Use this column guide when completing the 1095-C employee import spreadsheet. Download the template from the 1095-C List import flow, fill each required column, then upload the same file.
Who can import 1095-C employees
Employers with Benefits enabled, and Feature Admins who can administer 1095.
Before you begin
Download the 1095-C template
- Go to top nav 1094/1095, then secondary nav List.
- On 1095-C Employees, choose Add Employees.
- In Add New Employees, choose Import Employees Using 1095-C Spreadsheet.
- In the Import dialog, choose Download to get the employee template. You must use this template or your import will not work.
- Fill in employee information, choose the file under Upload your data, then choose Import.
Employee information (columns A–G)
First Name (Column A)
- Required. Maximum of 20 characters.
- Letters, spaces, and hyphens only.
Last Name (Column B)
- Required. Maximum of 20 characters.
- Letters, spaces, and hyphens only.
Address (Column C)
- Required.
- Allowed characters: letters, numbers, spaces, commas, periods, apostrophes, and hyphens.
City (Column D)
- Required.
- Allowed characters: letters, numbers, spaces, commas, periods, apostrophes, and hyphens.
State (Abbreviation) (Column E)
- Required. Exactly 2 letters.
ZIP (Column F)
- Required. Use 5 digits, or ZIP+4 as 12345-6789.
Social security number (Column G)
- Required. Enter 9 digits. Hyphens are removed on import.
- The SSN must not already exist on a 1095 form for the same 1094 subgroup.
Offer, coverage, and subgroup (columns H–AT)
Plan start month (2 digit number) (Column H)
- Enter the plan start month as a 2-digit number (for example, 01 for January).
1094 subgroup reference code (Column I)
- Required. Must match an existing 1094 subgroup Reference Code.
- Find the value on secondary nav Subgroups under 1094-C Subgroups in the Reference Code column.
Line 14 (Columns J–U)
- One code for each month (Jan–Dec). No month can be left blank.
- Allowed codes: 1A, 1B, 1C, 1D, 1E, 1F, 1G, 1H, 1I, 1J, 1K, 1T, 1U.
- Code definitions: 1095-C Code Appendix.
Line 15 (Columns V–AG)
- Enter an amount for any month where Line 14 is 1B, 1C, 1D, 1E, 1J, 1K, 1T, or 1U.
Line 16 (Columns AH–AS)
- One code for each month (Jan–Dec). No month can be left blank.
- Allowed codes: 2A, 2B, 2C, 2D, 2E, 2F, 2G, 2H.
- Code definitions: 1095-C Code Appendix.
Self Insured (Column AT)
- Enter Yes or No.
- If No, leave columns AU and later blank. Columns AU onward are only for self-insured covered individuals.
Employee covered individual (columns AU–BI)
Complete these columns only when Column AT is Yes and the employee had medical coverage for at least one month.
- First Name (Column AU)
- Last Name (Column AV)
- SSN (Column AW) — 9 digits
- Coverage (Yes/No) (Columns AX–BI) — one Yes or No for each month (Jan–Dec). If all 12 months are No, do not enter this employee covered-individual block.
Dependents 1–12 (columns BJ onward)
The template includes Dependent 1 through Dependent 12. Complete a dependent block only when Column AT is Yes and that dependent had medical coverage for at least one month. Each dependent block includes:
- First Name
- Last Name
- SSN — if you do not have the SSN, leave it blank and enter DOB (YYYY-MM-DD) instead
- DOB (YYYY-MM-DD) — required when SSN is blank; use YYYY-MM-DD format
- Coverage (12 monthly Yes/No columns) — if all 12 months are No, do not enter that dependent