Certain settings in the employee setup needs to be configured for us to be able to print a form 1095-C for an employee. This includes:

  • Employee Free Form Comments
  • Employee Contacts
  • Employee Check Marks
Configurations must be done or completed first before importing the XML file for the form 1095C. Otherwise, check marks will not be displayed in the form.

Employee Freeform Comments

Freeform comments, be it in an employee or company level, needs to have the heading to be configured first. This is a one-time setup, that once added into the system through a certain employee, these headings will then be readily available and visible across all employees.

Listed in Table 1 below are the needed configurations in the Employee Freeform comments tab of the employee setup. These comments will hold the information needed in the printing of form 1095-Cfor the completion of the form boxes 14, 15, and 16, as well as the Plan Start Month field in the Part II of the form 1095-C (Refer to Figure 1).

Figure 1: Part II Employee Offer Coverage of the Form 1095-C

Freeform Comment FieldsDescription / Heading
EE Freeform Comment 11Plan Start Month
EE Freeform Comment 12 - 24Box 14 All Months - Box 14 Dec
EE Freeform Comment 25 - 37Box 15 All Months - Box 15 Dec
EE Freeform Comment 38 - 50Box 16 All Months - Box 16 Dec

Table 1: Employee Freeforms for form 1095-C

Basically, when you have all the free form comments configured and already have some information pertaining to the appropriate fields, your Employee Free Form Comments would look like the image in Figure 2.

Figure 2: Employee Free Form Comments showing Free Form Comments #s 11 – 16.

Employee Contacts

Part III of the form, requires check marks to note if a beneficiary has been covered with a health insurance for specific month.

Employee Contacts tab of the employee setup is where the contacts or beneficiaries of the employees will be added. To be able to configure the check marks, it must also be configured first by following the steps below:

  • 1. Edit an existing contact and go to the Check Marks tab.
  • 2. In the grid, click anywhere and do the right-click.
  • 3. From the menu, you can select [Add] to add new check mark field, [Delete] if to delete an existing check mark, or [Rename] an existing check mark. This time, select [Add].
These check marks in the Employee Contact Check Marks tab are different with that of Employee Check Marks. Once added, these check marks will then be visible across all Employee Contacts.
  • 4. Add 13 check mark fields, each for each of the check boxes needed for every beneficiary in the part III of the form 1095-C by following step #3. Refer to the image below.

  • 5. To fill in the information, simply click on the check box and a date will then appear beside the box. By default, it will be the current date. However, you can change the date by simply double-clicking on the date to invoke the date screen and be able to select a date. You can choose a date from the past or in the future.

  • 6. So, in the image shown in #5, a check mark is set on Oct 2 ,2017. This will then appear in the form 1095-C of an employee to have a check mark in the column (d) Covered all 12 months of his beneficiary.

Employee Check Marks

As stated previously, this tab is different from that of the Employee Contact’s Check Marks tab. This is on a per employee level. Configuration needed in this module is a check mark for the Covered Individuals check box of the form 1095-C (Part III) as well as the Monthly Coverage information of the employee.

To check or uncheck the box, click on the box and a calendar will prompt, for you to be able to change or leave the date as it is.

Form Import

Before importing the XML file, you need to complete the configurations stated above. Otherwise, check marks will not be displayed in the form.

To import the XML file, go to Forms and Reports > Payroll Designer Then click the [Import] button


Once you have all the configurations added, you are now ready to enter necessary information for each employee. Currently, we must do it individually for there is no option that we can do an import/export of information to fill in those comment boxes.

Also, only pages 1 and 3 of the form 1095-C is available in the system.