1095-C Coverage Scenarios with Examples

Not sure which 1095-C codes to use? Here are the most common coverage scenarios with line-by-line examples. You can also use our interactive code helper tool.

1. Full-Time Employee, Enrolled All Year (Qualifying Offer)

Employee enrolled in MEC+MV plan covering employee, spouse, and dependents all year.

• Line 14: 1A (All 12 Months)
• Line 15: Blank
• Line 16: Blank

2. Full-Time Employee, Enrolled All Year (Non-Qualifying)

Employee enrolled in MEC+MV to employee and MEC to spouse/dependents, but not a qualifying offer.

• Line 14: 1E (All 12 Months)
• Line 15: Employee's monthly cost (All 12 Months)
• Line 16: 2C (All 12 Months — employee enrolled)

3. Full-Time Employee, Waived Coverage All Year

Coverage offered but employee waived for the entire year.

• Line 14: 1E (All 12 Months)
• Line 15: Employee's monthly cost (must still be entered even though waived)
• Line 16: Blank or affordability safe harbor (2F/2G/2H) if applicable

4. Full-Time Employee, Hired Midyear

Employee hired April 10th, eligible for coverage June 1st (after 30-day waiting period).

• Line 14: 1H (Jan–May) → 1E (Jun–Dec)
• Line 15: Blank (Jan–May) → Monthly cost (Jun–Dec)
• Line 16: 2A (Jan–Mar, not hired) → 2D (Apr–May, waiting period) → 2C (Jun–Dec, enrolled)

5. Part-Time Employee Becomes Full-Time Midyear

Part-time employee promoted to full-time Feb 4th, eligible May 1st (30-day LNAP).

• Line 14: 1H (Jan–Apr) → 1E (May–Dec)
• Line 15: Blank (Jan–Apr) → Monthly cost (May–Dec)
• Line 16: 2B (Jan–Mar, part-time) → 2D (Apr, LNAP) → 2C (May–Dec, enrolled)

6. Terminated Employee

Employee terminated April 10th, was enrolled Jan–Apr.

• Line 14: 1E (Jan–Apr) → 1H (May–Dec)
• Line 15: Monthly cost (Jan–Apr) → Blank (May–Dec)
• Line 16: 2C (Jan–Apr, enrolled) → 2A (May–Dec, no longer employed)

7. Employee Waived, Then Enrolled Midyear (Qualifying Life Event)

Employee waived coverage during open enrollment, got married in July (QLE), enrolled August 1st.

• Line 14: 1H (Jan–Jun) → 1E (Jul–Dec)
• Line 15: Blank (Jan–Jun) → Monthly cost (Jul–Dec)
• Line 16: 2G (Jan–Jun, FPL safe harbor) → 2C (Jul–Dec, enrolled)

Need More Help?

• 1095-C Line 14/15/16 Code Guide — Full code reference
• BoomTax Online Code Helper — Interactive tool
• Download Code Guidance PDF

Source: 1095-C Coverage Scenarios With Crystal Clear Examples (blog.boomtax.com)