1095-C Import Spreadsheet: Required Fields (Tax Year 2025)

This guide covers the required fields for importing Form 1095-C data into BoomTax using our Excel template. Download the 1095-C template here.

Form 1095-C - Part I, Employee and Employer Information

Employee Data (Blue Headers)

The following fields are required for every employee row:

1. Employee first name
1. Last name
2. Social security number (SSN)
3. Street address
4. City or town
5. State or province: Must be abbreviated (e.g., "TX" not "Texas")
6. Country code: Use "US" for United States
6. Zip or foreign postal code
10. Employer contact phone number
Plan start month

Lines 14, 15 & 16 (Offer of Coverage)

You can use either the "All 12 Months" column if there was no change during the year, or fill in each month individually (Jan-Dec).

Line 14: Offer of Coverage (Required)

A code is required for every month of the year. Common codes:

1A: Qualifying offer (MEC+MV to employee, MEC to spouse & dependents, affordable)
1E: MEC+MV offered to employee, MEC to spouse & dependents (non-qualifying)
1H: No offer of coverage (or not an employee that month)

See 1095-C Line 14/15/16 Code Guide for all codes.

Line 15: Employee Required Contribution

The employee's monthly share of the lowest-cost, self-only plan. Leave blank if Line 14 uses codes 1A, 1F, 1G, 1H, 1R, or 1S.

Line 16: Section 4980H Safe Harbor (Recommended)

Optional but highly recommended to reduce tax liability. Common codes:

2C: Employee enrolled in coverage
2D: Employee in a limited non-assessment period
2G: Coverage offered is affordable (FPL safe harbor)

ICHRA Plan Data (Purple Headers)

Complete this section only if the employer offers an Individual Coverage HRA (codes 1L, 1M, 1N, 1O, 1P, 1Q, 1T, or 1U).

Employee's age on January 1st of the tax year
17. ZIP Code: Employee's residence ZIP (codes 1L/1M/1N/1T) or primary work location ZIP (codes 1O/1P/1Q/1U)

Covered Individuals Data (Green Headers)

Complete this section only if the employer offers self-insured (or level-funded) health coverage.

a. Covered individual first name and last name
b. SSN
c. DOB (only if SSN is not available)
d. Coverage months: "All 12 Months" or individual months (Jan-Dec)

Multiple covered individuals: List each on a subsequent row. You can either fill in only the green columns and leave the rest blank, or duplicate the employee data for each row.

Download Template

Download the BoomTax 1095-C Excel Template

This article covers Tax Year 2025. Source: Import Spreadsheet Guidelines (blog.boomtax.com)