IRS · Official form

Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns

Form 1094-C is the cover sheet an Applicable Large Employer sends to the IRS along with its Forms 1095-C. Fill in the official IRS PDF below and download it.

This is the genuine IRS PDF, unmodified. Source: IRS official page.

What is 1094-C?

Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, summarizes an employer’s Affordable Care Act reporting for the year. It tells the IRS how many Forms 1095-C are attached, whether the employer offered minimum essential coverage each month, and its full-time employee counts.

One Form 1094-C must be designated as the authoritative transmittal for the employer. That copy carries the employer-level detail: total 1095-C count, aggregated ALE group membership, and the monthly certification boxes in Parts II through IV.

Who files 1094-C?

  • Applicable Large Employers (ALEs), generally those with 50 or more full-time employees including full-time equivalents
  • Each member of an aggregated ALE group files its own 1094-C for its own employees
  • Employers filing any Form 1095-C, since every batch of 1095-Cs needs a transmittal
  • Third-party administrators filing on an employer’s behalf, using the employer’s EIN

How to fill out 1094-C

  1. Enter the employer’s name, EIN, address, and a contact person in Part I, and the number of Forms 1095-C submitted with this transmittal.
  2. Check the box on line 19 if this is the authoritative transmittal, and if so complete Part II with the total 1095-C count and ALE group status.
  3. In Part III, certify month by month whether minimum essential coverage was offered and enter full-time and total employee counts.
  4. List other members of the aggregated ALE group in Part IV if applicable.
  5. Download the finished PDF for your records. Most employers must file it with the IRS electronically along with the Forms 1095-C.
Worth knowing: Most employers must file Forms 1094-C and 1095-C with the IRS electronically through the AIR system; paper filing is allowed only for very small filers. Check the current instructions at irs.gov before mailing anything.

Quick fill 1094-C on this page

Prefer to see the form itself while you type? Open 1094-C in the editor to fill it on the actual pages, add a signature, and download.

These are the form's own fields, in the order they appear on the pages. Fill in what you know; anything left blank stays a fillable field in the PDF, so you can finish it in any PDF reader. Nothing you type here is sent to IRS.

Page 1 25 fields
Page 2 65 fields
Page 3 60 fields

Processed on our own servers, never sent to a third-party service. Files are deleted automatically after two hours, and you can delete them sooner from the result screen.

Frequently asked questions

What is the difference between Form 1094-C and 1095-C?

Form 1095-C reports the coverage offered to one individual employee. Form 1094-C is the transmittal that summarizes and accompanies all of those 1095-Cs when the employer files them with the IRS.

Does every employer file Form 1094-C?

No. It applies to Applicable Large Employers, generally those averaging 50 or more full-time employees including full-time equivalents in the prior year. Smaller employers with self-insured plans use Forms 1094-B and 1095-B instead.

What is an authoritative transmittal?

If an employer sends more than one 1094-C batch, exactly one must be marked authoritative on line 19. Only that copy carries the employer’s aggregate totals and monthly certifications for the whole year.