Line 16 on the 1095-C form is used to report on an individual’s eligibility for health insurance coverage and his or her coverage status for the given month.
Line 16 addresses the following:
- Whether the individual was employed, and whether that employment was full-time or not.
- Whether the employee was enrolled in health insurance coverage.
- Whether the employer was eligible for any form of relief because of contributions to a union health plan or because the employee was in a limited non-assessment period. The most common limited non-assessment period is a new hire waiting period.
- Whether or not the offered coverage was affordable, and which IRS safe harbor was used to determine affordability.
Line 16 Codes
A Line 16 response is reported for each month of the year, and may contain one of the following codes:
2A – Not Employed
This response indicates that the individual was not employed during the reported month.
2B – Employed but Not Full Time for the Entire Month
This response indicates that the individual was employed during the month but not on a full-time basis; therefore, they were not eligible for health insurance benefits through their employer for the entire month.
2C - Enrolled
This response indicates the individual was employed during the reported month and covered under a health insurance plan.
2D – Waiting Period
This response indicates the employee was in a measurement or waiting period, prior to becoming eligible for health insurance coverage. This is sometimes referred to as a limited non-assessment period.
2E – Union Sponsored Plan
This response indicates the employee was covered under a multi-employer plan, such as a Union Sponsored Plan, for which the employer paid a fee based on a collective bargaining agreement.
2F – Waived Coverage
This response indicates the employee waived coverage for the reported month, and the employer used Form W-2 Safe Harbor to determine affordability.
2G – Waived Coverage
This response indicates the employee waived coverage for the reported month, and the employer used Federal Poverty Line Safe Harbor to determine affordability.
2H – Waived Coverage
This response indicates the employee waived coverage for the reported month, and the employer used Rate of Pay Safe Harbor to determine affordability.
See Also: Understanding Your Line 14 Codes