. Complete the Issuer or Other Coverage Provider section with the information to print in Part III on the 1095-B forms.

The Origin of the Health Coverage field defaults to B: Employer-sponsored coverage and cannot be changed. This is the code that will print in Line 8 of Part I on the 1095-B form.
Enter the name of the sponsor of the self-insured employer plan or other coverage sponsor in the Name field. The name can be up to 75 characters long.

Enter the mailing address (up to two lines) of the sponsor in the Address 1 and Address 2 fields. Each address can be alphanumeric and up to 35 characters long.

Enter the city for the sponsor in the City field. The city name can be alphanumeric and up to 22 characters long.
Enter the appropriate state abbreviation for the sponsor in the State field, or click the down-arrow button to select the correct one.
Enter the zip code for the sponsor in the Zip Code field. The zip code can be alphanumeric and up to 9 characters long (not including the dash). The system will automatically add the dash in the zip code if 9 digits are entered, using the format of ##### - ####.
Enter the phone number for the sponsor in the Contact Phone Number field. The phone number can be up to 30 digits long. The system will automatically add the dashes for the phone number (if entered with numbers only) using the following formats: 1) ### - #### if 7 digits are entered; 2) ### - #### x ## if 8 or 9 digits are entered; 3) ### - ### - #### if 10 digits are entered; or 4) ### - ### - #### x ## if 11 or more digits are entered.

Enter the federal ID number of the sponsor in the Employer Identification Number (EIN) field. The number can be up to 9 digits long (not including the dash). The system will automatically add the dash for the federal ID number if 9 digits are entered, using the format of ## - #######.

6. Click the Save button.

7. Click the Employee 1095-Bs tab.

8. In the View Option field, specify to view the 1095 information for employees that have or have not been submitted to the Internal Revenue Service. Enter Unsubmitted to view the 1095 information for employees that have not yet been submitted to the Internal Revenue Service, or enter Submitted to view the 1095 information for employees that have been submitted, or click the down-arrow button to select the correct one. By default, Unsubmitted will be selected.

9. All the employees with health coverage appear in the Employees List. For each employee, the information reported in Lines 1-7 of Part I on the 1095-B form displays, including the name, federal ID, birth date, and address.

Note: Only employees with applicable dates for the selected calendar year as entered in the Employee ACA Coverage Dates List on the ACA 1095s tab in the Employee File appear in the Employees List. The information displayed cannot be changed on this screen; if changes are needed, refer to the instructions for editing the 1095-B forms.

Steps to Edit 1095-B Forms

Tip: The birth date will only print on the 1095-B form if the employee does not have a federal ID entered.

10. To view all the dependents with health coverage under a particular employee, click on the employee in the Employees List and then the information for the employee and the dependents appears in the Covered Individuals List. For each covered individual, the information reported in Part IV on the 1095-B form displays, including the name, federal ID, birth date, and months of coverage.

Note: Only the dependents with applicable dates for the selected calendar year as entered in the Dependent ACA Coverage Dates List on the ACA 1095s tab (or the Dependents tab, if applicable) in the Employee File appear in the Covered Individuals List, along with the employee. The information displayed cannot be changed on this screen; if changes are needed, refer to the instructions for editing the 1095-B forms.

Steps to Edit 1095-B Forms

Tip: The birth date will only print on the 1095-B form if the covered individual does not have a federal ID entered.

11. To check the 1095s for common errors, click the Validate Employee 1095-Bs button located on the bottom of the screen. If there are errors, a screen will appear listing the employees with errors, along with a description of the error; the errors must be resolved before printing the 1095s or submitting the data to the Internal Revenue Service. Otherwise, if there are not any errors found, a message will appear; click OK.

Note: The Validate Employee 1095-Bs button is only enabled if Unsubmitted is specified in the View Option field.

Tip: If applicable, to print a listing of the errors, complete a print screen or print grid, or if desired, export the errors to a file using the Export Grid option.