Use this article as a column reference when you fill out the 1095-B employee import spreadsheet. Download the template from BerniePortal, complete it, then upload it to add employees to the 1095-B List. For IRS field definitions, use the Instructions for Forms 1094-B and 1095-B.
Who this is for
Employers with Benefits enabled, and Feature Admins who can administer 1095.
Before you begin
Finish configuring your 1094-B/1095-B subgroups before you can use the List tab. If subgroups are incomplete, the List page prompts you to finish configuration. See Configuring your 1094-B/1095-B forms.
Download and import the template
- Go to top nav 1094/1095, then secondary nav List.
- Select Add Employees.
- In the Add New Employees dialog, select Import Employees Using 1095-B Spreadsheet.
- In the Import dialog, select Download to get the employee template. You must use this template or the import will not work.
- Fill in employee information in the spreadsheet (column rules below).
- Under Upload your data, choose your completed .xlsx or .xls file, then select Import.
Leave the first two header rows in the template unchanged. Start employee data on row 3.
These columns identify the employee and assign the form to a 1094 subgroup.
- First Name (Column A) — Required. Letters, spaces, and hyphens only. Maximum 20 characters.
- Last Name (Column B) — Required. Letters, spaces, and hyphens only. Maximum 20 characters.
- Address (Column C) — Required. Letters, numbers, spaces, commas, periods, apostrophes, and hyphens are allowed.
- City (Column D) — Required. Letters, numbers, spaces, commas, periods, apostrophes, and hyphens are allowed.
- State (Abbreviation) (Column E) — Required. Exactly 2 letters (for example, OH).
- ZIP (Column F) — Required. Use 5 digits, or ZIP+4 as 12345-6789.
- Social security number (Column G) — Provide a 9-digit SSN unless you enter a date of birth in Column H. Hyphens are stripped on import. An employee with the same SSN cannot already exist in that 1094 subgroup.
- DOB if SSN not available (YYYY-MM-DD) (Column H) — Required when Column G is blank. Use YYYY-MM-DD. Cannot be a future date. You may also provide both SSN and date of birth.
- 1094 subgroup reference code (Column I) — Required. Must match an existing 1094 subgroup reference code in BerniePortal (shown in the Subgroups area).
- Health Coverage Code (Column J) — Required Line 8 origin code. Must be one of: A, B, C, D, E, F, or G. See the IRS instructions linked above.
Employee covered individual (columns K–Z)
The template labels this block Employee. The import expects covered-individual details for the employee on every row.
- First Name (Column K) — Required. Same name rules as Column A.
- Last Name (Column L) — Required. Same name rules as Column B.
- Social security number (Column M) — Provide a 9-digit SSN unless you enter a date of birth in Column N.
- DOB if SSN not available (YYYY-MM-DD) (Column N) — Required when Column M is blank. Use YYYY-MM-DD. Cannot be a future date.
- Coverage (Yes/No) (Columns O–Z) — Enter yes or no for each month (Jan–Dec). Values are not case-sensitive. Any value other than yes is treated as no.
Dependents (columns AA and beyond)
The template includes Dependent 1 through Dependent 12. Include a dependent only when that person was covered for at least one month. Each dependent block uses the same 16-column pattern:
- First Name — Required for that dependent. Leaving First Name blank skips the dependent and any later dependents in that block sequence.
- Last Name — Required when the dependent is included.
- SSN — Provide a 9-digit SSN unless you enter a date of birth in the next cell.
- DOB if SSN not available (YYYY-MM-DD) — Required when SSN is blank. Use YYYY-MM-DD. Cannot be a future date.
- Coverage (Jan–Dec) — Enter yes or no for each month, same rules as the Employee coverage columns.
Dependent 1 starts at Column AA. Each additional dependent begins 16 columns later (Dependent 2 at AQ, Dependent 3 at BG, and so on through Dependent 12).
Add one employee instead