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2023

Instructions for Forms

1094-C and 1095-C

1094-C, Transmittal of Employer-Provided Health Insurance

Offer and Coverage Information Returns, and Form 1095-C,

Employer-Provided Health Insurance Offer and Coverage, and

the instructions, such as legislation enacted after they were

published, go to

IRS.gov/Form1094C and IRS.gov/Form1095C.

The electronic-filing threshold for information returns required to

be filed on or after January 1, 2024, has been decreased to 10 or

more returns. See Electronic Filing, later.

IRS.gov/irb/2014-13_IRB/ar09.html.

For the final regulations under section 6055, Information

Reporting of Minimum Essential Coverage, see T.D. 9660,

2014-13 I.R.B. 842, at IRS.gov/irb/2014-13_IRB/ar08.html and

T.D. 9970, 2023-02 I.R.B. 311, at IRS.gov/irb/2023-02_IRB. For

the final regulations under section 4980H, Shared Responsibility

for Employers Regarding Health Coverage, see T.D. 9655,

2014-9 I.R.B. 541, at

IRS.gov/irb/2014-9_IRB/ar05.html. For

answers to frequently asked questions regarding the employer

Information-Reporting-by-Employers-on-Form-1094-C-and-

Form-1095-C.

For additional guidance and proposed regulatory changes

relating to section 6055, including the requirement to solicit the

TIN of each covered individual for purposes of the reporting of

health coverage information, see Proposed Regulations section

1.6055-1(h) and Regulations section 301.6724-1.

See Definitions, later, for key terms used in these instructions.

must be used to report to the IRS summary information for each

Applicable Large Employer (ALE Member) (defined below) and

to transmit Forms 1095-C to the IRS. Form 1095-C is used to

report information about each employee to the IRS and to the

whether an ALE Member owes a payment under the employer

shared responsibility provisions under section 4980H. Form

1095-C is also used in determining the eligibility of employees

for the premium tax credit.

coverage also use Form 1095-C to report information to the IRS

Form 1095-C for each employee who was a full-time employee

of the ALE Member for any month of the calendar year.

Generally, the ALE Member is required to furnish a copy of the

Form 1095-C (or a substitute form) to the employee.

an Applicable Large Employer, or if applicable, each person or

entity that is a member of an Aggregated ALE Group. An

Applicable Large Employer, generally, is an employer with 50 or

more full-time employees (including full-time equivalent

employees) in the previous year. For purposes of determining if

business days during the preceding calendar year, then the

Aggregated ALE Group is an Applicable Large Employer and

each separate employer within the group is an ALE Member.

Each ALE Member is required to file Forms 1094-C and 1095-C

reporting offers of coverage to its full-time employees (even if the

ALE Member has fewer than 50 full-time employees of its own).

employer shared responsibility provisions of section 4980H, see

Employer in the Definitions section of these instructions. For

more information on determining full-time employees, see

An employer that offers health coverage through a self-insured

health plan must report information about each individual

enrolled in such coverage. For an employer that is an ALE

Member, this information must be reported on Form 1095-C, Part

III, for any employee who is enrolled in coverage (and any

spouse or dependent of that employee). See the option to file

Form 1095-C, to report coverage of certain non-employees,

below.

ALE Members that offer health coverage through an

employer-sponsored, self-insured health plan must complete

Form 1095-C, Parts I, II, and III, for any employee who enrolls in

the health coverage, whether or not the employee is a full-time

employee for any month of the calendar year.

For full-time employees enrolled in an ALE Member’s

self-insured coverage, including an employee who was a

full-time employee for at least 1 month of the calendar year, the

Form 1095-C, Part II, the ALE Member must enter code 1G on

line 14 in the “All 12 Months” column or in the separate monthly

boxes for all 12 calendar months, and the ALE Member need not

complete Part II, lines 15 and 16.

premium tax credit (PTC) for a month if the individual is covered

by an individual coverage HRA or eligible for an individual

coverage HRA that is affordable.

-2-

Instructions for Forms 1094-C and 1095-C (2023)

Entity (DGE) in the Definitions section of these instructions for

more information. In the case of a Governmental Unit that has

delegated its reporting responsibilities for some of its employees,

the Governmental Unit must ensure that among the multiple

Forms 1094-C filed by or on behalf of the Governmental Unit

transmitting Forms 1095-C for the Governmental Unit’s

employees, one of the filed Forms 1094-C is designated as the

Authoritative Transmittal and reports aggregate employer-level

data for the Governmental Unit, as required in Parts II, III, and IV

District or the state must file an Authoritative Transmittal

reporting aggregate employer-level data for the School District.

For each full-time employee of an ALE Member, there must be

only one Form 1095-C filed for employment with that ALE

Member. For example, if an ALE Member separately reports for

each of its two divisions, the ALE Member must combine the

offer and coverage information for any employee who worked at

both divisions during the calendar year so that a single Form

Member. For any calendar month in which a full-time employee

works for more than one ALE Member of an Aggregated ALE

Group, only one ALE Member is treated as the employer of that

employee for reporting purposes (generally, the ALE Member for

whom the employee worked the greatest number of hours of

service), and only that ALE Member reports for that employee for

that calendar month. The other ALE Member is not required to

report for that employee for that calendar month, unless the

other ALE Member is otherwise required to file Form 1095-C for

that employee because the individual was a full-time employee

year. For a description of the rules related to determining which

ALE Member in an Aggregated ALE Group is treated as the

employer for a month in this situation, see the definition of

Employee.

Example. Employer A and Employer B are separate ALE

Members that belong to the same Aggregated ALE Group. Both

Employer A and Employer B offer coverage through the AB

health plan, which is an insured plan. In January and February,

Employee has 130 hours of service for Employer A and no hours

of service for Employer B. In March, Employee has 100 hours of

appropriate code on line 14 for January, February, and March;

should complete lines 15 and 16 per the instructions; and should

include Employee in the count of total employees and full-time

employees reported for those months on Form 1094-C. For the

months April through December, on Form 1095-C, Employer A

should enter code 1H (no offer of coverage) on line 14, leave

line 15 blank, and enter code 2A (not an employee) on line 16

(since Employee is treated as an employee of Employer B and

not as an employee of Employer A in those months), and should

exclude Employee from the count of total employees and

full-time employees reported for those months on Form 1094-C.

You will meet the requirement to file Forms 1094-C and 1095-C if

the forms are properly addressed and mailed on or before the

due date. If the due date falls on a weekend or legal holiday, then

the due date is the following business day. A business day is any

day that is not a Saturday, Sunday, or legal holiday.

on when Form 1095-C must be furnished.

You can get an automatic 30-day extension of time to file by

completing Form 8809, Application for Extension of Time To File

Information Returns. The form may be submitted on paper, or

through the FIRE System either as a fill-in form or an electronic

file. No signature or explanation is required for the extension.

However, you must file Form 8809 on or before the due date of

the returns in order to get the 30-day extension. Under certain

phone number listed in the instructions. You can also submit the

extension request online through the FIRE System. You are

encouraged to submit requests using the online fill-in form. See

Pub. 1220 for more information on filing online or electronically.

Send all information returns filed on paper to the following:

Instructions for Forms 1094-C and 1095-C (2023)

-3-

Center, Austin, TX 73301.

Shipping and mailing. If you are filing on paper, send the

forms to the IRS in a flat mailing (not folded), and do not

paperclip or staple the forms together. If you are sending many

forms, you may send them in conveniently sized packages. On

each package, write your name, number the packages

consecutively, and place Form 1094-C in package number one.

Postal regulations require forms and packages to be sent by

First-Class Mail. Returns filed with the IRS must be printed in

landscape format.

you establish reasonable cause. However, you can file up to 10

returns on paper; those returns will not be subject to a penalty for

failure to file electronically. The penalty applies separately to

original returns and corrected returns.

-4-

Instructions for Forms 1094-C and 1095-C (2023)

Method.

IRB/ar11.html.

Note. Enter an “X” in the “CORRECTED” checkbox only when

correcting a Form 1095-C previously filed with the IRS. If you are

correcting a Form 1095-C that was previously furnished to a

recipient, but not filed with the IRS, write, type, or print

“CORRECTED” on the new Form 1095-C furnished to the

recipient.

Correcting information affecting statement furnished to

employee using an Alternative Furnishing Method under

longer eligible to use an alternative furnishing method for the

employee for whom it filed a corrected Form 1095-C, it must

furnish a Form 1095-C to the employee and advise the employee

that Form 1095-C replaces the statement it had previously

furnished.

corrected returns for missing or incorrect TINs if you meet the

reasonable cause criteria. For additional information, see Pub.

Instructions for Forms 1094-C and 1095-C (2023)

-5-

You will meet the requirement to furnish Form 1095-C to an

full-time employees by March 1, 2024, for the 2023 calendar

year. See

Extensions of time to furnish statements to recipients,

below.

For more information on alternative furnishing methods for

employers, see

Qualifying Offer Method, later.

Filers of Form 1095-C may truncate the social security

number (SSN) of an individual (the employee or any family

member of the employee receiving coverage) on Form 1095-C

Except as provided below, statements must be furnished on

paper by mail (or hand delivered), unless the recipient

affirmatively consents to receive the statement in an electronic

format. If mailed, the statement must be sent to the employee's

last known permanent address, or if no permanent address is

known, to the employee's temporary address. For more

information on furnishing statements to non-full-time employees

and non-employees who are enrolled in employer-sponsored

self-insured health coverage, see

Alternative manner of

receiving the Form 1095-C electronically. An individual may

consent on paper or electronically, such as by email. If consent is

on paper, the individual must confirm the consent electronically.

A statement may be furnished electronically by email or by

informing the individual how to access the statement on the ALE

Member’s website. Statements reporting coverage and offers of

coverage under an expatriate health plan, however, may be

furnished electronically unless the recipient explicitly refuses to

consent to receive the statement in an electronic format. Specific

information on consents to furnish statements electronically can

be found in Regulations section 301.6056-2.

Extensions of time to furnish statements to recipients. The

due date for furnishing Form 1095-C is automatically extended

from January 31, 2024, to March 1, 2024. Thus, no additional

extensions will be granted.

Information reporting penalties. All employers subject to the

employer shared responsibility provisions and other employers

that sponsor self-insured group health plans that fail to comply

The penalty for failure to file a correct information return is

$310 for each return for which the failure occurs, with the total

penalty for a calendar year not to exceed $3,783,000.

The penalty for failure to provide a correct payee statement is

$310 for each statement for which the failure occurs, with the

total penalty for a calendar year not to exceed $3,783,000.

Special rules apply that increase the per-statement and total

-6-

Instructions for Forms 1094-C and 1095-C (2023)

electronically if the recipient affirmatively consents.

ALE Member, this Form 1094-C must report aggregate

employer-level data for the ALE Member and be identified on

line 19 as the Authoritative Transmittal. If multiple Forms 1094-C

are being filed for an ALE Member so that Forms 1095-C for all

full-time employees of the ALE Member are not attached to a

single Form 1094-C transmittal (because Forms 1095-C for

some full-time employees of the ALE Member are being

transmitted separately), one (and only one) of the Forms 1094-C

must report aggregate employer-level data for the ALE Member

and be identified on line 19 as the Authoritative Transmittal. For

more information, see

Filing Multiple Forms 1094-C, earlier.

Reminder. Lines 20–22 should be completed only on the

Authoritative Transmittal for the ALE Member. For more

information, see Authoritative Transmittal for ALE Members Filing

Multiple Forms 1094-C, earlier.

Line 21. If during any month of the calendar year the ALE

Member was a member of an Aggregated ALE Group, check

“Yes.” If you check “Yes,” also complete the “Aggregated Group

Indicator” in Part III, column (d), and then complete Part IV to list

the other members of the Aggregated ALE Group. If, for all 12

months of the calendar year, the employer was not a member of

an Aggregated ALE Group, check “No,” and do not complete

Part III, column (d), or Part IV.

Line 22. If the ALE Member meets the eligibility requirements

and is using one of the Offer Methods, it must check the

there is an alternative method of completing Form 1095-C and

an alternative method for furnishing Form 1095-C to certain

employees. If the ALE Member is using either of these

alternative rules, check this box. To be eligible to use the

Qualifying Offer Method, the ALE Member must certify that it

made a Qualifying Offer to one or more of its full-time employees

for all months during the year in which the employee was a

full-time employee for whom an employer shared responsibility

payment could apply. Additional requirements described below

must be met to be eligible to use the alternative method for

must enter the Qualifying Offer code 1A on Form 1095-C,

line 14, for any month for which the employee received a

Qualifying Offer (or in the “ All 12 Months” box if the employee

received a Qualifying Offer for all 12 months), and must leave

line 15 blank for any month for which code 1A is entered on

line 14. The ALE Member may, but is not required to, enter an

applicable code on line 16 for any month for which code 1A is

entered on line 14; a Qualifying Offer is, by definition, treated as

an offer that falls within an affordability safe harbor even if no

code is entered on line 16.

Instructions for Forms 1094-C and 1095-C (2023)

-7-

Required Contribution.

any month for which it made a Qualifying Offer to an employee,

even if the employee did not receive a Qualifying Offer for all 12

calendar months. However, if an employee receives a Qualifying

Offer for less than all 12 months, the ALE Member must furnish a

copy of Form 1095-C to the employee (rather than using the

alternative method of furnishing Form 1095-C described later).

January 1. Employee is in a health coverage waiting period (and

an employer shared responsibility payment could not apply with

respect to Employee, because Employee is in a Limited

in which both (1) the employee was a full-time employee, and (2)

an employer shared responsibility payment could apply with

respect to the employee. Employer may use the alternative

method of completing Form 1095-C under the Qualifying Offer

Method for this Employee. However, Employer may not use the

alternative method of furnishing Form 1095-C to Employee under

the Qualifying Offer Method because Employee did not receive a

Qualifying Offer for all 12 months of the calendar year.

employees under the Qualifying Offer Method. An ALE

1095-C to the employee if it furnishes the employee a statement

containing the following information.

may receive information about the offer of coverage and the

information on the Form 1095-C filed with the IRS for that

employee.

Tax Credit (PTC), for more information on eligibility for the

premium tax credit.

An ALE Member is not required to use the alternative method

of furnishing for an employee even if the alternative method

would be allowed. Instead, the ALE Member may furnish a copy

of Form 1095-C as filed with the IRS (with or without the

statement described earlier).

As stated earlier, an ALE Member may not use the alternative

furnishing method for a full-time employee who enrolled in

self-insured coverage. Rather, the ALE Member must furnish

use the 98% Offer Method, an employer must certify that, taking

into account all months during which the individuals were

employees of the ALE Member and were not in a Limited

Non-Assessment Period, the ALE Member offered affordable

health coverage providing minimum value to at least 98% of its

employees for whom it is filing a Form 1095-C employee

statement, and offered minimum essential coverage to those

employees’ dependents. The ALE Member is not required to

identify which of the employees for whom it is filing were full-time

employees, but the ALE Member is still required, under the

general reporting rules, to file Forms 1095-C on behalf of all its

full-time employees who were full-time employees for one or

more months of the calendar year. To ensure compliance with

any employee for whom it fails to file a Form 1095-C that the

employee was not a full-time employee for any month of the

calendar year. For this purpose, the health coverage is affordable

if the ALE Member meets one of the section 4980H affordability

safe harbors.

qualifies as a Limited Non-Assessment Period). Employer files a

Form 1095-C for each of the 300 employees (excluding the 25

employees that it identified as not possibly being full-time

employees). Employer may use the 98% Offer Method because

it makes an affordable offer of coverage that provides minimum

value to at least 98% of the employees for whom Employer files

a Form 1095-C. Using this method, Employer does not identify

whether each of the 300 employees is a full-time employee.

However, Employer must still file a Form 1095-C for all of its

full-time employees. Employer chooses to file a Form 1095-C on

-8-

Instructions for Forms 1094-C and 1095-C (2023)

ALE Member’s full-time employees and their dependents. For a

description of the differences between the definition of the term

“Limited Non-Assessment Period” used with respect to section

4980H(a) and the definition used with respect to section

4980H(b), relating to whether the ALE Member offers minimum

value coverage at the end of the Limited Non-Assessment

Period, see the

offered) is treated as offered minimum essential coverage for this

employees in a Limited Non-Assessment Period, for each

calendar month. An ALE Member must choose to use one of the

following days of the month to determine the number of

employees per month and must use that day for all months of the

year: (1) the first day of each month, (2) the last day of each

month, (3) the 12th day of each month, (4) the first day of the first

payroll period that starts during each month, or (5) the last day of

the first payroll period that starts during each month (provided

that for each month that last day falls within the calendar month

in which the payroll period starts). If the total number of

year, enter that number in line 23, column (c), “All 12 Months,” or

in the boxes for each month of the calendar year. If the number

of employees for any month is zero, enter -0-.

for each of the 12 calendar months. If the ALE Member was not

a member of an Aggregated ALE Group for all 12 months but

was a member of an Aggregated ALE Group for one or more

month(s), enter “X” in each month for which it was a member of

an Aggregated ALE Group. If an ALE Member enters “X” in one

or more months in this column, it must also complete Part IV.

An ALE Member must complete this section if it checks “Yes” on

line 21. If the ALE Member was a member of an Aggregated ALE

of full-time employees (using the number reported in Part III,

column (b), if a number was required to be reported) for the year

or for the number of months during which the ALE Member was

a member of the Aggregated ALE Group. If any member of the

Aggregated ALE Group uses the 98% Offer Method and thus is

not required to identify which employees are full-time employees,

all ALE Members of the Aggregated ALE Group should use the

monthly average number of total employees rather than the

monthly average number of full-time employees for this purpose.

Regardless of the number of members in the Aggregated ALE

to indicate which months it was part of an Aggregated ALE

Group.

you may apply for one online. Go to IRS.gov/EIN. You may also

apply by faxing or mailing Form SS-4 to the IRS. See the

Instructions for Form SS-4 and Pub. 1635.

Instructions for Forms 1094-C and 1095-C (2023)

-9-

determined based on the employee’s age, as defined in

Proposed Regulations 54.4980H(f)(7)(i), and the employee’s

applicable location, as defined in Proposed Regulations

54.4980H(f)(7)(ii).

cost silver plans in different parts of a rating area, an employee’s

applicable lowest cost silver plan is the lowest cost silver plan in

period preceding that stability period. (The look-back

measurement method for identifying full-time employees is

available only for purposes of determining and computing liability

under section 4980H, and not for purposes of determining if the

employer is an Applicable Large Employer.) For purposes of

both methods, 130 hours of service in a calendar month is

treated as the monthly equivalent of at least 30 hours of service

per week.

For more information on the identification of full-time employees,

including discussion of the monthly measurement method and

the look-back measurement method, and the rules for when an

ALE Member may use one or both methods, see Regulations

sections 54.4980H-1(a)(21) and 54.4980H-3, and Notice

2014-49, 2014-41 I.R.B. 66 (describing a proposed approach to

the application of the look-back measurement method in

situations in which the measurement period applicable to an

employee changes).

Note. A former employee (for example, a retiree) is not a

section 4980H(b). However, for the months in which the

employee was an employee of the ALE Member, such an

employee would be included in the total employee count

reported on Form 1094-C, Part III, column (c). Also, if during the

Limited Non-Assessment Period the employee enrolled in

coverage under a self-insured, employer-sponsored plan, the

ALE Member must file a Form 1095-C for the employee to report

coverage information for the year.

Full-time equivalent employees. A combination of employees,

each of whom individually is not treated as a full-time employee

Governmental Unit and Agency or Instrumentality of a Gov-

ernmental Unit. A Governmental Unit is the government of the

United States, any state or political subdivision thereof, or any

Indian tribal government (as defined in section 7701(a)(40)) or

subdivision of an Indian tribal government (as defined in section

7871(d)). For purposes of these instructions, references to a

Governmental Unit include an Agency or Instrumentality of a

Governmental Unit. Until guidance is issued that defines the

term “Agency or Instrumentality of a Governmental Unit” for

purposes of section 6056, an entity may determine whether it is

otherwise indicated.

Hours of service. An hour of service is each hour for which an

employee is paid, or entitled to payment, for the performance of

-16-

Instructions for Forms 1094-C and 1095-C (2023)

paid, or entitled to payment, for a period of time during which no

duties are performed due to vacation, holiday, illness, incapacity

(including disability), layoff, jury duty, military duty, or leave of

absence. An hour of service does not include any hour of service

performed as a bona fide volunteer of a government entity or

tax-exempt entity, as part of a Federal Work-Study Program (or a

substantially similar program of a state or political subdivision

thereof) or to the extent the compensation for services

performed constitutes income from sources outside the United

Regulations sections 54.4980H-1(a)(24) and 54.4980H-3(b),

and Notice 2015-87, Q&A 14, at

ar11.html. See section VI of the preamble to the section 4980H

Individual coverage HRA. An HRA is a type of account-based

IRS.gov/

Newsroom/Health-Reimbursement-Arrangements-HRAs.

Limited Non-Assessment Period. A Limited Non-Assessment

Period generally refers to a period during which an ALE Member

4980H(b) only if the employee is offered health coverage by the

first day of the first month following the end of the period. Also,

the first five periods described below are Limited

Non-Assessment Periods for section 4980H(b) only if the health

coverage that is offered at the end of the period provides

minimum value. For more information on Limited

Non-Assessment Periods and the application of section 4980H,

see Regulations section 54.4980H-1(a)(26).

determine whether an employee is a full-time employee, the

period beginning with the first full calendar month in which the

employee is first otherwise (but for completion of the waiting

period) eligible for an offer of health coverage and ending no

later than 2 full calendar months after the end of that first

calendar month.

an ALE Member is using the look-back measurement method to

determine whether an employee is a full-time employee and the

employee is reasonably expected to be a full-time employee at

his or her start date, the period beginning on the employee’s

start date and ending not later than the end of the employee’s

third full calendar month of employment.

determine whether a new employee is a full-time employee, and

the employee is a variable hour employee, seasonal employee,

or part-time employee, the initial measurement period for that

employee and the administrative period immediately following

the end of that initial measurement period.

Period following change in status that occurs during initial

measurement period under the look-back measurement method.

If an ALE Member is using the look-back measurement method

to determine whether a new employee is a full-time employee,

and, as of the employee’s start date, the employee is a variable

during the initial measurement period, the employee has a

change in employment status such that, if the employee had

begun employment in the new position or status, the employee

would have reasonably been expected to be a full-time

employee, the period beginning on the date of the employee’s

of the third full calendar month following the change in

employment status. If the employee is a full-time employee

based on the initial measurement period and the associated

Minimum essential coverage (MEC). Although various types

of health coverage may qualify as minimum essential coverage,

for purposes of these instructions, minimum essential coverage

refers to health coverage under an eligible employer-sponsored

plan. An individual coverage HRA is a self-insured group health

plan and an eligible employer sponsored plan. For more details

on minimum essential coverage, see

coverage HRA that is affordable is treated as providing minimum

value.

Offer of health coverage. An ALE Member makes an offer of

coverage to an employee if it provides the employee an effective

opportunity to enroll in the health coverage (or to decline that

coverage) at least once for each plan year. For this purpose, the

plan year must be 12 consecutive months unless a short plan

year of less than 12 consecutive months is permitted for a valid

business purpose. An ALE Member makes an offer of health

coverage to an employee for the plan year if it continues the

if that health coverage provides minimum value and does not

have an Employee Required Contribution for the coverage for

any calendar month of more than 9.5% (as adjusted) of a

monthly amount determined as the mainland federal poverty line

for a single individual for the applicable calendar year, divided by

12.

offer to a spouse that is subject to one or more reasonable,

objective conditions, regardless of whether the reasonable,

objective conditions are satisfied. For example, an offer of

Instructions for Forms 1094-C and 1095-C (2023)

-17-

spouse for reporting purposes. Note that this treatment is for

reporting purposes only, and will generally not affect the

spouse’s eligibility for the premium tax credit if the spouse did

not meet the condition and therefore did not have an actual offer

of coverage. A conditional offer to a spouse is reported by

entering code 1J or 1K (as applicable) on line 14 of Form

1095-C. See the instructions for line 14 for more information. An

offer to a dependent does not include an offer to a dependent

that is subject to one or more reasonable, objective conditions

actually had an offer of coverage. In addition, an offer of

coverage is treated as made to an employee’s dependents only

if the offer of coverage is made to an unlimited number of

dependents regardless of the actual number of dependents, if

any, an employee has during any particular calendar month.

An ALE Member offers health coverage for a month only if it

offers health coverage that would provide coverage for every day

of that calendar month. For reporting purposes, this means that

an offer of coverage does not occur for a month if an employee’s

coverage, the coverage would have ended if the employee had

enrolled in coverage). However, see the description of Code

Series 2—Section 4980H Safe Harbor Codes and Other Relief

for Employers, code 2B, which may be applicable in these

circumstances to indicate that the ALE Member is treated as

having offered coverage for the entire month for purposes of

section 4980H.

An ALE Member offers health coverage to an employee if it,

or another employer in the Aggregated ALE Group, or a third

party, such as a multiemployer or single employer Taft-Hartley

all calendar months during the calendar year for which the

employee was a full-time employee for whom a section 4980H

assessable payment could apply, with an Employee Required

Contribution for each month, not exceeding 9.5 % (as adjusted)

of the mainland single federal poverty line divided by 12,

provided that the offer includes an offer of MEC to the

employee’s spouse and dependents (if any).

Privacy Act and Paperwork Reduction Act Notice. We ask

states, and the District of Columbia for use in administering their

tax laws. We may also disclose this information to other

countries under a tax treaty, to federal and state agencies to

depending on individual circumstances. The estimated average

time is:

-18-

Instructions for Forms 1094-C and 1095-C (2023)