Id

Month of coverage. Available values:

• All: All months
• January: January
• February: February
• March: March
• April: April
• May: May
• June: June
• July: July
• August: August
• September: September
• October: October
• November: November
• December: December

Offer of Coverage Code. Required if Share has a value, including zero. Available values:

Pre-ICHRA Codes (available before 2020):

• 1A: Qualifying offer: minimum essential coverage providing minimum value offered to full-time employee with employee required contribution ≤ 9.5% (as adjusted) of mainland single federal poverty line and at least minimum essential coverage offered to spouse and dependent(s)
• 1B: Minimum essential coverage providing minimum value offered to employee only
• 1C: Minimum essential coverage providing minimum value offered to employee and at least minimum essential coverage offered to dependent(s) (not spouse)
• 1D: Minimum essential coverage providing minimum value offered to employee and at least minimum essential coverage offered to spouse (not dependent(s))
• 1E: Minimum essential coverage providing minimum value offered to employee and at least minimum essential coverage offered to dependent(s) and spouse
• 1F: Minimum essential coverage NOT providing minimum value offered to employee; employee and spouse or dependent(s); or employee, spouse, and dependents
• 1G: Offer of coverage to an individual who was not an employee or not a full-time employee and who enrolled in self-insured coverage
• 1H: No offer of coverage (employee not offered any health coverage or employee offered coverage that is not minimum essential coverage)
• 1J: Minimum essential coverage providing minimum value offered to employee and at least minimum essential coverage conditionally offered to spouse; minimum essential coverage not offered to dependent(s)
• 1K: Minimum essential coverage providing minimum value offered to employee; at least minimum essential coverage offered to dependents; and at least minimum essential coverage conditionally offered to spouse

ICHRA Codes (introduced 2020, require ZIP code):

• 1L: Individual coverage HRA offered to employee only
• 1M: Individual coverage HRA offered to employee and dependent(s) (not spouse)
• 1N: Individual coverage HRA offered to employee, spouse, and dependent(s)
• 1O: Individual coverage HRA offered to employee only using employment site ZIP code affordability safe harbor
• 1P: Individual coverage HRA offered to employee and dependent(s) (not spouse) using employment site ZIP code affordability safe harbor
• 1Q: Individual coverage HRA offered to employee, spouse, and dependent(s) using employment site ZIP code affordability safe harbor
• 1R: Individual coverage HRA that is NOT affordable
• 1S: Individual coverage HRA offered to an individual who was not a full-time employee
• 1T: Individual coverage HRA offered to employee and spouse (not dependents)
• 1U: Individual coverage HRA offered to employee and spouse (not dependents) using employment site ZIP code affordability safe harbor

Note: Codes 1B, 1C, 1D, 1E, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1T, 1U require employee share amount (0.00 is a valid value).

Employee required contribution share - Employee Share of Lowest Cost Monthly Premium, for Self-Only Minimum Value Coverage - May not exceed 3499.99

Safe harbor code - Applicable Section 4980H Safe Harbor Code. Available values:

• 2A: Form W-2 safe harbor
• 2B: Federal poverty line safe harbor
• 2C: Rate of pay safe harbor
• 2D: Part-time employee safe harbor for employees who were not full-time for any month of the year
• 2E: Multiemployer interim rule relief
• 2F: Qualifying offer method
• 2G: Qualifying offer transition relief
• 2H: Other affordability safe harbor

ZIP/postal code. For coverage area (optional, unless codes 1L to 1U are used).