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Form 1094C: Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns
Department of the Treasury Internal Revenue Service Form 1094-C is a Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns. This form is filed by an Applicable Large Employer (ALE) Member, and it requires reporting information for ALE Members who offered health coverage.
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IRS Form 1094C - Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns
Department of the Treasury Internal Revenue Service Form 1094-C is a Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns. This form is filed by an Applicable Large Employer (ALE) Member, and it requires reporting information for ALE Members who offered health coverage.
Risk Radar
Scan points- 1Failing to check the box on Line 19 if it is the authoritative transmittal for this ALE Member.
- 2Filing without completing Part I lines 1 through 6 (Name, EIN, Address details).
- 3Incorrectly indicating on Line 21 whether the ALE Member is part of an Aggregated ALE Group.
- 4Omitting required certifications in Part II, such as selecting all applicable checkboxes under Line 22.
- 5Failing to list names and EINs for Other ALE Members in Part IV when they are aggregated.
Plain English
This form serves as the cover sheet when you send in your required health insurance documentation to the IRS. It tells the agency which employer's records are included and provides summary details about the coverage offered during the year. The filing confirms that the accompanying documents meet IRS standards for reporting.
Submission Date
- Filing date: 2025-10-01 22:10:18
- Preparation window: collect IDs, supporting records, and signatures in advance.
- Final review: verify names, dates, and required fields before submission.
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What this form is for
- Use this form when an Applicable Large Employer (ALE) Member needs to submit Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns for health coverage offered.
- Do not use Form 1094-C when the ALE Member is not required to report information regarding offered health coverage.
- Check Form 1095-C instead when submitting the actual individual offer and coverage documentation accompanying this transmittal.
Form selector
Use this form or another form?
Filing for a single entity that offers coverage
This form acts as the primary transmittal document for all associated Forms 1095-C.
✓ Check Part I details.
When an ALE Member is part of a larger group
Use this form to report on behalf of multiple entities within an Aggregated ALE Group (Part IV).
✓ Ensure names/EINs are listed correctly in Part IV.
If the employer has no Designated Government Entity contact
Omit details from lines 9 and 10, as this entity is not applicable for the reporting ALE Member.
✓ Verify that line 17 remains blank or reserved.
When submitting a transmittal that isn't the official one
Check the box on Line 19 to indicate it is *not* the authoritative transmittal for this ALE Member.
✓ Refer to instructions regarding what to do if 'No' is checked.
Deadline or filing window
The Form 1094-C (2025) relates to data for the calendar year. The specific filing deadline is not stated on the form, but the filer must ensure all accompanying Forms 1095-C are submitted with this transmittal.
Checklist
What you need before filling it out
Part I: ALE Member Name (Line 1)
The full name of the Applicable Large Employer (Employer) · Part I
Part II: Total Forms Filed (Line 20)
The total number of Forms 1095-C filed by and/or on behalf of the ALE Member. · Part II
Part III: Monthly Counts (Lines 24-35)
Specific counts for each month, such as 'Jan 25' or 'Dec'. · Part III
Part IV: Other ALE Members (Line 36+)
The Name and EIN of other entities within the Aggregated ALE Group. · Part IV
Certification (Signature)
A declaration stating the return is true, correct, and complete under penalty of perjury. · Bottom of Page 1
ALE Member Status (Line 21)
Whether the ALE Member is a member of an Aggregated ALE Group ('Yes' or 'No'). · Part II
Before you submit
- 1Verify that the revision date on Form 1094-C is 20/25.
- 2Confirm that Line 18 accurately reflects the total number of Forms 1095-C accompanying this transmittal.
- 3Check if Line 19 requires a 'Yes' selection, indicating this is the authoritative transmittal for the ALE Member.
- 4If Part II, Line 21 indicates 'No,' confirm that Part IV has been omitted entirely (or is empty).
- 5Ensure all monthly counts in Part III are populated or marked as applicable/zeroed out.
- 6Verify that the Name and EINs listed in Part IV correspond to entities within the Aggregated ALE Group.
- 7Confirm a signature, title, and date have been placed at the bottom of Page 1.
How to file this form
- 1Complete Part I by entering the employer's name (Line 1), EIN (Line 2), and contact information through Line 16.
- 2Fill out Part II, indicating the total number of Forms 1095-C filed (Line 20) and selecting whether the ALE Member is part of an Aggregated ALE Group (Line 21).
- 3Populate Part III by entering the monthly coverage data for all 12 months across Lines 24 through 35.
- 4If required, complete Part IV by listing the Name and EINs of other members of the Aggregated ALE Group on Lines 36 onward.
- 5Sign and date the return under penalty of perjury at the bottom of Page 1 to certify accuracy.
- 6Submit Form 1094-C (2025) along with all accompanying Forms 1095-C, keeping a copy for your records.
Known limitations
- 1Part IV (Other ALE Members of Aggregated ALE Group) does not need to be completed if the ALE Member is not a member of an Aggregated ALE Group.
- 2The form requires specific certifications of eligibility to be selected from Part II, which include 'Qualifying Offer Method' and two items listed as 'Reserved'.
- 3If the filer checks "No" for question 19 ('Is this the authoritative transmittal for this ALE Member?'), they must refer to instructions (not provided verbatim) for further guidance.
Field map
Compact field-by-field guide
Payer Info
1 items
Identifying information of the business or person making the payment.
Recipient Info
1 items
Identifying information of the person or entity receiving the payment.
Amounts
1 items
The payment amount subject to reporting for the applicable box category.
Withholding
1 items
Backup withholding amount if applicable.
Signatures
1 items
Name and phone number of the person to contact about this return.
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Fillable formOpen in Editor->The current edition on file is 20/25, with a revision date of 5/21/25. The form directs users to www.irs.gov/Form1094C for instructions and the latest information.
What changed or needs a fresh check
- Edition date — confirm the revision date reads 20/25.
- Form number — confirm the document header displays Form 1094-C.
- Signature — ensure a signature, title, and date are present in Part I for declaration.
- OMB Number — verify the OMB No. is listed as 1545-2251.
- Total Forms Submitted — confirm the total number of Forms 1095-C being submitted is accurately recorded on Line 18.
Quick Facts
Downloads
After you file
- 1Retain a copy of Form 1094-C after filing.
- 2The form is dated as being created on 5/21/25, and the revision date is 20/25.
- 3Sign the return to certify that the information is true, correct, and complete under penalties of perjury.
- 4Ensure all required fields are completed, including Part I (ALE Member Information) and other relevant parts based on the ALE status.
Sources
- SRCForm 1094-C is the Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns (Page 1).
- SRCThe form revision date on file is 20/25 (Page 1).
- SRCPart I covers ALE Member information, including Name, EIN, Address, and Contact details for both the employer and designated government entity (Pages 1).
- SRCQuestion 18 specifies that Part I includes a total number of Forms 1095-C submitted with this transmittal (Page 1).
- SRCPart II requires checking if the ALE Member is part of an Aggregated ALE Group, and lists certifications like 'Qualifying Offer Method' (Page 1).
- SRCPart III provides monthly reporting fields for Jan 25 through Dec (Pages 2).
- SRCPart IV allows listing names and EINs of Other ALE Members within an Aggregated ALE Group (Pages 3).
- SRCThe form includes a declaration under penalty of perjury that the return is true, correct, and complete (Page 1).
Common confusion points
What is an 'ALE Member'?
The filer must be an Applicable Large Employer (ALE) Member who provided health insurance coverage.
How do I know if Part IV applies to me?
If the ALE Member is part of a group, what does 'Aggregated Group Indicator' mean?
What should I check in Part II under Certifications of Eligibility?
Where do the details for each month go?
Is there a specific deadline mentioned on this form?
What happens if I am NOT the authoritative transmittal?
Workflow map
Related forms and next steps
Before
Current
After
Often used with
⚠ If something goes wrong
- The filer must refer to instructions when answering question 19 regarding authority.
Questions about IRS Form 1094C
What is IRS Form 1094C used for?
This form serves as the cover sheet when you send in your required health insurance documentation to the IRS. It tells the agency which employer's records are included and provides summary details about the coverage offered during the year. The filing confirms that the accompanying documents meet IRS standards for reporting.
Who must file IRS Form 1094C?
An Applicable Large Employer (ALE Member) must file Form 1094-C with the Internal Revenue Service.
What information does IRS Form 1094C require?
The form collects extensive data, including Part I details like the ALE Member's EIN and contact information; Part II provides total counts and eligibility certifications; and Part IV lists other members of an Aggregated ALE Group.
Where do I file IRS Form 1094C?
The instructions direct users to go to www.irs.gov/Form1094C for routing specifics, but no specific service center address is listed on this form itself.
How do I complete IRS Form 1094C?
The preparer must fill out Part I with ALE Member details, then complete Part II summarizing coverage counts (like the total number of Forms 1095-C filed). If applicable, Part IV lists other members in an Aggregated ALE Group. Finally, a signature and date are required at the bottom.
What happens if IRS Form 1094C is filed incorrectly?
Under penalties of perjury, the filer declares that if the return and accompanying documents are not true, correct, and complete, they have made a false declaration.
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