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How do I complete line 15 on the 1095-C form?

Views: 1509 Created: 2016-07-28 11:50 Last Updated: 2016-08-24 16:01


How do I complete line 15 on the 1095-C form?


Line 15 on the 1095-C is for the employee share of the lowest cost monthly premium for self-only minimum value coverage.  Line 15 is only required if you entered code 1B, 1C, 1D, or 1E on line 14.

To complete line 15, enter the dollar value of the lowest cost premium option offered to that employee.  Even if the employee actually enrolled in a higher cost coverage option, or opted out of coverage all together, line 15 should reflect the premium of the lowest cost option offered.

When entering or importing data for line 15, if the same premium applies to the entire calendar year, the value may be entered into the All 12 Months box.  However, if the lowest cost premium varied during the calendar year, enter the correct dollar amount in each of the individual monthly boxes.  If you are required to enter an amount in line 15 and if the employee was not required to contribute to the premium, enter 0.00, do not leave the box blank.

An example:

  • An employer offers options of single-only coverage for $100 per month or family coverage for $200 per month.  The premium entered on line 15 will be $100, even if the employee actually enrolled in family coverage.


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