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ACA: Should the System Generated 1095-C Form List Fully-Insured Covered Dependents in Part III ? (Doc ID 2926794.1)

Last updated on FEBRUARY 09, 2023

Applies to:

Oracle Advanced Benefits - Version 12.2.9 and later
Information in this document applies to any platform.


Should Fully Insured Plan Designated Dependents show up on the 1095-C form in Part III under Covered Individuals?

Example Verification:

1. Employer only has fully-insured medical plans
      - This can be checked by navigating to US Super HRMS Manager > Total Compensation > Programs and Plans > Plans > General Tab (Right side of panel).
      - Check field labeled 'Primary Funding Method' - should either say "Fully Insured" or "Self Insured".

2. Employee has at least one life event on file for the reporting year.
      - Check this by navigating to US Super HRMS Manager > People > Benefits Service Center > Desktop Activities > View Person Life Events

3. Check that employee is covered in a plan which is listed as Fully Insured

4. Employee has designated dependents in the plan (View in Desktop Activities (above navigation) > View Enrollment Results > Designate Dependents > View Checked individuals.

5. Now view the test 1095-C form under Total Compensation (Navigation from #1) > Affordable Care Act > View Employee Archive Details
      - Search by Year > GRE > Employee Name
      - View Part III in the test form page that displays
      - View that the covered dependents are not listed in Part III of the 1095-C form.



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