3.41.267 Affordable Care Act Information Return Processing on Service Center Recognition/Image System (SCRIPS)

Manual Transmittal

November 14, 2017

Purpose

(1) This transmits IRM 3.41.267, Optical Character Recognition (OCR) Scanning Operations, Affordable Care Act Information Return Processing on Service Center Recognition/Image System (SCRIPS).

Material Changes

(1) Editorial, spelling corrections throughout this IRM.

(2) IRM 3.41.267.1, Program Scope and Objectives, section replaced Ethics as required in IRM 1.11.2.2.5, Address Management and Internal Controls. All subsequent sections in the IRM were updated to reflect the addition.

(3) IRM 3.41.267.2(2) Instruction on the processes for IRM deviation was moved to related resources relocated to IRM 3.41.267.1.7(2).

(4) IRM 3.41.267.2.1(1) Tax year 2017 was added to the instruction.

(5) IRM 3.41.267.2.2(2)

  • Reduced the output file normal limit of 200,000 data records to 50,000 for production startup on 05/01/2017. IPU 17U0788 issued 05-03-2017

  • Reinstated the 200,000 data records file size from IPU 17U0788 directly above.

(6) IRM 3.41.267.2.3

  • (1) Updated the references to the keystroke combinations to reflect the standard keyboard now used.

  • (2) Replaced the term glossary with Terms/Acronyms/Definitions and updated the reference to the new location of the glossary in the instruction.

  • (4) Placed lists of tables in a table showing location, name, and use for each.

  • (4)a) Updated the reference to location of the glossary which moved from an exhibit to IRM 3.41.267.1.6.

  • (4)c) Added reference to new Exhibit 3.41.267-5 which contains a table for informational use.

(7) IRM 3.41.267.3 Removed the reserved statement and added instruction on document preparation done at the scanner. IPU 17U1067 issued 06-27-2017

(8) IRM 3.41.267.3.1(1)

  • Clarification of the valid delinquent dates for tax year 2015 and tax year 2016 were added. IPU 17U0788 issued 05-03-2017

  • A note was added to the instruction to suspend to supervisor any units of work (UWs) where the system will not allow entry of a valid received date. IPU 17U0788 issued 05-03-2017

  • The note added on IPU 17U0788 directly above was removed due to system programming updates.

(9) IRM 3.41.267.3.1(2) Tax years for penalty assessment under delinquent return date column was updated to reflect the new tax year being processed

(10) IRM 3.41.267.3.2.1

  • (1) Added an additional reject code X and clarified a page within the unit of work could be rejected. IPU 17U1067 issued 06-27-2017

  • (2) Added a title, Source Documents, after the stated reference cited in the instruction. IPU 17U1067 issued 06-27-2017

  • (3) Clarified the instruction by defining a single page within the form could be rejected. IPU 17U1067 issued 06-27-201

(11) IRM 3.41.267.5(3) Updated the references to the keystroke combinations to reflect the standard keyboard in use.

(12) IRM 3.41.267.6.1(5) and (6) Keystroke reference changed from <CTRL> to <Ctrl> to reflect the standard keyboard in use.

(13) IRM 3.41.267.6.2

  • Keystroke reference changed from <CTRL> to <Ctrl> to reflect the standard keyboard used.

  • (2) Form Identification (FI) tables were updated to represent the filing season 2018 screen used for identifying pages not identified at the scanner.

  • (4)b) OE from paper was added to the reasons a unit of work would be pulled from traditional processing.

(14) IRM 3.41.267.7.1 Updated the references to the keystroke combinations to reflect the standard keyboard used.

(15) IRM 3.41.267.7.3

  • (4) Existing instruction restructured for consistency to match the format of the like instruction located at IRM 3.41.267.7.1(4).

  • (5) Updated the references to the keystroke combinations to reflect the standard keyboard used.

(16) IRM 3.41.267.7.4(7) Updated the references to the keystroke combinations to reflect the standard keyboard used.

(17) IRM 3.41.267.7.5 Keystroke reference changed from <CTRL> to <Ctrl> to reflect the standard keyboard used.

(18) IRM 3.41.267.7.6 Updated the references to the keystroke <CTRL> to <Ctrl> and <Action/Enter> to <Enter> because standard keyboards are used.

(19) IRM 3.41.267.7.8(2)d) Key combination <CTRL>-<AUTO> was updated to <Ctrl>-<Shift>-<A> due to the switch to standard keyboards.

(20) IRM 3.41.267.7.8.1 Keystroke reference changed from <CTRL> to <Ctrl> to reflect the standard keyboard now used.

(21) IRM 3.41.267.7.8.2 Updated the references to the keystroke <CTRL> to <Ctrl> and <Action/Enter> to <Enter> because standard keyboards now used.

(22) IRM 3.41.267.9(4)

  • The earliest year cut off was updated from 1896 to 1897 for filing season 2017 production. IPU 17U0788 issued 05-03-2017

  • The earliest year cut off was updated from 1897 to 1898 for filing season 2018 production.

  • Keystroke reference <F14> was changed to <Ctrl>-4 to reflect the standard keyboard combination now required.

(23) IRM 3.41.267.9

  • (9) The word second was removed from the instruction since there is not a second name line in the program. The reference to alpha and down was changed to Shift up arrow and shift down arrow due to standard keyboard use.

  • (14) Cross validation for Form 1095-B, Health Coverage, line nine to line eight comparison notated to be valid for tax year 2015 only.

(24) IRM 3.41.267.9.3(1)

  • n) and o) Updated the references to the keystroke <Action/Enter> to <Enter> because standard keyboards in use.

  • p) and q) Names of field prompts updated and valid amount of characters for those fields added.

(25) IRM 3.41.267.9.5(2)

  • e) Instruction to enter 0 if 0 or 00 is present on the field as a taxpayer entry.

  • f) Updated the references to the keystroke <Action/Enter> to <Enter> because standard keyboards in use.

(26) IRM 3.41.267.9.5(6) Updated the references to the keystroke <Action/Enter> to <Enter> due to the change to standard keyboards.

(27) IRM 3.41.267.9.7(2) Added instruction to void Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, documents misplaced in the wrong submission.

(28) IRM 3.41.267.10(3) Added additional instance when re-imaging the transmittal is required.

(29) IRM 3.41.267.11(1) OE from paper was incorporated into the criteria for a transmittal to be routed for 1094 series image only processing.

(30) IRM 3.41.267.11.1(4) Screen selection menu was updated for DV image only selection to reflect the system changes for filing season 2018 and the references to the keystroke combinations changed to reflect the standard keyboard used.

(31) IRM 3.41.267.12

  • (1) Two additional reference reports were added to the instruction listing: Throughput Statistics Report and Workstation Operator Statistics. The previously listed Cumulative DLN Report was updated to read Cumulative DLN Assignment Report. IPU 17U0788 issued 05-03-2017

  • (1) Name was changed for the override report from "<F14> Override Report" to "Override Report" .

  • (2) Reference to a table present resembling each of the reports was removed.

(32) IRM 3.41.267.12.3

  • The word "assignment" was added to the title to reflect the true title of the report. IPU 17U0788 issued 05-03-2017

  • (1) A leading zero was removed from the report number. IPU 17U0788 issued 05-03-2017

(33) IRM 3.41.267.12.4"<F14>" was removed from the title and instruction content to reflect the standard keyboard used.

(34) IRM 3.41.267.12.6 The descriptions of the production report was updated throughout the subsection. IPU 17U0788 issued 05-03-2017

(35) IRM 3.41.267.12.8(4)

  • Condition for missing parent name was updated. Report reason for missing parent employer identification number (EIN) and applicable condition was added. IPU 17U0788 issued 05-03-2017

  • A notation of Tax Year 2015 Only was added to the threshold table for Form 1095-B, Health Coverage, where line 8 and line 9 filer entries are not compatible. Other tax years do not contain a line nine for this threshold.

(36) IRM 3.41.267.12.9 A subsection for description of the Throughput Statistics Report (IPS06440) was added. IPU 17U0788 issued 05-03-2017

(37) IRM 3.41.267.12.10 A subsection for description of Workstation Operator Statistics Program and Function Summary Report (IPS00803) was added. IPU 17U0788 issued 05-03-2017

(38) IRM 3.41.267.13

  • A section was added to instruct on block status window access and monitoring. IPU 17U0788 issued 05-03-2017

  • Updated the references to the keystroke <ALT> to <Alt> because a standard keyboard is now in use.

(39) IRM 3.41.267.13.1 A subsection was added to instruct on actions to take for output verification suspended documents. A table was added containing the reason codes, status and the description of each reason code condition. IPU 17U0788 issued 05-03-2017

(40) IRM 3.41.267.14

  • A section titled, Purging Documents, was added to instruct on what conditions must be present prior to purging documents from the system. IPU 17U1308 issued 09-05-2017

  • (7) Document 12990, Records Control Schedules and the requirement

(41) Exhibit 3.41.267-1 Exception for four digit form identification number (Form ID) was replaced to reflect the only form and tax year which does not meet the definition due to a revision of the form identifiers (IDs). The word "current" was removed from the YYTY definition since the program will be processing prior year returns. IPU 17U0788 issued 05-03-2017

(42) Exhibit 3.41.267-2 The title was change from "Glossary of Terms" to "Terms/Definitions/Acronyms" .

(43) Exhibit 3.41.267-3 Zone Improvement Plan was added to the title to precede the acronym ZIP.

(44) Exhibit 3.41.267-4 Zone Improvement Plan was added to the title to precede the acronym ZIP.

(45) Exhibit 3.41.267-5 A table of major city codes was added for use in entering the address fields.

(46) Exhibit 3.41.267-6

  • Instruction for tax year 2015 valid delinquent date added to existing current year instruction for the Form 1094 (series) returns. Tax year screen prompt and related instructions were moved from below the corrected box instruction to above the void box prompt for the Form 1095 (series) returns. IPU 17U0788 issued 05-03-2017

  • Throughout the exhibit updates were made to references to use the keystroke <Action> or <Enter> to <Enter> because standard keyboards in use.

  • Throughout the exhibit updates were made to the instructions for the prompt Date of Birth to instruct to enter data in the field if the three components (MM, DD, YYYY) of the date are able to be determined.

  • Form 1094, (series) returns instructions for the prompt, Delinq. Return Date, were updated with the new valid delinquent date ranges for filing season 2018.

  • Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, page 1, prompt, Line 22-Offer Method Transition, only valid for tax year 2015 was added to the instruction and the existing note was removed for consistency.

  • Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, page 1 prompt, Line 22-Sec. 4980H, was updated by adding the only valid for tax years 2015 and 2016. Which tax years the prompt will be displayed on was added to the instruction column.

  • Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, page 2 prompt, Line 23-12 months-Sec. 4980H Ind., was updated by adding the only valid for tax years 2015 and 2016. Which tax years the prompt will be displayed was added to the instruction column.

  • Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, page 2 prompt, Line 24-Jan-Sec. 4980H Ind. through Line 35-Dec-Sec. 4980H Ind., was updated by adding the only valid for tax years 2015 and 2016. Which tax years the prompt will be displayed was added to the instruction column.

  • Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, page 1 prompts for Line 15, received added instruction to enter a zero (0) if 0 or 00 was present on the taxpayer’s entry. Instruction also added to not enter a zero if a negative sign was present on the entry.

  • Instruction was added to each instance to not make an entry and press <Enter> if the Social Security Number (SSN) present is a single repeating digit such as 111111111, 222222222, etc., or sequential 123456789 for the Form 1095 series.

(47) Exhibit 3.41.267-7 Additional exhibit was cited in the reminder for Zone Improvement Plan (ZIP) Code and Country/Foreign postal code, valid character column.

(48) Exhibit 3.41.267-8 An exhibit was added to for use as an aid in determining which reports to use for input of receipt and production volumes when dropping unit production cards (UPCs) into the Batch/Block Tracking System (BBTS). IPU 17U0788 issued 05-03-2017

Effect on Other Documents

IRM 3.41.267 dated November 16, 2016 (effective January 01, 2017) is superseded. This IRM incorporates the following IRM Procedural Updates (IPUs): 17U0788 issued 05-03-2017, 17U1067 issued 06-27-2017, and 17U1308 issued 09-05-2017.

Audience

These instructions will be used by Wage and Investment, SCRIPS Processing Site employees working paper submitted Affordable Care Act information returns.

Effective Date

(01-01-2018)

Linda J. Brown
Director, Submission Processing
Wage and Investment Division

Program Scope and Objectives

  1. This program provides human intervention for data verification of electronic data record created by optical recognition engines for the purpose of data capture from paper returns filed with the Service.

  2. Purpose: Daily processing of processable paper filed Affordable Care Act information returns processing (ACA-IRP) on the Service Center Recognition/Image Processing System (SCRIPS) are covered in this IRM. This processing will convert the taxpayer data reported to electronic data records for further validations to be applied to determine if the filer’s information return submission is acceptable to fulfill the filers filing requirement.

  3. Audience: The users of the IRM are Submission Processing data transcribers in Data Conversion Operation and their support staff which includes but is not limited to the following: peripheral operators, clerks, leads and supervisors. These instructions apply to all campuses.

  4. Policy Owner: The Director of Submission Processing.

  5. Program Owner: Mail Management Data Conversion Section, Paper Processing Branch (an organization within Submission Processing).

  6. Primary Stakeholders: Service and Enforcement, ACA Implementation, Compliance Strategy and Policy and Small Business/Self Employed (SB/SE), Operations Business Support, and Office of Servicewide Penalties are affected by the completion of these data records to posting.

Background

  1. Paper information returns which are sent to the Service by filers to fulfill their requirement to file an information return with the Service and provide their taxpayer identification number (TIN). The information present on the filings must be converted to an electronic data record for use by the Service. Input of data present and validation of the data records during conversion of these paper returns to electronic data records is required.

Authority

  1. Authority for these procedures is found in Title 26 of the United States Code (USC) or more commonly known as the Internal Revenue Code (IRC). The IRC has been amended by acts, public laws, treasury determinations, rules, and regulations such as the following:

    • Information Reporting on Health Coverage by Insurers IRC 6055

    • Information Reporting on Health Coverage by Employers IRC 6056

    • Failure to File a Correct Information Return IRC 6721

    Note:

    The above list may not be all inclusive of the various updates to the IRC.

Responsibilities

  1. The Operations manager is responsible for securing, assigning and providing training for the staff needed to perform the task required throughout this instruction.

  2. The Planning and Analysis Staff is responsible for providing feedback and support to local management to achieve and effectively monitor scheduled goals.

  3. The team manager is responsible for assigning, monitoring and controlling the work flow to accomplish timely completion of the tasks required throughout this IRM.

  4. The employee is responsible for applying the instruction present to the assigned task on the SCRIPS system to accurately convert paper data to an electronic data record for proper posting for use by the Service.

Program Management and Review

  1. Program Goals: The goal of this program is to convert processable Affordable Care Act information documents filed on paper media to electronic data records.

  2. Program Reports: Below is a list of reports which show schedules, receipts, production and inventory for the paper documents to electronic data conversion process. These reports will be utilized to report and monitor daily and weekly status of the program to completeness:

    • IPS0083, Workstation Operator Statistics Program and Function Summary Report

    • IPS01119, Run Balance Report

    • IPS06440, Throughput Statistics Report

    • PCC 2240, Daily Production Report - Program Sequence

    • PCC 6040, SC WP&C Performance and Cost Report

    • PCC 6240, SC WP&C Program Analysis Report

    • PCB 0440, Daily Workload and Staff Hours Schedule

    • PCB 0540, Weekly Workload and Staffing Schedule

  3. Program Effectiveness: Goals will be measured utilizing standard managerial reports by documents processed per hour and completion of each function compared to the established schedule for completion each week. Each functionality is expected to retain or exceed schedule prior to the program completion date stated in IRM 3.30.123, Work Planning and Control - Processing Timeliness: Cycles, Criteria, and Critical Dates. Quality reviews are expected to be conducted and monitored by local management and corrective action taken to ensure quality products are released to the next function.

  4. Annual Review: Review the processes included in this manual annually to ensure accuracy and promote consistent tax administration. This may be included under responsibilities for a manager

Program Controls

  1. Unit Production Cards (UPCs) are dropped daily to record activity in each functionality of this program. See Exhibit 3.41.267-8, Unit Production Card (UPC) Inputs for Batch Block Tracking System (BBTS), for instruction on where to obtain each required number for reporting.

  2. Local reports may be utilized to establish additional information for maintaining daily program control. Local reports do not replace the established official reports and required production reports.

Terms/Definitions/Acronyms

  1. The terms and acronyms utilized throughout this instruction are located in Exhibit 3.41.267-1, Terms/Acronyms/Definitions.

Related Resources

  1. The following table lists the IRM primary sources of guidance on the processing of paper filed forms under the Affordable Care Act program.

    IRM Title Guidance on
    IRM 3.10.5 Campus Mail and Work Control - Batch/Block Tracking System (BBTS) utilizing BBTS to drop unit production cards for daily incoming receipts and production
    IRM 3.10.72 Campus Mail and Work Control - Receiving, Extracting, and Sorting receiving, extracting, sorting, and routing mail within the Submission Processing campuses
    IRM 3.10.8 Campus Mail and Work Control - Information Returns Processing fine sorting, correspondence routing and disposition for Information Returns Program
    IRM 3.13.62 Campus Document Services, Media Transport and Control shipping of SCRIPS requests
    IRM 3.41.274 OCR Scanning Operations, General Instructions for Processing via SCRIPS workstation functions, workstation keyboard, windows environment and general instruction for entering data from tax returns and related data through SCRIPS
    IRM 3.41.275 OCR Scanning Operations, Scanner Operations on SCRIPS scanning returns on the SCRIPS scanner
    Document 12990 Records Control Schedules time frame to destroy paper sample after conversion to electronic data records
    Document 13056 Employee Toolkit: Shopping for Personally Identifiable Information (PII) shipping of SCRIPS requests
    Document 13144 Proper PII Shipping Procedures shipping of SCRIPS requests
  2. IRM deviations must be submitted in writing following instructions from IRM 1.11.2.2, Internal Management Documents System - Internal Revenue Manual (IRM) Process, IRM Standards, and elevated through appropriate channels for executive approval.

  3. The IRS adopted the Taxpayer Bill of Rights in June 2014. Employees are responsible for being familiar with and acting in accordance with taxpayer rights. See IRC 7803(a)(3), and the following site for additional information about the Taxpayer Bill of Rights: http://irweb.irs.gov/AboutIRS/tbor/default.aspx.

  4. Ship SCRIPS document requests in accordance with IRM 3.13.62, Campus Document Services, Media Transport and Control, following Personally Identifiable Information (PII) guidelines located at: http://publish.no.irs.gov/mailtran/pii.html, titled Postal and Transport Policy. Prepare Form 3210, Document Transmittal, and include with ship documents.

Introduction

  1. This IRM section describes certain tasks necessary in the processing of Affordable Care Act information returns processing (ACA-IRP) filed on paper with the Service Center Recognition/Image Processing System (SCRIPS).

Source Documents

  1. The instructions in this section apply only to the form types listed below for tax years 2015 through 2017:

    Affordable Care Act Information Returns Processing (ACA-IRP)
    Form, Title
    Form Characteristics
    Form 1094-B, Transmittal of Health Coverage Information Returns transmitting one or more Form 1095-B, Health Coverage
    Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns transmitting one or more Form 1095-C, Employer-Provided Health Insurance Offer and Coverage
    Stand-alone Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns (SA1094C) must have an entry in both corrected box (checked) and Part I, Line 19 box (checked)
    Form 1095-B, Health Coverage transmitted by Form 1094-B, Transmittal of Health Coverage Information Returns
    Form 1095-C, Employer-Provided Health Insurance Offer and Coverage transmitted by Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns

Program Codes

  1. Program number 44320 will be used for the processing functions of Affordable Care Act information returns as instructed in this IRM.

  2. Output files will be limited to approximately 200,000 data records of each form type ("B" and "C" ) to accommodate the receiving systems limitations.

    Example:

    A valid output file will consist of no more than 200,000 data records of form type "B" and 200,000 data records of form type "C" .

How to Use This Internal Revenue Manual (IRM)

  1. Keystroke Combinations:

    • Carets enclose keystroke combinations (e.g., <Enter> ).

    • A hyphen separates multiple keystroke combinations (e.g., <Ctrl>-M). This means hold down the <Ctrl> key while pressing the "M" key.

  2. Terms and Acronyms - Exhibit 3.41.267-1, Terms/Definitions/Acronyms, contains terms and the definitions of terms related directly and indirectly to ACA-IRP SCRIPS processing.

  3. QUICK START - Each function (Original Entry Image (OE-Image), Data Validation Image (DV-Image)) begins with QUICK START instructions intended to speed access to a unit-of-work (UW). Detailed data entry and validation instructions are found in the following narrative, see IRM 3.41.267.9, General Correction Procedures, and the tables and transcription sheet exhibits in the back of this IRM. General instructions may also be found in IRM 3.41.274, OCR Scanning Operations, General Instructions for Processing via SCRIPS.

    Reminder:

    Whenever IRM 3.41.274, OCR Scanning Operations, General Instructions for Processing via SCRIPS, and this IRM conflict, this IRM will take precedence.

  4. Tables

    Table Location Table Table Entries and Use
    Exhibit 3.41.267-1 Terms/Acronyms/Definitions provides the corresponding definitions for the provided listing of terms and abbreviations utilized throughout section 267 of chapter 41.
    IRM 3.41.267.1.7 Related Resources list the related resources to be used in conjunction with the instruction given
    IRM 3.41.267.2.1 (1) Source Documents
    Form list and form characteristics
    list each form name and title and states the characteristics of each form type
    IRM 3.41.267.5 (3) Workstation Operations
    Specific Key Functionality
    list specific keyboard keys and key combinations with the functionality of each listed
    Exhibit 3.41.267-2 States, State Codes, and Zone Improvement Plan (ZIP) Codes Sorted by State lists ZIP code ranges sorted by the state
    Exhibit 3.41.267-3 States, State Codes, and Zone Improvement Plan (ZIP) Codes Sorted by ZIP Code lists states sorted by the ZIP code range
    Exhibit 3.41.267-4 Zone Improvement Plan (ZIP) Code, City, and State Exceptions lists exceptions to the ZIP code ranges
    Exhibit 3.41.267-5 Alphabetical Listing of Major Cities with Major City Codes and Zone Improvement Plan (ZIP) Codes lists major city codes for use with address entry
    Exhibit 3.41.267-6 Affordable Care Act Information Return Transcription Sheets lists screen prompt and instruction by form page for use in the OE and DV functions
    Exhibit 3.41.267-7 Valid Characters list valid characters and describes the characters allowed in fields present on the transcription sheets
  5. Transcription sheets:

    • Exhibit 3.41.267-6, Affordable Care Information Return Transcription Sheets, and contains transcription sheets for use in the OE and DV functions.

    • There are separate sheets for each form type and page number defining, screen prompt, description and instruction of each individual data field present on the documents.

    • These sheets provide most of the information needed to process ACA-IRP documents on SCRIPS.

Affordable Care Act Information Return Processing Document Preparation

  1. Use IRM 3.41.275, OCR Scanning Operations, Scanner Operations on SCRIPS, for instruction on scanning forms into the SCRIPS system.

  2. Perform perfection by placing the UW in the proper succession (order) to make it scannable if required.

    Example:

    A Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, contains a blank page 2 and a completed page 2 followed by a page 3. Cover the entire blank page 2 or copy page 1, in order to scan the work into the SCRIPS system.

  3. If condition exists prohibiting scanning of a processable UW perform OE from paper process on the UW.

    Note:

    Form 1094 (series) return must still under go image only process for the retention copy.

Coding of Late-Filed Submissions

  1. Late filed Form 1094-B, Transmittal of Health Coverage Information Returns, and Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, submissions received from the IRP sort function with an IRS Received Date stamp require the Delinquent Return Date (IRS received date) and Delinquent Return Indicator information processed.

  2. Delinquent Return Indicator - (Box 1) may be coded in the delinquent return indicator field (left most "For Official Use Only" box). If indicators ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ are present do not enter a delinquent return date.

    Delinquent Return Indicator Definition of Indicator Delinquent Return Date
      Assessed Return ≡ ≡ ≡ ≡ ≡ ≡
      Collection secured ≡ ≡ ≡ ≡ ≡ ≡
    ≡ ≡ ≡ Examination secured ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡
    Suppress notice indicator ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡
      Prepared by Civil Penalty Unit ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡
    ≡ ≡ Penalty assessment will be automatic Return date required
    • for tax year 2017 ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡

    • for tax year 2016 ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡

    • for tax year 2015 ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡

    blank Timely filed - no date No date entry
  3. A Delinquent Return Date, (boxes 2 through 7) is not present on the transmittal (Form 1094 (series) return) AND delinquent return code ≡ ≡ ≡ ≡ ≡ ≡ ≡ is not present, AND it has a valid IRS received date stamp, there should be a delinquent return indicator "≡ ≡ " and a valid received date entered in the 2nd, 3rd, 4th, 5th, 6th and 7th "For Official Use Only" boxes. Enter the date in the MMDDYY format from the boxes or the received date stamp. If there is an "≡ ≡ ≡ " entered in the field and no delinquent return date or an invalid delinquent return date is present remove the "≡ " .

Scanner

  1. See scanner operator instruction in IRM 3.41.275, OCR Scanning Operations, Scanner Operations on SCRIPS, for complete scanner operating instructions.

  2. In order to scan ACA-IRP select manual feed process from the transport console "IRP-ACA" menu.

    Note:

    The system will assume the first page is a Form 1094 (series) returns.

  3. Submissions (Form 1094 (series) and all associated Form 1095 (series)) will be scanned again one submission at a time.

    Note:

    The scanner will not reject any pages except mechanical rejects.

  4. Press the <F3> key to denote the end of the submission which will prompt "Start New Batch, or Q to Quit" .

Scanner Rejects
  1. The scanner will print the reject code "M" (Mixed Document Type) or "X" to the left of the Document Locator Number (DLN) area on any form or page rejection.

  2. A mixed document type submission received from the scanning function will always be one of the form types listed in IRM 3.41.267.2.1 (1),Source Documents.

  3. Only "non-conforming" , mixed, invalid document types, or pages within the submission will reject.

Correspondence on Processable Returns

  1. No entry is "valid" for use with this program.

  2. Remove any entry present in the screen input if noticed.

Unprocessable Unit-of- Work

  1. All unprocessable documents will be returned to the IRP sort function. The IRP sort function will correspond with the filer concerning their submission and ask the filer to refile processable documents.

Unprocessable Unit-of-Work Conditions

  1. The following conditions make a "return" unprocessable:

    • You cannot determine what the taxpayer data is (foreign language, completely illegible).

    • You cannot determine the type of return.

    • You cannot determine the tax year of the return.

    • Invalid tax year on the 1094 series.

      Example:

      Tax year 2014 or prior are not valid returns for SCRIPS to process.

    • You cannot determine the tax year of the submission.

      Example:

      The tax year on the transmittal and the tax year on all details do not match.

    • When the name of the filer/employer on the transmittal document (Form 1094 (series)) has one or more of the first four characters present illegible, is entirely illegible, or missing and cannot be secured from the first detail record.

      Exception:

      For Form 1094-B, Transmittal of Health Coverage Information Returns, the filer cannot be secured from the first detail record or any of the detail documents.

    • The filer altered box titles.

    • The submission did not contain a transmittal (corresponding Form 1094 series return).

    • When the filer or employer Employer Identification Number (EIN) on the transmittal has an illegible character or is missing and not available on the first detail.

      Exception:

      For Form 1094-B, Transmittal of Health Coverage Information Returns, the filer cannot be secured from the first detail record or any of the detail documents.

    • When the EIN on the transmittal is equal to a repeating number or sequential numbers.

      Example:

      A repeating EIN is 11-1111111, 22-2222222, etc., and a sequential EIN is 12-3456789.

    • The submission is a Form 1094-B, Transmittal of Health Coverage Information Returns, with no corresponding Form 1095-B, Health Coverage, records.

    • The employer EIN on Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, does not match the employer listed on Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, being transmitted and is noticed.

      Caution:

      This does not apply to the "B" series.

    • The submission is a Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, with no corresponding Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, records "and" the corrected box "and" line 19 both "are not marked" by the filer.

Unprocessable Unit-of-Work Disposition

  1. All unprocessable units-of-work (UW) will be pulled daily and returned to the IRP sort unit for taxpayer correspondence or disposition.

  2. A report titled, IRP ACA Pull Document/Submission Report, will display additional unprocessable UW’s which will be pulled and daily and returned to the IRP sort unit. Characteristics of the report can be seen in IRM 3.41.267.12.8, Pull Unit of Work (Submission) Report.

Workstation Operations

  1. Refer to the IRM 3.41.274, OCR Scanning Operations, General Instructions for Processing via SCRIPS, for a description of these and other items:

    • Keyboard Layout

    • Login/Logoff

    • Operator Statistics

    • Post-to-Close

    • Interrupt/Resume

    • Suspend/Resume

    • Status Line

    • Window Prompts

    • Key Functions

  2. Whenever IRM 3.41.274, OCR Scanning Operations, General Instructions for Processing via SCRIPS, and this IRM conflict, this IRM will take precedence.

  3. Some function key descriptions are listed in the table below.

    Key Description
    <F5> Allows you to move the entry field so that it appears in different places relative to the area on the scanned image.
    <F7> or <Esc> Allows you to go back and review previous documents or previous pages in the unit-of-work.
    <Insert> Places the cursor in Overstrike Mode. The keyboard is normally in Overstrike Mode; however, <Insert> takes the keyboard out of Overstrike Mode.
    <Ctrl>-<Shift>-<Delete>
    <Ctrl>-<Shift>-<Del>
    Deletes a unit-of-work.
    <Ctrl>-<Shift>
    and arrow keys (←→↑↓arrows)
    Allows you to move the image strip when it is not lined up. Will hold the position for the current image.
    <Ctrl>-<D> Copies the data from the same field on the previous document.
    <Page Up> ACA IRP: Allows you to move between page 1, page 2 and or page 3(s) of Form 1094-C, Form 1095-B and Form 1095-C.
    <Page Down> ACA IRP: Allows you to move between page 1, page 2 and or page 3(s) of Form 1094-C, Form 1095-B and Form 1095-C.
    <Ctrl>-M Enlarges the size of the scanned image that appears above the entry field.
    <Ctrl>-L Reduces the size of the scanned image that appears above the entry field.

Forms Identification (FI) Function

  1. The scanner will not recognize all documents or all pages of all documents. These pages of the documents are called non-conforming forms. They could be photocopies of official documents, official forms but for some reason do not meet the official specifications for measurement, homemade documents of varying formats or documents without the required form identification number in the upper right hand corner of the page. The FI function allows the manager/work leader to identify the form (or the page of the form) to avoid rework at the scanner. The FI screen has an image and an entry template on the right. The entry template permits the operator to select what form type the image is, or to delete a single image or an entire submission from further processing. The menus shown on the screen will vary depending on how your supervisor profiled you.

    Example:

    If you are not profiled for the FI function, this option will not be present on the OE Function Menu.

Forms Identification (FI) QUICK START

  1. From the Workstation Main Menu, select the numeric code for Original Entry (OE).

  2. From the Original Entry (OE) Selection Menu, select the numeric code for Form Identification (FI) Selection Menu.

  3. From the Form Identification (FI) Selection Menu, select the numeric code for the type of FI needed.

  4. The first group of images, from a Unit-of-Work (UW) requiring identification, opens.

  5. If an incorrect option was selected from the Form Identification Selection Menu, press the <Ctrl>-P key combination to set post-to-close and press <F9> to suspend, before entering any data, to return to the Form Identification Selection Menu.

    Note:

    Notify your supervisor.

  6. Press the <Ctrl>-P key combination to end FI after completing the current UW.

  7. The system returns you to the Form Identification Selection Menu when the last image identification in the UW is completed.

Form Identification (FI) Processing

  1. The system assigns a six digit sequence number instead of a document locator number (DLN) to documents it cannot identify. This number assists in locating the UW when researching documents. Once the form type and page has been identified, the system will assign a DLN to the document if required.

  2. Identify the image, make the appropriate number or letter selection from the template in the form identification menu selection. The tables below will appear on the SCRIPS work station directly below each other and will have additional rows for easier viewing.

    Form 1094 Series

    Menu Option Form (Form ID) Menu Option Form (Form ID)
    A 1094-B pg 1 (11016) C 1094-C pg 1 (120118)
    B 1094-B pg 1 (1115) D 1094-C pg 1 (120117)
        E 1094-C pg 1 (120116)
           
        F 1094-C pg 2 (120218)
        G 1094-C pg 2 (120217)
        H 1094-C pg 2 (120216)
           
        I 1094-C pg 3 (120316)
        J 1094-C pg 3 (120315)

     

    Form 1095 Series

    Menu Option Form (Form ID) Menu Option Form (Form ID)
    1 1095-B (560116) 5 1095-C pg 1 (600117)
    (600116) pg 1
    2 1095-B (560115) 6 1095-C pg 1 (600116)
           
    3 1095-B pg 3 (560317) 7 1095-C pg 3 (600317)
    4 1095-B pg 3 (560316) 8 1095-C pg 3 (600316)
           
    X Remove    


    The <Enter> key must be pressed to complete a selection.

  3. If you cannot identify the image, press <F9> to suspend the document for research. These will require research to determine exactly which document type they are. If the image is unprocessable, press "X" to remove the document from further processing.

  4. If there are multiple form types in a submission, this will also need to be researched further to determine if the submission should be deleted. Deleting the entire submission maybe more efficient, rather than removing many single documents. Delete submissions by pressing the <Ctrl>-<Shift>-<Delete> or <Ctrl>-<Shift>-<Del> key combination:

    1. Deleting the entire submission may be more efficient if the first detail document was recognized and the remainder is of another type and they were not recognized. Removing single documents may be more efficient if most of the images in the UW were recognized.

    2. The UW needs to be pulled and researched before it is either corrected and re-scanned, placed in OE from paper transcription or sent to the IRP sort function for disposition.

  5. To end a session, press the <Ctrl>-P key combination to set post-to-close. The system returns you to the Original Entry (OE) Selection Menu when you complete the last image in the UW.

Original Entry (OE) Function

  1. The OE function is used to manually key enter data from both scanned images and from paper documents. The menus shown on the screen will vary depending on how your supervisor profiled you.

    Example:

    If you are not profiled for the OE function, this option will be grayed on the Workstation Main Menu.

Original Entry (OE) Image QUICK START

  1. From the Workstation Main Menu, select Original Entry (OE).

  2. From the Original Entry (OE) Selection Menu, select OE Image Selection Menu.

  3. From the OE Image Selection Menu, select ACA-IRP OE Image Selection Menu.

  4. From the ACA-IRP OE Image Selection Menu, select one of the following:

    • 1 - All ACA-IRP OE Image

    • 2 - 1094-B OE Image

    • 3 - 1094-C OE Image

  5. After the selection is entered press <Enter> as prompted or press <Alt>-X to exit to previous menu.

  6. The first individual document in a UW requiring OE opens. See Exhibit 3.41.267-6, Affordable Care Act Information Return Transcription Sheets.

    1. The scanned image of the document will display on the left side of the workstation screen.

    2. Data will be input in the specific field window, displayed on the right side of the workstation screen.

  7. If an incorrect option was selected, press the <Ctrl>-P key combination and then suspend this UW. Notify your supervisor.

  8. If the last data entered is not the last field of the page and there is no other data present on the page, press <F6> key to release a document and display the next template.

  9. Press the <Ctrl>-P key combination (post-to-close) to end OE from Image.

  10. The system will return you to the Original Entry (OE) Selection Menu when you complete the last document in the current UW.

Original Entry (OE) Image Processing

  1. The Status Line at the bottom of the screen displays the following information:

    1. The program field shows 44320 for ACA-IRP documents.

    2. The DLN field shows the DLN of the document being displayed.

    3. The document field shows the relative count of the document.

      Example:

      If it is the first document in a unit-of-work containing 250 documents, the document field shows a count of 1 of 250.

    4. The Pg field shows the relative count of the page of the document.

      Example:

      If it is Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, page 1, the Pg field will show 1 of 2 or 1 of 3 depending on the length of the return filed; Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, page 2 will show as 2 of 2 or 2 of 3 depending on the length of the return filed.

    5. The Status Line shows "IN" when the insert mode is on and "Nu" when the numeric mode is on.

  2. In OE from image, you manually enter information into the template using a scanned image of the return as a source.

Original Entry (OE) From Paper Quick Start

  1. From the Workstation Main Menu, select Original Entry (OE).

  2. From the Original Entry (OE) Selection Menu, select OE Paper Selection Menu.

  3. From the OE Paper Selection Menu, select IRP ACA OE Paper Selection Menu.

  4. From the IRP ACA OE Paper Selection Menu, select the form type:

    • 1 - 1094-B OE Paper

    • 2 - 1094-C OE Paper

  5. If the wrong program was selected and the first page of the first document has not been completed, press the <Esc> key to cancel the entry. You will be returned to the IRP ACA OE Paper Selection Menu.

Original Entry (OE) From Paper Processing

  1. In OE from Paper, the workstation operators will manually enter information into the system and eliminate all transport processing. The operators will need the paper IRP ACA units-of-work to perform OE from paper. For documents entered from paper, SCRIPS assigns DLNs, but does not print them on the documents. As each new IRP ACA document is processed, the system displays the DLN for that document in the DLN field of the status Line at the bottom right side of the screen.

  2. After selecting the form type from the IRP ACA OE Paper Selection Menu, you will first be prompted for the form year, followed by the system reminder window "Enter amounts as DOLLARS ONLY" .

  3. A blank Form 1094-X template will be displayed for the first document in the block with the Sequence Number field displayed for entry. The first document must begin with sequence number "00" .

  4. The Status Line at the bottom of the monitor screen contains the following information:

    1. The Program field shows 44320 for IRP ACA documents.

    2. The DLN field shows the DLN of the current document.

    3. The SUB field shows the relative count of submission work.

    4. The Status Line shows "IN" when the insert mode is on and "Nu" when the numeric mode is on.

  5. Write the DLN assigned by the system in the upper right-hand corner of the paper document (either the Form 1094-X or Form 1095-X).The system assigned DLN is shown in the DLN field of the Status Line.

    Reminder:

    Writing the DLN is necessary so that subsequent operators may retrieve the unit-of-work (UW).

  6. After entering Pg 1 (or 2), you will be prompted "Is a page 2 (or 3) present?" :

    Exception:

    Form 1094-B, Transmittal of Health Coverage Information Returns, has a Pg 1 ONLY, therefore the system will move straight into a Form 1095-B, Health Coverage, template.

    1. If "Yes" , a page 2 (or 3) template will be presented.

    2. If "No" , you will be prompted "Is next document 1095-X?" .

      Response Choice
      If
      Action required
      Then
      "Yes" a 1095-X will be presented asking for a sequence number.

      Note:

      When entering a 1095-X, the different DLN in the Status Line will be similar to a 1099 detail document in regular IRP versus the 1096 DLN

      "No" presentation will be the next sequence number prompt for the same document type
  7. Once all documents have been input you will press the <Esc> and <F8> keys to end OE from paper or press <Ctrl>-P (Post-to-Close) while entering, but before releasing the last document in the UW. The system will return you to the IRP ACA OE paper Selection Menu.

Releasing a Unit-of-Work in Original Entry (OE)

  1. For OE Image, when you release the last document in a unit-of-work, the UW is released:

    1. If <Ctrl>-P has been pressed before releasing the UW, the OE Selection Menu will open.

    2. If <Ctrl>-P has not been pressed, another UW will open.

Selecting a Specific Unit-of-Work in Original Entry (OE)

  1. A specific ACA-IRP unit-of-work may be selected for OE by following these steps:

    1. From the Workstation Main Menu, select the numeric code for OE. The Workstation Main Menu closes, and the OE Selection Menu opens. The menus shown on the screen will vary depending on how operator was profiled by supervisor. For instance, if operator was not profiled for OE function, this option will not display on the menu.

    2. From the OE Selection Menu, enter the numeric code for OE Select Block. The OE Selection Menu closes and the Open Block/Unit-of-Work window opens.

    3. From the Open Block/UW window, enter the 14 digit DLN from the Form 1094 (series) return.

    4. Press the <Enter> key. The open Block/UW window closes and the selected UW opens.

    5. The designated Form 1094 (series) opens. Enter data using IRM 3.41.267.9, General Correction Procedures, and Exhibit 3.41.267-6, Affordable Care Act Information Return Transcription Sheets, and other instruction, as needed, in this IRM.

    6. If the block is not available, an error message is displayed indicating the block is not available.

      Example:

      A message will be displayed if you previously worked on this block, or if another operator is currently working on the Block/UW.

    7. If an incorrect UW is selected for the Block/UW menu, press the <Ctrl>-P key combination and then suspend the unit of work. Notify your supervisor.

Data Validation (DV) Function

  1. The DV function is used to manually correct data from scanned images. The menus shown on the screen will vary depending on how your supervisor profiled you.

    Example:

    If you are not profiled for the DV function, this option will be grayed on the menu Workstation Main Menu.

  2. The Status Line at the bottom of the screen displays the following information:

    1. The DLN field shows the DLN of the document being displayed.

    2. The SUB field shows the relative count of the document.

      Example:

      If it is the first document in a UW containing 80 documents, the SUB field shows a count of 1 of 80.

    3. The Pg field shows the relative count of the page of the document.

      Example:

      If it is Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, page 1, the Pg field will show 1 of 3; page 3 will show as 3 of 3.

    4. The Status Line shows "Au" when the automatic mode is on, "IN" when the insert mode is on, and "Nu" when the numeric mode is on.

      Note:

      Auto Indicator is a toggle which turns the Auto Mode on and off. When Auto is on, the cursor automatically moves from the current field to the next field requiring perfection. When Auto is off, the cursor manually moves through every field using the cursor movement keys. A Select Block or Suspended Block in DV will require the operator to restore the Auto On mode using <Ctrl>-<Shift>-<A>.

Data Validation (DV) From Image QUICK START

  1. From the Workstation Main Menu, select the numeric code for Data Validation (DV).

  2. From the Data Validation (DV) Selection Menu, select the numeric code for DV Selection Menu.

  3. From the DV Image Selection Menu, select the numeric code for DV Selection Menu.

  4. The first UW opens and the cursor stops at the first highlighted field when the AUTO is on. Use the exhibits in this IRM and the general correction procedures to make necessary corrections.

  5. If an incorrect option was selected from the DV Selection Menu before entering any data, press <Ctrl>-P, press <F9> to suspend and return to the DV Selection Menu. Notify supervisor.

  6. After entering the last field on document, if Auto is off, press the <F6> key to release the document and display the next template.

  7. Press the <Ctrl>-P key combination to not receive additional blocks once the current UW is completed.

  8. The system returns you to the Data Validation (DV) Selection Menu when you release the last document.

Selecting a Specific Unit-of-Work in Data Validation (DV)

  1. A specific UW of ACA-IRP documents, may be selected for DV by following these steps:

    1. From the Workstation Main Menu, select the numeric code for DV. The Workstation Main Menu closes, and the DV Selection menu opens. The menus shown on the screen will vary depending on how you were profiled by supervisor.

      Example:

      If you were not profiled for the DV function, this option will not display on the menu.

    2. From the Data Validation (DV) Selection Menu, enter the numeric code for DV Select Block. The Data Validation (DV) Selection Menu closes, and the Open Block/Unit-of-Work window opens.

    3. Enter the 14 digit DLN from Form 1094 (series) document.

    4. Press the <Enter> key. The Open Block/UW window closes and the selected UW opens.

    5. The first document needing correction opens.

    6. Enter data using Exhibit 3.41.267-6, Affordable Care Act Information Return Transcription Sheets, and other exhibits, as needed, in this IRM.

    7. A suspended UW in DV will require the operator to restore the "Auto ON" mode.

      Reminder:

      If after entering the DLN, the screen goes white for a second and then returns to the menu, the block was technically worked. The system ran through all the system checks and there were no errors.

    8. If an incorrect UW is selected from the Block/Unit-of-Work menu, press the <Ctrl>-P key combination and suspend the UW. Notify your supervisor.

General Correction Procedures

  1. Use these procedures as a guide during the Original Entry (OE) and Data Validation (DV) functions. Not all items will always apply to specific situations in either function. You may have to correct a field not highlighted because of a correction made to a highlighted field. You are required to sight verify any field containing any incorrect characters. If the system stops on a field, sight verify and correct all incorrect items in that field.

  2. If you reach the maximum field length while entering data, the cursor, in most cases, will automatically move to the next field. Therefore, incorrect characters can be inadvertently entered into the next field. Remove or correct these characters.

  3. Any checkbox present on any form type will require sight verification if the system reads the box as marked.

  4. The <Ctrl>-4 (Override key) is not enabled for field character type, tax year, or invalid date (MMDDYYYY).

    Example:

    Invalid dates would be 01321980, 13011980, 00011980, 01020080 or a date before 01011898.

  5. Error Messages—Error messages with information are often helpful to correct the error and may be found in the Prompt Area. Most error messages are two lines with the first line being the error message and the second line containing information to help resolve the error condition.

  6. The skip key stop points are flagged with an asterisk (*) at the upper right hand top corner of the normal proper placement of the numerous check boxes present on the return.

    Caution:

    Taxpayer generated forms may not have the checkbox placement required by the Service. Ensure the skip box asterisk are not mistaken for taxpayer entries during OE or DV operations.

  7. While working in OE Image or DV Image, if you cannot determine the data for any field (except the Street Address, City fields) from the image because it is illegible or the image is incomplete, suspend the UW and pull the paper document for verification.

  8. The <F11> key may be pressed to view the entity information from a Form 1094-B, Transmittal of Health Coverage Information Returns, or Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, while the transmitted form is displayed. It will also display the entity information from the transmitted form while a Form 1094-B, Transmittal of Health Coverage Information Returns, or Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, is displayed.

  9. In certain situations the scanner may read a name or address or even a city without spaces or spread over the name line or address fields. If the system read the name and address, leave as is.

    Note:

    If the scanner reads a line correctly but placed the information in an incorrect field, move the information as scanned to the correct entry field using <Shift> up and down arrows. Standard abbreviations are not required for addresses moved to the correct field.

  10. The <Ctrl>-<F7> combination key function provides the operator the ability to access the last edited field or the last flagged field of the previous document.

  11. Taxpayer Identification Number (TIN) fields (Social Security Number (SSN) or Employer Identification Number (EIN)) presented as 1-xxx-xx-xxxx-0 or 1-xx-xxxxxxx-0, or any variation thereof, should be entered as xxxxxxxxx, omitting the leading and ending numerics.

  12. If detail documents (Form 1095 series) are presented consecutively with the same responsible party or employee and the same covered individuals duplicated, enter one document and VOID the duplicate(s).

  13. For additional information on function keys refer to the table in IRM 3.41.267.5(3), Workstation Operations, or IRM 3.41.274, OCR Scanning Operations, General Instructions for Processing via SCRIPS, Exhibit 3.41.274-1, Function Key Use and Description by Form Type, and Exhibit 3.41.274-2, Summary of Function Keys by Form Type.

  14. Cross field validations occur on certain conditions and will require data transcriber sight validation and verification. Follow the screen prompts to allow systemic determination of the disposition of the UW. See the table below for these conditions.

    Form Number Field Comparison Field Valid Condition Invalid Condition(s)
    Requiring Sight Verification
    1094-C Line 19
    Part II
    Part III
    Part IV
    1. L19 is blank PII, PIII and PIV is blank.

    2. L19 is marked PII, PIII and PIV each are partially or fully populated.

    1. L19 is blank PII, PIII and PIV each or individually partially or fully populated.

    2. L19 is marked PII, PIII and PIV is blank.

    3. >sight verification required

    1095-B Line 8 Tax Year 2015 ONLY
    Line 9
    1. L8 and L9 is blank

    2. L8 is C, D, E, or F and L9 is blank

    3. L8 is A or B and L9 has an entry

    1. L8 has an invalid character

    2. L8 is C, D, E, or, F and L9 has an entry

    3. L8 is A or B and L9 has no entry

    4. >sight verification required

    1095-B
    and
    1095-C Covered Individuals:
    SSN DoB
    1. SSN is present and no DoB is present

    2. SSN is not present and a valid DoB is present

    3. No SSN is present no DoB is present and no name is present

    1. Partial SSN is present and no DoB is present

    2. SSN is not present and a invalid DoB is present

    3. No SSN is present no DoB is present and no name is present

    4. >sight verification required

    1095-B
    and
    1095-C
    All 12 months one or more 'month' marked All 12 months box is checked and Jan through Dec boxes contain no checks All 12 months box is checked and one or more of Jan through Dec boxes contain a checks
    >sight verification required
    1095-B Page 3
    Name
    SSN
    and/or DoB
    Page 1
    Line 1
    Line 2
    and/or Line 3
    Entries match
    data capture continues
    Entry mismatch
    Page 3 will be dropped
    >sight verification required
    1095-C Page 3
    Employee
    SSN
    Page 1
    Line 1
    Line 2
    Entries match
    data capture continues
    Entry mismatch
    Page 3 will be dropped
    >sight verification required

Name and Address Block Reader (NABR)

  1. Name and Address Block Reader is referred to as NABR. NABR is used to improve the accuracy of addresses captured by the scanner from IRP documents. The NABR accomplishes this improvement by comparing the address captured by the scanner with a database of addresses used by the United States Postal Service. SCRIPS will process the NABR through a Postal Database.

  2. When validating a NABR change, ensure the system read the correct ZIP Code. If address, city and state changes were made and a correct ZIP Code is not present in the data field, correct the information to match what is on the image.

Name Entry

  1. Enter the information as shown on the document, except as instructed below:

    1. If the filer has submitted the same name twice on a form, enter it only once.

    2. Space for a period.

    3. Never enter two consecutive spaces.

    4. If during sight verification a correction needs to be made, or if in OE, enter the first name first and last name last.

    5. Space within a true last name where shown.

    6. Omit apostrophe (') if shown in name line. Do not space for an apostrophe.

    7. Omit slash (/) if shown in name line. Space for a slash.

    8. Enter a hyphen (-) where shown. Do not space before or after the hyphen.

    9. Enter numerics present in the name line.

    10. Enter ampersand "&" when present in the name line.

    11. Disregard second name line if present.

Address Elements

  1. Enter the information exactly as shown on the document except as instructed below or when the NABR has perfected the address. See IRM 3.41.267.9.1, Name and Address Block Reader (NABR):

    1. Do not enter periods in the address field, however, punctuation such as slash (/) and hyphen (-) are acceptable. If a period is present between two numbers enter a space for the period.

    2. If an ampersand is present in the street address enter as AND.

    3. If an apostrophe is present omit the apostrophe and do not leave a space for the apostrophe.

    4. If perfecting only part of the address, such as the state or Zone Improvement Plan (ZIP) Code do not go back to the street address to abbreviate or correct characters if the scanner picked up the street address as present on the document.

      Exception:

      If the name of the street is a direction, the direction must be spelled out. Do not abbreviate street names.

      Example:

      123 North Street should be entered as 123 NORTH ST.

    5. If a document has a street address and a PO Box, enter both on the address line with the PO Box or (*) entered first. If the combination is too long, the PO Box takes precedence. Also, use abbreviations as necessary to limit this entry to 35 positions. Enter as much of the street address with abbreviations as possible.

    6. If two street addresses are present with the same city and ZIP, enter the first street address. If two addresses are present, including a PO Box and an address, with different city and ZIP, enter the first in the address, city, state and ZIP fields.

    7. Omit "No" , "No." , "Num" , "#" symbol and "Number " if it appears as a prefix to a house, apartment, Route, or PO Box number.

    8. If North, South, East or West is shown as part of the city name, use the standard abbreviation (such as N=North, S=South, etc.). NEVER use a Major City Code and the standard abbreviation together.

      Example:

      West Miami enter as W MIAMI, not W MF.

    9. If the city contains numerics, enter as alphas.

      Example:

      29 Palms enter as TWENTY NINE PALMS.

    10. If multiple street designations are present only abbreviate the last designation present.

      Example:

      1234 Circle Road Drive should be entered as: 1234 CIRCLE ROAD DR

    11. If correcting or transcribing an address field add st, nd, rd or th to a numbered street when there is a street designation such as Road or Street.

      Note:

      102 S. 38 Road would be transcribed as 102 S 38TH RD

    12. If the street address cannot be determined or is blank, enter "Z" in the Address field. If the city cannot be determined or is blank, enter "ZZZ" in the City field and leave the State and ZIP Code fields blank.

    13. Enter standard abbreviations for states and territories as shown in Exhibit 3.41.267-2, States, State Codes, and Zone Improvement Plan (ZIP) Codes Sorted by State, and Exhibit 3.41.267-3, States, State Codes, and Zone Improvement Plan (ZIP) Codes Sorted by ZIP Code.

    14. If there is no state, but a ZIP Code is present, enter the ZIP Code as shown and press <Enter>. This will generate the state code for this ZIP Code in the prompt area. Follow the screen prompt to accept this code or to enter a different code.

    15. If there is no ZIP Code (or the ZIP Code is less than or more than five digits) but a state is present, press the <Enter> key in the ZIP Code field. The system will generate the default ZIP Code for this state.

      Note:

      DO NOT generate the default ZIP Code without first entering the ZIP Code "if" present on the form.

    16. If the system finds the ZIP Code entered and present on the form does not match the state code present, the system will ask "Is this a foreign address?" If the answer is "Yes" the system will continue by presenting fields for a foreign address entry, Province (17 characters), Foreign postal code (35 characters). If the answer is "No" the system will correct the ZIP Code upon pressing <Enter>.

      Note:

      DO NOT generate the default ZIP Code without first entering the ZIP Code present on the form.

    17. Foreign street addresses are entered in the street address field, foreign city in the city field, foreign province in the Province field, and Country and foreign postal code in the Foreign postal code field. Use abbreviations as necessary to limit this entry to 35 positions.

    18. Army Post Office (APO), Diplomatic Post Office (DPO) and Fleet Post Office (FPO) addresses must be transcribed with the appropriate two-character state code followed by the corresponding unique five digit ZIP Code.

    19. When an APO, DPO or FPO is used, do not enter any other data in the city field.

    20. If the ZIP Code is out of range on APO, DPO or FPO addresses, enter 34001 for Miami, 09001 for New York and 96201 for San Francisco or Seattle.

    21. When APO, DPO or FPO is to be transcribed in the city field, the state code field must correspond with the tables below.

    Valid Zone Improvement Plan (ZIP) Code for APO, DPO and FPO

    State Code ZIP Code Range Geographic Location
    AA 340 Americas
    AE 090-098 Europe
    AP 962-966 Pacific

     

    Example:

    EXAMPLE: ENTER AS:
    APO New York, NY 091XX APO AE 091XX
    FPO San Francisco, CA 962XX FPO AP 962XX

Transmittal Taxpayer Identification Number (TIN)

  1. Each transmittal Form 1094 (series) return must have a complete nine digit (numeric) employer identification number (EIN) present to be considered a processable unit of work.

  2. If the EIN is a single repeating digit such as 111111111, 222222222, etc., or sequential 123456789 then the submission is considered unprocessable.

  3. If no employer identification number (EIN) is present and a social security number format is present suspend the UW. The format for EIN is NN-NNNNNNN and the format for SSN is NNN-NN-NNNN.

  4. If the TIN/EIN is missing, illegible, or has more than or less than nine digits on Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, and can be determined or found on the first detail document enter the EIN from the first detail document (Line 8) in the field.

    Reminder:

    If the transmittal is a Form 1094-B, Transmittal of Health Coverage Information Returns, the filers EIN cannot be secured from the details Form 1095-B, Health Coverage.

  5. If the complete EIN for a transmittal cannot be found on the return submission delete the UW by placing nine zeros (000000000) in the EIN field.

Money Amount Fields

  1. Money fields are dollars only.

  2. Enter money amounts as follows:

    1. If a dollar amount is present and no cents are present, enter dollar amount.

    2. If a dollars and cents amount is present, enter the dollars only.

      Note:

      Do not round the dollars up or down based on cents if present.

    3. If a dollar amount is present and it is followed by a line, dash or hyphen, enter the dollar amount.

    4. If a dollar amount is present and the cents is lined through, enter dollar amount.

    5. If a dollar amount of 0 or 00 is present enter a single 0.

    6. If money amount is a negative zero (e.g., -00, -0.00. -00.00, etc.), it MUST be removed, press <F3> to clear the field and then press <Enter>.

  3. Do not enter negative amounts (identified with a minus (-) before the amount or the amount is within brackets).

  4. If two or more money amounts are on the same line, press <F3> to clear the field and then enter the first dollar amount present.

  5. If the money amount is illegible, suspend the UW as "Poor Quality Image" (<F9>; press "S" ; select "Poor Quality Image" ).

  6. If after suspending for "Poor Quality Image" you are still unable to determine the correct money amount from the physical document, press <F3> to clear the field and then press <Enter>.

  7. If a code or other non-monetary entry is present in a monetary field press <F3> to clear the field then press <Enter>.

Deleting a Unit-of-Work or Submission

  1. To delete a filer's entire submission (or unit-of-work, or transmittal), enter nine zeroes in the EIN (Line 2) or "00" in the tax year of the Form 1094 (series) return.

  2. Pull and send the deleted Form 1094 (series) and all the associated detail documents back to the IRP sort function. Deleting a submission is usually a procedure used by a manager or work leader.

  3. Always delete a submission if:

    • the detail document Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, line 7 and 8, Applicable Large Employer Member (Employer), does not match the employer present on Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns.

    • the box titles have been changed.

    • the tax year cannot be determined.

    • the tax year of the transmittal and all the detail documents do not match.

    • it has invalid (including subsequent) tax year documents.

    • the incorrect detail document type was selected during "FI" .

    • the Form 1094 (series) return is missing either the name (line 1) or EIN (line 2) of the filer or employer.

      Exception:

      On Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, both Line 1- 2 and Line 9-10 cannot be blank. If Line 1-2 is blank and Line 9-10 is not blank, SCRIPS will move the Line 9-10 entity data to Line 1-2 entity data systemically after operator verification of the data fields.

    • the Form 1094 (series) return first four characters of the filer or employer name is illegible and is not retrievable within the submission.

Voiding a Supporting Detail Document

  1. Only detail document Form 1095 (series).

  2. Void a detail document if:

    • the void box on the top of the form is marked.

    • the form is crossed out or the word VOID is written over it.

      Note:

      The void box marked by the filer or employer makes all data on the form invalid.

    • the void box and corrected box are both checked.

    • the only data on the document (detail) present is the Part I entity data AND the detail is not marked corrected (the CORRECTED box is not marked).

    • the form is a summary record in the submission. The form may be marked by the filer as a "summary" , "total" , or "subtotal" form.

    • the form is blank.

    • detail documents (Form 1095 series) are presented consecutively with the same responsible party or employee and the same covered individuals duplicated, enter one document and VOID the duplicate(s).

    • the printed physical form is missing data due to improper printing of the form by the taxpayer.

    • one or two Form 1095-C documents have a different employer than the rest of the documents.

    • it can be determined a number of Form 1095-C documents do not belong in the submission.

  3. DO NOT void a document (detail) if the system misread and placed an "X" in either the void or corrected boxes when one is not present on the document.

Re-Imaging Form 1094 Series Returns

  1. The <F12> key allows you to flag or mark a Form 1094 (series) return, to be sent through Image Only processing.

  2. Re-image (Image only) processing is required when the true and complete image is not clear or complete.

  3. Re-image the return if any page of the return contains processable taxpayer entries and the following exist:

    • skewed, folded or otherwise unreadable

    • scanned in backwards

1094 Series Image Only Processing

  1. Submissions processed for re-imaging (the <F12> key was used) or processed using OE paper input will be routed to the SCRIPS scanning function for image only processing and archiving. Only a true and complete image is taken for this purpose. However, in order to allow for retrieval of the image in the future, the DLN must be key entered with each image. The menus shown on the screen will vary depending on how your supervisor profiled you.

    Example:

    If you are not profiled for the 1094 Image Only function, this option will not be present on the Data Validation Function Menu.

1094 Image Only

  1. From the Workstation Main Menu, select Data Validation (DV).

  2. From the Data Validation (DV) Selection Menu, select "1094 Image Only."

  3. A 1094 Image Only block opens a UW containing up to 100 records/returns.

    Note:

    100 records or returns could be more than 100 images due to multiple page records/returns.

  4. If a document was not recognized by the scanner, a window will open that allows you to identify the image and page of each image of Form 1094-B, Transmittal of Health Coverage Information Returns, or Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns. Additionally, a single image or entire block may be removed from further processing. The window will offer the options below:

    DV Image Only Selection

    Screen Selection Form/Page/Form Identification Number
    A 1094-B (Form Year ID 110116)
    B 1094-B (Form Year ID 11016)
       
    C 1094-C pg 1 (Form Year ID 120218)
    D 1094-C pg 1 (Form Year ID 120117)
    E 1094-C pg 1 (Form Year ID 120116)
       
    F 1094-C pg 2 (Form Year ID 120218)
    G 1094-C pg 2 (Form Year ID 120217)
    H 1094-C pg 2 (Form Year ID 120216)
       
    I 1094-C pg 3 (Form Year ID 120316)
    J 1094-C pg 3 (Form Year ID 120315)
       
    X Delete page

     

    1. If the image is not either form type/page number then press <F12> to remove the document from further processing.

    2. Press <Ctrl>-<Shift>-<Delete> or <Ctrl>-<Shift>-<Del> key combination to remove the entire block.

    3. If the image is identified as a 1094 series form type page one the DLN must be entered. If the document is removed or not a page 1, a DLN is not required.

  5. If the record/return is the same block number, only the two digit sequence number is required. If the block number changes, then a 14 digit DLN is required.

  6. Whenever a 14 digit DLN is entered, the DLN will be validated by requiring you to enter it twice. Each component of the DLN (i.e., the File Location Code, Tax Class, Document (Doc) Code, Julian Date, Blocking Series, Sequence Number and Year Digit) will undergo validation. Any invalid component will generate an error message explaining the error.

Supervisor Section Affordable Care Act Return Program Reports

  1. The following is a listing of the Affordable Care Act information return reports available on SCRIPS:

    • IRM 3.41.267.12.1, Document Locator Number (DLN) Output Report

    • IRM 3.41.267.12.2, Assigned Document Locator Number Report

    • IRM 3.41.267.12.3, Cumulative Document Locator Number (DLN) Assignment Report

    • IRM 3.41.267.12.4, Override Report

    • IRM 3.41.267.12.5, Inventory Report

    • IRM 3.41.267.12.6, Production Report

    • IRM 3.41.267.12.7, Run Balancing Report

    • IRM 3.41.267.12.8, Pull Unit of Work (Submission) Report

    • IRM 3.41.267.12.9, Throughput Statistics Report

    • IRM 3.41.267.12.10, Workstation Operator Statistics - Program and Function Summary Report

  2. The following subsections contain the content found on the report.

Document Locator Number (DLN) Output Report

  1. The title of the report is IRP ACA DLN Output Report (IPS01118).

  2. The report will reflect the entire production for the site for a given time frame.

  3. The report will contain the following:

    1. Service Center

    2. Run Date

    3. Page number

    4. Program number

    5. DLNs and a notation if it is a transmittal DLN or detail DLN

    6. File Location Code (FLC), Tax Class and Document Code (TAX/DOC), Julian date, Block number and Volume

Assigned Document Locator Number Report

  1. The title of the report is IRP ACA Assigned DLN Report (IPS03339).

  2. The report will reflect production for the individual scanner for a given time frame.

  3. The report will contain the following:

    1. Program number

    2. Run Date and Time

    3. Scanner Job ID

    4. Start Time

    5. End Time

    6. DLNs and a notation if it is a transmittal DLN or detail DLN

    7. File Location Code (FLC), Tax Class and Document Code (TAX/DOC), Julian date, Block number and Volume

    8. The summary page for the scan job by document code and form type

Cumulative Document Locator Number (DLN) Assignment Report

  1. The title of the report is Cumulative DLN Assignment Report (IPS11110).

  2. The report will reflect the total number of DLN assignments by form type and form page time frame.

  3. The report will contain the following:

    1. Doc Code - Document Code
      four digits digit one and two is the document code
      digits three and four are the page number

    2. Form
      form number followed by page number (P1, P2, P3, etc.)

    3. Volume

    4. Total

    5. End Time

Override Report

  1. The title of the report is IRP ACA Override Report (IPS11100).

  2. The report will reflect the total count of override key strokes for a given time frame.

  3. The report will contain the following:

    1. Function Code

    2. Doc Code - Document Code
      two digit number

    3. Field Number

    4. Field Description

    5. Override Count

    6. End Time

Inventory Report

  1. The title of the report is Inventory Report (IPS03350).

  2. The report will reflect inventory for a given time frame reflecting the carry over form volume on the SCRIPS system.

  3. The report will contain the following:

    1. Initial Inventory

    2. Process Date

    3. Returns Input

    4. Returns Deleted

    5. Returns Output

    6. Carry Over Inventory

    7. End Time

Production Report

  1. The title of the report is IRP ACA Production Report (IPS11120).

  2. The report will reflect the following scanned volumes and year to date output totals

  3. The report will contain the following:

    1. Service Center

    2. Run Date and clock Time

    3. Page number

    4. Scanned volumes by document code and form type for today, subtotals and totals

    5. Output volumes by document code and form type and deletes for year to date along with cumulative, subtotals and totals

    6. Status summary for all functions for today/current and year to date cumulative

Run Balancing Report

  1. The title of the report is IRP ACA Run Balancing Report (IPS01119).

  2. The report will reflect the entire production for the site for a given date.

  3. The report will contain the following:

    1. Service Center

    2. Run Date

    3. Page number

    4. FTP File ID number

    5. The file name (i.e., OCR1010B for forms in the B series and OCR1010C for forms in the C series)

Pull Unit of Work (Submission) Report

  1. The title of the report is IRP ACA Pull Document/Submission Report (IPS00812).

  2. The report will list submissions and documents required to be pulled for a date range.

  3. The report will contain the following:

    1. Service Center

    2. Run Date

    3. Page # - Number

    4. Block

    5. Doc DLN/Seq# - Document DLN Sequence number

    6. App - Application FI, OE or DV

    7. SEID - Standard Employee Identification

      Note:

      An SEID of 000000 represents the SCRIPS system which created the action based on programming and or specific responses to questions posed to the data transcriber.

    8. Date/Time

    9. Reason

  4. The reason will be one of the following pull document report codes:

    Report Reason Condition
    SINGLE ORIGINAL 1094-C Standalone Original Form 1094-C
    CONSECUTIVE PARENT Two consecutive Form 1094-X
    MISSING PARENT NAME Name missing from Form 1094-B (Line 1) or Form 1094-C (Line 1 and Line 9) transmittal return
    MIXED SUBMISSION Mixed form types

    Example:

    Marked “Remove” in FI

    PULL IMAGE ONLY Marked “Remove” in Image Only
    PULL F12 is pressed to remove document in OE/DV
    PULL STANDALONE 1094-B Standalone Form 1094-B
    PULL IMAGE ONLY – NO DLN F12 is pressed in Image Only on recognized document
    INVALID TAX YEAR Invalid Tax Year
    MISSING PARENT EIN Missing valid nine digit EIN on Form 1094 series return
    DEL UW- INVALID SSN/INVALID DOB Threshold: Form 1095-B – Line2/Line3
    DEL UW- INVALID DOB Threshold: Form 1095-B – Line 3
    DEL UW- INVALID ORIGIN OF POLICY Threshold: Form 1095-B – Line 8
    Tax Year 2015 ONLY
    DEL UW- INVALID SHOP/ORIGIN OF POLICY
    Threshold: Form 1095-B – Line8/Line9
    DEL UW- INVALID EINS Threshold: Form 1095-B – Line 11
    DEL UW – INVALID SSN/INVALID DOB Threshold: Form 1095-B – Line 23(b)-40(b) SSN/DOB
    DEL UW- INVALID DOB Threshold: Form 1095-B – Line 23(c)-40(c) DoB
    DEL UW- INVALID MONTH COMBO Threshold: Form 1095-B – Line 23(d)-40(d) Months Covered
    DEL UW – INVALID NAME Threshold: Form 1094-C – Line 1
    DEL UW- INVALID MISSING NAME/SSN Threshold: Form 1095-C – Line 1/Line 2
    DEL UW – INVALID SSNS Threshold: Form 1095-C – Line 2
    INVALID PLAN MONTH Threshold: Form 1095-C – Plan Month
    DEL UW – INVALID SSN/INVALID DOB Threshold: Form 1095-C – Line 17-34(b)-Line 17-34(c)
    DEL UW- INVALID DOB Threshold: Form 1095-C – Line 17(c)-34(c) DoB

Throughput Statistics Report

  1. The title of the report is Throughput Statistics Report (IPS06440).

  2. The report will reflect processing function productions for a given date range.

  3. The following process functions will be listed on the report rows: Scandriver, Transport/Sync, OE Crossover, Form Identification, Block Verification, OE Image, OE Paper, Program Validation, Data Validation, QR Summarization, Block Output, Image Archive, Backup Image Archive and Block Purge.

  4. The report will contain the following:

    1. Service Center

    2. From and to date range and clock time

    3. Run Date and clock time

    4. Page Number

    5. Processing Functions

    6. Total Blocks

    7. Total Documents

    8. Process Time

    9. Documents Per Hour

Workstation Operator Statistics Program and Function Summary Report

  1. The title of the report is Workstation Operator Statistics Program and Function Summary Report (IPS00803).

  2. The report will display the number of documents processed in each function for a given date range.

  3. The following process functions will be listed on the report rows: 460, 470, 480, 47X and 48X.

  4. The report will contain the following:

    1. Service Center

    2. From and to date range

    3. Run Date and clock time

    4. Page Number

    5. Function Code

    6. Program Number

    7. Process Time

    8. Total Key Strokes

    9. Document Per Hour

    10. Summary by Program

Block Status Window

  1. The Block Status window shows a more detailed status of the blocks/UWs in the search criteria data entered in the Block Search Criteria window.

  2. A change of operational parameters of blocks/UWs can also be completed in the Block Status window. Depending on the parameter, a change to the parameter for individual blocks/UWs or multiple blocks/UWs can be completed at the same time.

    1. Press the <Alt>-A key combination and all blocks eligible for selection will be selected.

    2. Blocks reflecting a status of "DELETE" or "DONE" will not be selected. Selected blocks will be marked with a check symbol in the Block Selected for Update column.

    3. If you choose to not perform any updates on the selected blocks, you can deselect all blocks by pressing the <Alt>-A key combination.

    4. You could also choose to cancel the blocks selected and close the Block Status window by pressing the <Alt>-X key combination.

  3. Block status monitoring (IPS0697) window shows a more detailed status of the blocks/UWs.

Output Verification Audit

  1. An output verification process ran on all UWs prior to output will systemically suspend any UW with invalid conditions in the UW, post DV.

  2. UWs containing invalid conditions will appear on the Block Status Monitoring window (IPS0697) and should be reported to System Administrators (SA) to be researched by the contractor.

  3. The reason will be one of the following pull document report codes:


    Reason Code
    Status Output Verification Audit/
    Description
    DUPDLN SUSPND Duplicate DLN across a block (11 digit DLN)
    the block has previously been output and therefore is a duplicate DLN
    BADDLN SUSPND DLN is
    not 14 characters in length
    not numeric or
    where characters four or five not valid document code
    BADDOC SUSPND The block/UW contains one or more documents not properly completed in the sub-task.
    document status between one and 699 (700 is "normal" )
    BADTIN SUSPND TIN not nine characters in length
    not numeric
    BADUW SUSPND Stand-alone Form 1094-B submission
    stand-alone Form 1094-C submission, original (not corrected)
    submission with no valid (non-deleted) documents
    BADDAT SUSPND Form 1095-X document with a valid status and VOID box checked
    Form 1094-B with no filer name, box 1 (a required output tag)
    question marks on a non-voided document in any field containing
    any documents with a field equaling a status > 10 (not perfected) on a non-voided document
      DELETE Form 1094-C with no Applicable Large Employer (ALE) member name, box 1 (a required output tag)

Purging Documents

  1. Once blocks/UWs of documents have been processed through SCRIPS and "accepted" by down-stream processing, the files containing the document images, ASCII data, and statistical information can be purged from the SCRIPS system.

    Note:

    Accepted means the output files and "the returns in those files" have cleared all error conditions.

  2. It is recommended a system purge be done two (2) weeks after the output date.

    Note:

    The only time you can purge documents prior to the two week period is if the system gets to 80% capacity or after notifying headquarters.

  3. Only those blocks/Units of Work (UWs) available for purge can be purged. The system keeps track of which blocks/UWs are available for purge and only allows you to purge those blocks/UWs. SCRIPS will not allow any blocks waiting for Quality Review (QR) Block Summarization or flagged for Quality Review to be purged.

  4. Files containing reports are strongly recommended to remain on the system for six weeks before being purged.

    Exception:

    Reports can be deleted after seven working days however six weeks is the preference.

  5. Deleted documents and/or blocks/UWs are removed from the system when the form type is purged. The remainder of the form types on SCRIPS operate in the same manner.

    Example:

    Information return documents (UWs) are removed when a information return block purge is performed.

  6. In order for deleted documents/blocks/UWs to be "removed" from the system, a purge for the form type must be initiated and activated. If you open a purge window but do not select any blocks for purge, the deleted documents/blocks/UWs will not be removed. Documents/blocks/UWs will not be purged until the deletion has been appropriately reported.

  7. Physical documents (UWs scanned in the SCRIPS area) will be retained for 30 days after data has been verified as converted to tape per Document 12990, Records Control Schedules, Record Control Schedule (RCS) 29, item 85, Information Returns. If systemic issues exist for downstream systems a longer period will be required and enforced by head quarters staff.

Terms/Acronyms/Definitions

TERM/ACRONYM DEFINITION
ACA IR
ACA-IRP
IRP-ACA
Affordable Care Act form types in the Form 1094 (series) or Form 1095 (series) of returns.

Reminder:

Only forms listed in IRM 3.41.267.2.1, Sources Documents, are processable (acceptable) under these instructions.

ALE Applicable Large Employer employs 50 or more full-time equivalent employees alone, is the controlling group entity or common owner of multiple business entities with employees as defined under aggregation rules.
ALE Member Applicable Large Employer Member which is part of a group business entity which employs 50 or more full-time equivalent employees.
Alpha Character A character (letter) of the alphabet.
Alphanumeric Field A field that accepts both alpha and numeric characters.
APO Army Post Office
Application Refers to the system utilized for form type being processed (i.e., IRP, ACA-IRP, Schedule K-1s, Form 940, Form 941, Stand-alone Schedule Rs).
Block DLN The first 11 digits of 14 digit document locator number (DLN) which consists of a two digit file location code, tax class, (tax class is always 5 for ACA-IRP), two digit document type, three digit Julian day, three digit block number. Also see DLN.
Capture The process of obtaining images of a document for character recognition and operator use.
Character Any symbol or alpha (special or numeric), which represents information.
Character Recognition The process of converting information from paper images to digital data form.
Corrected Document A return with the corrected box marked or a filer notation such as the word amended or corrected notated on the return.
Cursor A vertical line showing the position where the next entry will be keyed in.
Data Fields Those fields which do not include entity fields, e.g., on all documents listed such as: money amounts, dates, indicators, covered individuals, etc.
Detail Document Every Form 1095 (series) also referred to as supporting return or document or a child return.
DLN
(Document Locator Number)
A 14 digit document locator number which consists of a two digit file location code, tax class, (tax class is always "5" for ACA-IRP), two digit document type, three digit Julian day, three digit block number, two digit sequence number and a year digit. Also see Block DLN.
DoB, DOB
(Date of Birth)
A date consisting of a month, day and year combination.

Caution:

If any of these three are missing the remaining combination is not a DoB. Do not enter anything in the field if all three things are not able to be determined.

Document Code
(Doc Code)
The fourth and fifth position of each DLN which identifying the type of return the electronic data record has captured. The following is the document code- form number and form title for ACA-IRs.
  • 11 - Form 1094-B, Transmittal of Health Coverage Information Returns

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

  • 56 - Form 1095-B, Health Coverage

  • 60 - Form 1095-C, Employer-Provided Health Insurance Offer and Coverage

DPO Diplomatic Post Office
EIN An employer identification number (a nine digit number) typically identifies an entity such as a corporation, a trust, a nonprofit association, or a sole proprietor which resides on the business master file. Usually in NN-NNNNNNN format.
Employee A recipient listed in Part I of Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, issued by their employer (ALE).
Entity/Entity Fields The portion of the document which deals with TIN, name, and requests an address be present for the entries.
Field Specific area provided for data entry.
Filer The entity listed on the transmitting Form 1094 (series) which will always be a business entity with a corresponding employer identification number (EIN) or the employer.
Flag A question mark used to designate an unrecognizable character, or an error within a field. <F12> also flags a Form 1094 series for re-image.
File Location Code (FLC) A two digit number designed to represent the Service Center an action was taken on a taxpayer module. The action could be a transaction representing a return filing or subsequent compliance action.
Form Identification Number
(Form ID)
Usually a six digit number located at the top right of each page of a SCRIPS ACA-IRP document.
  • First two digits = Document Code

  • Third and fourth digit = Page number of the return

  • Fifth and sixth number = Tax year the template (layout or landscape placement) was last updated

Exception:

Form 1094-B, Transmittal of Health Coverage Information Returns, for tax year 2015 has a four digit form ID where the page number of the return is not present.

FPO Fleet Post Office
Function Keys The upper row of keys on the SCRIPS keyboard. The function keys are <F1> through <F12>.
Highlighting A three dimensional shadowing of a template field used to direct attention to the field. Used in OE to show the current cursor position. Used in DV to show the current cursor position, and also the current field containing an error.
The <Ctrl>-5 function key highlights the corresponding field on the image template.
Image Strip A section of the true and complete image which is magnified and displayed above the template. The image strip displayed will be a magnified version of the corresponding field which is highlighted on the image.
Pressing <Ctrl>-3 toggles the image strip on and off.
Key Combination Keystroke commands which require two or more simultaneous key presses.

Example:

Press <Ctrl>-P or post-to-close means to press and hold the <Ctrl> key and then press the <P> key before releasing the <Ctrl> key.

Menu A list of operations/options from which the workstation operator makes a selection.
Message Window A window which appears within the main window. It usually appears in the center of the screen. The system uses these windows to relay messages to the operator.
NABR Name and Address Block Reader compares the address captured from the scanner and the United States Postal Service database of addresses.
Non-Conforming Form A form the scanner cannot recognize.
Numeric Character A number ranging from 0 to 9. A digit.
Original Document A return without a corrected box marked or amended or corrected notated by the filer on the return.
Prompt A message or statement displayed that requires an operator response.
Recipient The individual taxpayer listed in Part I of the Form 1095 (series) return which is the employee or responsible party.
Responsible Individual The entity listed in Part 1 of Form 1095-B, Health Coverage, which is the holder, controller or owner of the insurance policy.
SA1094C Stand-alone Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, with no details.
See IRM 3.41.267.2.1 (1), Source Documents, for more information.
Sequence Number/ Serial Number (SN) A two digit number located at positions 12 and 13 within the DLN which uniquely identifies the document.
Sight-Verify Examine a highlighted field in DV. If correct, release the field. If incorrect, correct the field. Also, called verify.
Social Security Number (SSN) A nine digit number issued to an individual by the Social Security Administration. The IRS uses this number to process tax documents and returns. Usually in NNN-NN-NNNN format.
Special Characters (symbols) *, &, /, -, %, #, ?, etc.

Note:

Ampersand "&" is not considered a special character in the name line entry.

Status Line A strip of information found along the bottom right side of the main working window below the prompt area. Indicates the program number, DLN/SN, document count, and auto, Insert and Numeric indicators.
Submission A Form 1094 (series) return with associated detail documents, Form 1095 (series), or a SA1094C. Also, called a unit-of-work (UW).
Template A window which contains fields for data entry. The template mirrors the actual form layout, to the fullest extent possible.
TIN Taxpayer Identification Number. Either an EIN or an SSN.
Transmittal
(Parent document)
(Parent return)
A Form 1094-B, Transmittal of Health Coverage Information Returns, or Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, being filed with the Service.
True and Complete Image The image the system displays for data entry or validation purposes. If available, the system will always display it on the left half of the monitor screen.
Unit-of-Work (UW) A group of ACA-IRP documents containing one Form 1094 (series) transmittal and corresponding Form 1095 (series) returns or one SA1094C as defined. SCRIPS controls a unit-of-work by the Form 1094 (series) 14 digit DLN.
YYTY The tax year being processed normally current year minus one. Term used to eliminate dates on form prompts which change each year.
YYPY The current processing year normally the current year. Term used to eliminate dates on form prompts which change each year.

States, State Codes, and Zone Improvement Plan (ZIP) Codes Sorted by State

If the ZIP Code is missing or invalid, add 01 to the first three digit ZIP Code shown.

STATE STATE CODE ZIP CODE RANGE
Alabama AL 350-369
Alaska AK 995-999
America Samoa AS 96799 (only)
Americas APO/DPO/FPO AA 340
Arizona AZ 850-865
Arkansas AR 716-729
California CA 900-908, 910-961
Colorado CO 800-816
Connecticut CT 060-069
Delaware DE 197-199
District of Columbia DC 200, 202-205
Europe APO/DPO/FPO AE 090-098
Federated States of Micronesia FM 969
Florida FL 320-342, 344, 346, 347, 349
Georgia GA 300-319, 399
Guam GU 969
Hawaii HI 967, 968
Idaho ID 832-838
Illinois IL 600-629
Indiana IN 460-479
Iowa IA 500-528
Kansas KS 660-679
Kentucky KY 400-427
Louisiana LA 700-714
Maine ME 039-049
Marshall Islands MH 969
Maryland MD 206-219
Massachusetts MA 010-027, 055
Michigan MI 480-499
Minnesota MN 550-567
Mississippi MS 368-397
Missouri MO 630-658
Montana MT 590-599
Nebraska NE 680-693
Nevada NV 889-898
New Hampshire NH 030-038
New Jersey NJ 070-089
New Mexico NM 870-884
New York NY 004, 005, 100-149
North Carolina NC 270-289
North Dakota ND 580-588
Northern Mariana Islands MP 969
Ohio OH 430-459
Oklahoma OK 730-732, 734-749
Oregon OR 970-979
Pacific APO/DPO/FPO AP 962-966
Palau PW 969
Pennsylvania PA 150-196
Puerto Rico PR 006, 007, 009
Rhode Island RI 028, 029
South Carolina SC 290-299
South Dakota SD 570-577
Tennessee TN 370-385
Texas TX 733, 750-799
Utah UT 840-847
Vermont VT 050-054, 056-059
Virginia VA 201, 220-246
Virgin Islands VI 008
Washington WA 980-986, 988-994
West Virginia WV 247-268
Wisconsin WI 530-549
Wyoming WY 820-831

States, State Codes, and Zone Improvement Plan (ZIP) Codes Sorted by ZIP Code

If the ZIP Code is missing or invalid, add 01 to the first three digit ZIP Code shown.

ZIP CODE RANGE STATE CODE STATE
004, 005, 100-149 NY New York
006, 007-009 PR Puerto Rico
008 VI Virgin Islands
010-027, 055 MA Massachusetts
028, 029 RI Rhode Island
030-038 NH New Hampshire
039-049 ME Maine
050-054, 056-059 VT Vermont
060-069 CT Connecticut
070-089 NJ New Jersey
090-098 AE Europe APO/DPO/FPO
150-196 PA Pennsylvania
197-199 DE Delaware
200, 202-205 DC District of Columbia
201, 220-246 VA Virginia
206-219 MD Maryland
247-268 WV West Virginia
270-289 NC North Carolina
290-299 SC South Carolina
300-319, 399 GA Georgia
320-342, 344, 346, 347, 349 FL Florida
340 AA Americas APO/DPO/FPO
350-369 AL Alabama
370-385 TN Tennessee
386-397 MS Mississippi
400-427 KY Kentucky
430-459 OH Ohio
460-479 IN Indiana
480-499 MI Michigan
500-528 IA Iowa
530-549 WI Wisconsin
550-567 MN Minnesota
570-577 SD South Dakota
580-588 ND North Dakota
590-599 MT Montana
600-629 IL Illinois
630-658 MO Missouri
660-679 KS Kansas
680-693 NE Nebraska
700-714 LA Louisiana
716-729 AR Arkansas
730-732, 734-749 OK Oklahoma
733, 750-779 TX Texas
800-816 CO Colorado
820-831 WY Wyoming
832-838 ID Idaho
840-847 UT Utah
850-865 AZ Arizona
870-884 NM New Mexico
889-898 NV Nevada
900-908, 910-961 CA California
962-966 AP Pacific APO/DPO/FPO
96799 (only) AS American Samoa
967, 968 HI Hawaii
969 PW Palau
969 GU Guam
969 MP Marianna Islands
970-979 OR Oregon
980-986, 988-994 WA Washington
995-999 AK Alaska

Zone Improvement Plan (ZIP) Code, City, and State Exceptions

Exceptions to ZIP where State ZIP Code must be five digits

ZIP CITY STATE
75502 Texarkana AR
45275 Airport KY
71749 Junction City LA
03801 Naval Base ME
20331 Andrews AFB MD
06390 Fishers Island NY
73949 Texhoma TX
20041 Dulles Int'l Airport VA
20370 Navy Annex VA
20301 Pentagon VA
49936 Alvin WI

Alphabetical Listing of Major Cities with Major City Codes and Zone Improvement Plan (ZIP) Codes

Major City State Code Major City Code ZIP Code
Aberdeen SD AD 574
Abilene TX AB 796
Akron OH AK 443
Albany GA AY 317
Albany NY AL 122
Albuquerque NM AQ 871
Alexandria VA AX 223
Alhambra CA YA 918
Allentown PA AW 181
Amarillo TX AM 791
Anaheim CA AH 928
Anchorage AK AN 995-996
Anderson SC AJ 296
Ann Arbor MI AP 481
Arlington TX IA 760
Arlington VA AR 222
Arvada CO AV 800, 804
Asheville NC AS 288
Athens GA AE 306
Atlanta GA AT 303, 311, 399
Atlantic City NJ AC 084
Auburn AL AF 368
Augusta GA AG 309
Augusta ME AA 043
Aurora CO AZ 800
Aurora IL AO 605
Austin TX AU 733, 787
Bakersfield CA BD 933
Baltimore MD BA 212
Baton Rouge LA BR 708
Battle Creek MI QK 490
Beaumont TX BT 777
Bellingham WA BH 982
Berkeley CA BE 947
Bethlehem PA BM 180
Billings MT IB 591
Biloxi MS BL 395
Binghamton NY BC 139
Birmingham AL BI 352
Bismarck ND BB 585
Bloomington IN BQ 474
Bloomington MN BN 554
Boca Raton FL BZ 334
Boise ID BS 837
Bossier City LA BW 711
Boston MA BO 021, 022
Boulder CO BV 803
Bradenton FL BG 342
Bremerton WA BY 983
Bridgeport CT BP 066
Bronx NY BX 104
Brooklyn NY BK 112
Brownsville TX BJ 785
Buffalo NY BF 142
Burlington VT BU 054
Cambridge MA CB 021, 022
Camden NJ CD 081
Canton OH CA 447
Cape Coral FL CF 339
Casper WY CZ 826
Cedar Rapids IA CR 524
Champaign IL CX 618
Chandler AZ YZ 852
Chapel Hill NC CJ 275
Charleston SC CT 294
Charleston WV CW 253
Charlotte NC CE 282
Charlottesville VA CV 229
Chattanooga TN CG 374
Chesapeake VA CP 233
Cheyenne WY CY 820
Chicago IL CH 606-608
Chula Vista CA DV 919
Cincinnati OH CN 452, 459
Clarksville TN YN 370
Clearwater FL CQ 337
Cleveland OH CL 441
Colorado Springs CO CS 809
Columbia SC CU 292
Columbus GA CM 318, 319
Columbus OH CO 430, 432
Corpus Christi TX CC 783, 784
Cranston RI RT 029
Cumberland MD CK 215
Dallas TX DA 752, 753
Davenport IA DP 528
Dayton OH DY 453, 454
Daytona Beach FL DF 321
Dearborn MI DB 481
Decatur IL DT 625
Denver CO DN 800-802
Des Moines IA DM 503, 509
Detroit MI DE 482
Dubuque IA DQ 520
Duluth MN DL 557, 558
Durham NC DU 277
East Lansing MI ET 488
East Orange NJ EO 070
East St Louis IL ES 622
Easton PA EA 180
El Paso TX EP 799, 885
Elizabeth NJ EL 072
Erie PA ER 165
Eugene OR EU 974
Evanston IL EN 602
Evansville IN EV 477
Fairbanks AK FK 997
Fall River MA FR 027
Far Rockaway NY RK 110, 116
Fargo ND FA 581
Fayetteville AR FB 727
Fayetteville NC FN 283
Flint MI FT 485
Florence AL FC 356
Florence SC FE 295
Flushing NY FG 113
Fort Lauderdale FL FL 333
Fort Pierce FL FP 349
Fort Smith AR FS 729
Fort Wayne IN FY 468
Fort Worth TX FW 761
Fresno CA FO 936-938
Gainesville FL GF 326
Gaithersburg MD GG 208
Galveston TX GA 775
Garland TX GD 750
Gary IN GY 464
Gastonia NC GN 280
Glendale AZ GE 853
Glendale CA GL 912
Grand Rapids MI GR 495
Great Falls MT GT 594
Greeley CO GC 806
Green Bay WI GB 543
Greensboro NC GO 274
Greenville SC GV 296
Greenwood MS GW 389
Hackensack NJ HS 076
Hamilton OH HA 450
Hammond IN HM 463
Hampton VA HP 236
Harlingen TX HR 785
Hartford CT HD 061
Harrisburg PA HG 171
Hattiesburg MS HT 394
Helena MT HE 596
Henderson NV HF 890
Hialeah FL HI 330
High Point NC HC 272
Hollywood FL HW 330
Honolulu HI HL 968
Houston TX HO 770, 772
Huntington WV HN 257
Huntington Beach CA HB 926
Huntsville AL HU 358
Independence MO IE 640
Indianapolis IN IN 462
Inglewood CA ID 903
Irvine CA IV 926, 927
Irving TX IR 750
Jackson MS JN 392
Jacksonville FL JV 322
Jamaica NY JA 114
Jamestown NY JM 147
Janesville WI JE 535
Jersey City NJ JC 070, 073
Johnson City TN JH 376
Johnstown PA JO 159
Joliet IL JT 604
Jonesboro AR JB 724
Kalamazoo MI KZ 490
Kansas City KS KA 661
Kansas City MO KC 641, 649
Kennewick WA KW 993
Kenosha WI KE 531
Kingsport TN KP 376
Knoxville TN KN 379
Lafayette IN LF 479
Lafayette LA LL 705
Lake Charles LA LC 706
Lakeland FL LK 338
Lakewood CO LW 801, 802, 804
Lancaster PA LP 176
Lansing MI LG 489
Laredo TX LD 780
Las Cruces NM LZ 880
Las Vegas NV LV 891
Lawrence MA LQ 018
Lewiston ME LT 042
Lexington KY LX 405
Lincoln NE LN 685
Little Rock AR LR 722
Long Beach CA LB 907, 908
Long Island City NY LI 111
Lorain OH LO 440
Los Angeles CA LA 900, 901
Louisville KY LE 402
Lowell MA LM 018
Lubbock TX LU 794
Lynn MA LY 019
Macon GA MA 312
Madison WI MN 537
Manchester NH MR 031
Marietta GA MT 300
Melbourne FL ML 329
Memphis TN ME 375, 381
Meridian MS MD 393
Mesa AZ MZ 852
Metairie LA MI 700
Miami FL MF 330-332
Milwaukee WI MW 532
Minneapolis MN MS 554
Missoula MT MM 598
Mobile AL MO 366
Modesto CA MC 953
Monroe LA MB 712
Montgomery AL MG 361
Muskegon MI MK 494
Naperville IL NP 605
Nashua NH NS 030
Nashville TN NA 372
Newark NJ NK 071
New Bedford MA ND 027
New Brunswick NJ NB 089
New Haven CT NH 065
New Orleans LA NO 701
Newport News VA NN 236
Newton MA NE 024
New York NY NY 100-102
Niagara Falls NY NF 143
Norfolk VA NV 235
Norman OK NR 730
North Charleston SC NC 294
North Hollywood CA NW 916
North Las Vegas NV NT 890
North Little Rock AR NL 721
Oakland CA OA 946
Oak Park IL OP 603
Oceanside CA OE 920
Ogden UT OG 842, 844
Oklahoma City OK OC 731
Olympia WA OL 985
Omaha NE OM 681
Orlando FL OR 328
Oshkosh WI OK 549
Overland Park KS OV 662
Owensboro KY OW 423
Oxnard CA OX 930
Palo alto CA PQ 943
Parkersburg WV PK 261
Parma OH PZ 441
Pasadena CA PD 910, 911
Paterson NJ PN 075
Pembroke Pines FL PP 330
Pensacola FL PE 325
Peoria AZ PY 853
Peoria IL PL 616
Petersburg VA PG 238
Philadelphia PA PH 190-192
Phoenix AZ PX 850
Pine Bluff AR PB 716
Pittsburgh PA PI 151, 152
Pocatello ID PC 832
Port Arthur TX PA 776
Portland ME PT 041
Portland OR PO 972
Portsmouth NH PS 038
Portsmouth VA PM 237
Providence RI PR 029
Provo UT PV 846
Pueblo CO PU 810
Punta Gorda FL PJ 339
Quincy MA QU 021, 022
Racine WI RA 534
Raleigh NC RL 276
Reading PA RD 196
Reno NV RE 895
Richmond VA RI 231, 232
Riverside CA RS 925
Roanoke VA RO 240
Rochester NY RC 146
Rock Hill SC RH 297
Rockford IL RF 611
Sacramento CA SC 942, 958
Saginaw MI SG 486
Salem OR XR 973
Salinas CA YL 939
Salt Lake City UT XU 841
San Antonio TX SO 782
San Bernardino CA SR 924
San Diego CA SD 921
San Francisco CA SF 941
San Jose CA SJ 951
San Juan PR XJ 009
Santa Ana CA SA 927
Santa Barbara CA SZ 931
Santa Fe NM YF 875
Sarasota FL XS 342
Savannah GA GS 314
Schenectady NY SK 120, 123
Scottsdale AZ YS 852
Scranton PA XC 185
Seattle WA SE 981
Shawnee Mission KS SM 662
Sheboygan WI XB 530
Shreveport LA SH 711
Silver Spring MD SS 209
Sioux City IA SX 511
Sioux Falls SD IQ 571
South Bend IN SB 466
Spartanburg SC SQ 293
Spokane WA SW 992
Springfield IL XL 627
Springfield MA XA 011
Springfield MO XO 657, 658
Springfield OH XH 455
Stamford CT ST 069
Staten Island NY SI 103
St Joseph MO XM 645
St Louis MO SL 631
St Paul MN SU 551
St Petersburg FL SP 337
Sterling Heights MI YH 483
Stockton CA SN 952
Syracuse NY SY 132
Tacoma WA TC 984
Tallahassee FL TL 323
Tampa FL TA 336
Tempe AZ TE 852
Terre Haute IN TH 478
Titusville FL TT 327
Toledo OH TO 436
Torrance CA TN 905
Topeka KS TP 666
Trenton NJ TR 086
Tucson AZ TU 857
Tulsa OK TS 741
Tuscaloosa AL TB 354
Utica NY UT 135
Van Nuys CA VN 913, 914
Vancouver WA VA 986
Virginia Beach VA VB 234
Waco TX WX 767
Warren MI WR 480
Warren OH WO 444
Warwick RI WW 028
Washington DC DC 200, 202-205, 569
Waterbury CT WT 067
Waterloo IA WL 507
West Allis WI WA 532
West Valley City UT WC 841
West Palm Beach FL WP 334
Westminister CO WD 800, 802
Wheeling WV WH 260
White Plains NY WJ 106
Wichita KS WK 672
Wichita Falls TX WF 763
Wilkes-Barre PA WB 187
Williamsport PA WM 177
Wilmington DE WI 198
Wilmington NC WN 284
Winston-Salem NC WS 271
Winter Haven FL WG 338
Worcester MA WE 016
Yonkers NY YK 107
York PA YR 173, 174
Youngstown OH YO 445

Affordable Care Act Information Return Transcription Sheets

OE/DV Screen Prompt Description Instructions
Form 1094-B, Transmittal of Health Coverage Information Returns
Tax Year (located top right hand of form) The tax year is a must enter field entry.
  • Enter the tax year printed/present in the upper right hand corner of the form.

  • Requires 2 consecutive matching entries to leave the field.

  • Enter "00" if an invalid tax year is present.

    Example:

    Tax year 2014 is an invalid year.

    Then select "yes" when prompted to delete the UW.

Note:

The system will 1) recognize the tax year present and 2) present the year for site verification before releasing from the field.

Delinq. Indicator First box
For Official Use Only
Enter the code, if present, from the first For Official Use Only box.
Notes:
  • If the box is blank, the code may be present in the top margin of the document.

  • If the code is ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ , do not enter data in the Delinq. Return Date field.

  • If the code is ≡ ≡ ≡ enter the valid date in the Delinq. Return Date field.

Delinq. Return Date Date stamp in white space of
For Official Use Only
Enter the date from the IRS received date stamp, if present.
  1. If the boxes are blank, enter the date from the IRS received date stamp in MMDDYY format see the valid dates below.

  2. If multiple conflicting received dates are present or the received date stamp is circled out leave blank.

  3. If the received date stamp is illegible, enter the signature date. If the signature date is illegible, missing, or timely, leave blank.

  4. The valid dates are:
    ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡
    ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ .

  • If the ≡ ≡ is missing and a valid Delinquent Date is present in the Delinquent Return Date field, enter an "≡ ≡ ≡ " .

  • If the received date present is not valid remove the "≡ ≡ ≡ " from the Delinquent Indicator field.

Corr Ind Correspondence Indicator DO NOT enter any codes present from the last two For Official Use Only boxes. Press <Enter>.
Line 1- Filer's Name Filer’s name Enter the full name shown. If any character in the name is illegible enter a space for that character. If the name is missing and is not present delete the UW from the system. Press <Enter>.
Line 2-EIN Employer identification number (EIN) Enter the nine digit EIN present.

Caution:

Delete the UW by entering all zeros in the EIN field when:
- the TIN is missing or is more than or less than nine digits
- any digit is illegible and the filer entity is not present on the first detail
- single repeating digit such as 111111111, 222222222, etc., or sequential 123456789 is entered as the EIN.

Line 3-Name of Contact Name of person to contact Enter the full name shown. If any character in the name is illegible enter a space for the illegible character. If the name is missing and is not present press <Enter>.
Line 4-Contact Phone Contact telephone number Enter up to the first twelve numbers if present.
Must be blank, 7, 10, or 12 numerics.

Note:

Extensions are not required to be entered.

Line 5-Address Street address Enter the street address from the form.
If a foreign address, enter the address.
Line 6-City City or town Enter the name of the city.
If a foreign address is present, enter the city.
Line 7-State/Province State or province Enter the two-character code for the state listed on the document.
If a foreign address, enter the province.
Line 8-Zip/ Foreign Postal Code Country and ZIP or foreign postal code Enter the five digit ZIP Code. If missing, press <Enter> to bypass this field.
If a foreign address, enter the country and/or foreign postal code.
Line 9-Total 1095-B Total number of Forms 1095-B submitted with this transmittal Enter the number present on the document.
OE/DV Screen Prompt
Page 1
Description
Page 1
Instructions
Form 1095-BHealth Coverage - Page 1
Tax Year (located top right hand of form) The tax year is a must enter field entry.
  • Enter the tax year printed/present in the upper right hand corner of the form.

  • Requires 2 consecutive matching entries to leave the field.

  • Enter "00" when an invalid tax year is present or the year does not match the transmittal.

Example:

Tax year 2014 is an invalid year.

Then select "yes" when prompted to delete the return.

Note:

The system will 1) recognize the tax year present and 2) present the year for site verification before releasing from the field.

VOID Box VOID Box Enter "X" if marked.

Note:

All data on the form is invalid if the filer marks the void box, writes void on the form, marks through the entire form or the SCRIPS operator has voided the return due to duplication within the submission.

CORRECTED Box CORRECTED Box Enter "X" if marked.
Line 1-Resp. Name Name of responsible individual Enter the full name shown. If any character in the name is illegible enter a space for the illegible character. Do not leave two consecutive spaces.
Line 2-SSN Social security number (SSN) Enter the nine digit SSN present.
  • If the SSN is more than nine digits enter the first nine digits.

  • If any digit is illegible or missing enter a period for the illegible or missing digit.

  • If blank, single repeating digit such as 111111111, 222222222, etc., or sequential 123456789 do not make an entry. Press <Enter>.

Line 3-Date of Birth Date of birth (if SSN is not available) Enter the date of birth if present in MM-DD-YYYY format if a complete date is present.

Caution:

If any of one of MM, DD or YYYY are missing the remaining combination "is not" a DoB. Do not enter any data in the field if all three things are not able to be determined.

Line 4-Address Street address Enter the street address from the form.
If a foreign address, enter the address.
Line 5-City City or town Enter the name of the city.
If a foreign address is present, enter the city.
Line 6-State/Province State or province Enter the two character code for the state listed on the document.
If a foreign address, enter the province.
Line 7-Zip/Foreign Postal Code Country and ZIP or foreign postal code Enter the five digit ZIP Code. If missing, press <Enter> to bypass this field.
If a foreign address, enter the Country and/or foreign postal code.
Line 8-Origin of Policy Enter letter identifying Origin of the Policy...▸ Enter the alpha character present.
  • Valid characters are "A" , "B" , "C" , "D" , "E" and "F" .

  • If multiple characters are present enter the first valid character.

  • If no valid characters are present leave blank.

Tax Year 2015 ONLY
Line 9-SHOP Mark. identifier
Small Business Health Options Program (SHOP) Marketplace identifier, if applicable Enter all alpha and numeric characters present.

Note:

This field is only valid for tax year 2015 returns.

Line 10-Emp. Name Employer name Enter the full name shown. If any character in the name is illegible enter a space for the illegible character. Do not leave two consecutive spaces.
Line 11-EIN Employer identification number Enter the nine digit EIN present. If the EIN is:
  • missing enter nothing

  • is more than nine digits enter the first nine digits.

  • If any digit is illegible or missing enter a period for the illegible or missing digit

Line 12-Address Street address Enter the street address from the form.
If a foreign address, enter the address.
Line 13-City City or town Enter the name of the city.
If a foreign address is present, enter the city.
Line 14-State/Province State or province Enter the two-character code for the state listed on the document.
If a foreign address, enter the province.
Line 15-Zip/Foreign Postal Code Country and ZIP or foreign postal code Enter the five digit ZIP Code. If missing, press <Enter> to bypass this field.
If a foreign address, enter the Country and/or foreign postal code.
Line 16-Name   Enter the full name shown. If any character in the name is illegible enter a space for the illegible character. Do not leave two consecutive spaces.
Line 17-EIN   Enter the nine digit EIN present.
  • If the EIN is more than nine digits enter the first nine digits.

  • If any digit is illegible or missing enter a period for the illegible or missing digit.

Line 18-Contact Phone Contact telephone number Enter up to the first twelve numbers if present.
Must be blank, 7, 10, or 12 numerics.

Note:

Extensions are not required to be entered.

Line 19-Address Street address Enter the street address from the form.
If a foreign address, enter the address.
Line 20-City City or town Enter the name of the city.
If a foreign address is present, enter the city.
Line 21-State/Province State or province Enter the two-character code for the state listed on the document.
If a foreign address, enter the province.
Line 22-Zip/Foreign Postal Code Country and ZIP or foreign postal code Enter the five digit ZIP Code. If missing, press <Enter> to bypass this field.
If a foreign address, enter the Country and/or foreign postal code.
Line 23(a)-Covered Ind.
through
Line 28(a)-Covered Ind.
Name of covered individual(s) Enter the full name shown. If any character in the name is illegible enter a space for the illegible character. Do not leave two consecutive spaces.

Note:

Instructions repeat for all entries for each covered individual listed on line 23, columns (a, b, c d and e) through line 28, columns (a, b, c, d, and e).

Line 23(b)-SSN
through
Line 28(b)-SS
N
SSN Enter the nine digit SSN present.
  • If the SSN is more than nine digits enter the first nine digits.

  • If any digit is illegible or missing enter a period for the illegible or missing digit.

  • If blank, single repeating digit such as 111111111, 222222222, etc., or sequential 123456789 do not make an entry. Press <Enter>.

Caution:

Do not enter any data present in columns (b, c, d, or e) if there is no corresponding name present in column (a).

Line 23(c)-DoB
through
Line 28(c)-DoB
DOB (If SSN is not available) Enter the date of birth if present in MM-DD-YYYY format if a complete date is present.

Caution:

If any of one of MM, DD or YYYY are missing the remaining combination "is not" a DoB. Do not enter any data in the field if all three things are not able to be determined.

Caution:

Do not enter any data present in columns (b, c, d, or e) if there is no corresponding name present in column (a).

Line 23(d)-12 Months
through
Line 28(d)-12 Months
Covered all 12 months Enter "X" if marked.

Caution:

Do not enter any data present in columns (b, c, d, or e) if there is no corresponding name present in column (a).

Line 23(e)-Jan
through
Line 28(e)-Dec
Months of coverage Jan through Dec Enter "X" if marked.

Note:

Instructions repeat for all entries for each covered individual listed on line 23, columns (a, b, c, d, and e) through line 28, columns (a, b, c, d, and e).

Caution:

Do not enter any data present in columns (b, c, d, or e) if there is no corresponding name present in column (a).

OE/DV Screen Prompt
Page 3
Description
Page 3
Instructions
Form 1095-B, Health Coverage - Page 3
Resp. Name Name of responsible individual Enter the full name shown. If any character in the name is illegible enter a space for the illegible character. Do not leave two consecutive spaces.
SSN Social security number (SSN) Enter the nine digit SSN present.
Enter a period for illegible characters.
If blank, single repeating digit such as 111111111, 222222222, etc., or sequential 123456789 do not make an entry. Press <Enter>.
Date of Birth Date of birth (if SSN is not available) Enter the date of birth if present in MM-DD-YYYY format if a complete date is present.

Caution:

If any of one of MM, DD or YYYY are missing the remaining combination "is not" a DoB. Do not enter any data in the field if all three things are not able to be determined.

Line 23a)-Covered Ind.
through
Line 40)-Covered Ind.
Name of covered individual(s) Enter the full name shown. If any character in the name is illegible enter a space for the illegible character. Do not leave two consecutive spaces.

Note:

Instructions repeat for all entries for each covered individual listed on line 23 (columns a, b, c, d, and e) through line 40 (columns a, b, c, d, and e).

Line 23b)-SSN
through
Line 40)-SS
N
SSN Enter the nine digit SSN present.
  • If the SSN is more than nine digits enter the first nine digits.

  • If any digit is illegible or missing enter a period for the illegible or missing digit.

  • If blank, single repeating digit such as 111111111, 222222222, etc., or sequential 123456789 do not make an entry. Press <Enter>.

Caution:

Do not enter any data present in columns (b, c, d, or e) if there is no corresponding name present in column (a).

Line 23c)-DoB
through
Line 40)-DoB
DOB (If SSN is not available) Enter the date of birth if present in MM-DD-YYYY format if a complete date is present.

Caution:

If any of one of MM, DD, or YYYY are missing the remaining combination "is not" a DoB. Do not enter any data in the field if all three things are not able to be determined.

Caution:

Do not enter any data present in columns (b, c, d, or e) if there is no corresponding name present in column (a).

Line 23d)-12 Months
through
Line 40)-12 Months
Covered all 12 months Enter "X" if marked.

Caution:

Do not enter any data present in columns (b, c, d, or e) if there is no corresponding name present in column (a).

Line 23e)-Jan
through
Line 40)-Dec
Months of coverage Jan through Dec Enter "X" if marked.

Caution:

Do not enter any data present in columns (b, c, d, or e) if there is no corresponding name present in column (a).

OE/DV Screen Prompt
Page 1
Description
Page 1
Instructions
Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns - Page 1
Tax Year (located top right hand of form) The tax year is a must enter field entry.
  • Enter the tax year printed/present in the upper right hand corner of the form.

  • Requires 2 consecutive matching entries to leave the field.

  • Enter "00" if an invalid tax year is present.

    Example:

    Tax year 2014 is an invalid year.

    Then select "yes" when prompted to delete the UW.

Note:

The system will 1) recognize the tax year present and 2) present the year for site verification before releasing from the field.

Corrected CORRECTED Box Enter "X" if marked.
Delinq. Indicator First box
For Official Use Only
Enter the code, if present, from the first For Official Use Only box.
Notes:
  • If the box is blank, the code may be present in the top margin of the document.

  • If the code is ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ , do not enter data in the Delinq. Return Date field.

  • If the code is "≡ " , enter the valid date in the Delinq. Return Date field.

Delinq. Return Date Date stamp in white space of
For Official Use Only
Enter the date from the IRS received date stamp, if present.
  1. If the boxes are blank, enter the date from the IRS received date stamp in MMDDYY format see the valid dates below.

  2. If multiple conflicting received dates are present or the received date stamp is circled out leave blank.

  3. If the received date stamp is illegible, enter the signature date. If the signature date is illegible, missing, or timely, leave blank.

  4. The valid dates are:
    ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡
    ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ ≡ .

  • If the "≡ ≡ ≡ " is missing and a valid Delinquent Date is present in the Delinquent Return Date field, enter an "≡ " .

  • If the received date is not valid remove the "≡ ≡ " from the Delinquent Indicator field.

Corr Ind Correspondence Indicator DO NOT enter any codes present from the last two For Official Use Only boxes. Press <Enter>.
Line 1-ALE Member Name of ALE Member (Employer) Enter the full name as shown if present.
  • If any character in the name is illegible enter a space for the illegible character.

  • Do not leave two consecutive spaces.

  • If the name is missing and is not present press <Enter>.

  • See IRM 3.41.267.9.2, Name Entry, for additional instruction on filers names.

Line 2-EIN Employer identification number Enter the nine digit EIN present.
  • If the EIN is missing, incomplete, invalid, or more than or less than nine digits then check the first detail document for the EIN. If present enter on Line 2- EIN.

  • If the EIN is not present on the first detail AND line 9 and line 10 are blank, then enter nine zeros (000000000) to delete the UW.

  • If there is no entry on line 1 and 2 and there is an entry on line 9 and line 10 the system will move the entity on line 9 and line 10 to line 1 and line 2 systemically.

  • If the EIN is a single repeating digit such as 111111111, 222222222, etc., or sequential 123456789 or is more than or less than nine digits and the correct EIN is not present on the first detail then enter nine zero (000000000) to delete the UW.

Line 3-Address Street address Enter the street address from the form.
If a foreign address, enter the address.
Line 4-City City or town Enter the name of the city.
If a foreign address is present, enter the city.
Line 5-State/Province State or province Enter the two-character code for the state listed on the document.
If a foreign address, enter the province.
Line 6-Zip/ Foreign Postal Code Country and ZIP or foreign postal code Enter the five digit ZIP Code. If missing, press <Enter> to bypass this field.
If a foreign address, enter the Country and/or foreign postal code.
Line 7-Contact Name Name of person to contact Enter the full name shown. If any character in the name is illegible enter a space for the illegible character. If the name is missing and is not present press <Enter>.
Line 8-Contact Phone Contact telephone number Enter up to the first twelve numbers if present.
Must be blank, 7, 10, or 12 numerics.

Note:

Extensions are not required to be entered.

Line 9-Designated Name Name of Designated Government Entity (only if applicable) Enter the full name shown. If any character in the name is illegible enter a space for the illegible character. If the name is missing and is not present press <Enter>.

Note:

If there is no ALE data present on Line 1 and 2, and valid data is verified on Line 9 and 10 the designated entity data will be moved to the ALE entity data systemically.

Line 10-EIN Employer identification number (EIN) Enter the nine digit EIN present.
  • If the TIN is illegible enter period.

  • If the TIN is missing digits enter periods for the missing digits.

  • If the TIN is more than nine digits enter the first nine digits present.

  • If the TIN appears in SSN format enter nothing. If missing or is not present press <Enter>.

Line 11-Address Street address Enter the street address from the form.
If a foreign address, enter the address.
Line 12-City City or town Enter the name of the city.
If a foreign address is present, enter the city.
Line 13-State/Province State or province Enter the two-character code for the state listed on the document.
If a foreign address, enter the province.
Line 14-Zip/ Foreign Postal Code Country and ZIP or foreign postal code Enter the five digit ZIP Code. If missing, press <Enter> to bypass this field.
If a foreign address, enter the Country and/or foreign postal code.
Line 15-Contact Name Name of person to contact Enter the full name shown. If any character in the name is illegible enter a space for the illegible character. If the name is missing and is not present press <Enter>.
Line 16-Contact Phone Contact telephone number Enter up to the first twelve numbers if present.
Must be blank, 7, 10, or 12 numerics.

Note:

Extensions are not required to be entered.

Line 18-Total 1095-Cs Total number of Forms 1095-C submitted with this transmittal Enter the number present on the document.
Line 19-Authoritative ALE Member Is this the authoritative transmittal for this ALE Member? If “yes,” check the box and continue... Enter "X" if marked.
Line 20-Total 1095-C on behalf of ALE Total number of Forms 1095-C filed by and/or on behalf of ALE Member... Enter the number if present.
  • Only valid characters are digits.

  • If alpha characters or words are present leave the entry blank or blank the field.

Line 21-ALE Member of group-Yes Is ALE Member a member of an Aggregated ALE group?... Yes box Enter "X" if the "Yes" box is marked.
Line 21-ALE Member of group-No Is ALE Member a member of an Aggregated ALE group?... No box Enter "X" if the "No" box is marked.
Line 22-Offer Method Line 22 box "A" Enter "X" if the box is marked.
Tax Year 2015 ONLY
Line 22-Offer Method Transition
Line 22 box "B" Only valid for tax year 2015.
Enter "X" if the box is marked.

Note:

This field is only valid for tax year 2015 returns.

Tax Year 2015 and 2016 ONLY
Line 22-Sec. 4980H
Line 22 box "C" Only valid for tax years 2015 and 2016.
Enter "X" if the box is marked.
Line 22-98% Offer Line 22 box "D" Enter "X" if the box is marked.
OE/DV Screen Prompt
Page 2
Description
Page 2
Instructions
Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns - Page 2
Line 23-12 months-Essential Coverage-Yes First check box in column (a) "Yes" row 23 Minimum Essential Coverage Offer Indicator labeled Yes Enter an "X" if the "Yes" box is checked.
Line 23-12 months-Essential Coverage-No Second check box in column (a) "No" row 23 Minimum Essential Coverage Offer Indicator labeled No Enter an "X" if the "No" box is checked.
Line 23-12 months-Full Time count Column (b)Full-Time Employee Count for ALE Member Enter the number from line 23 column (b) if present.
Line 23-12 months-Total Emp. Coun Column (c) Total Employee Count for ALE Member Enter the number from line 23 column (c) if present.
Line 23-12 months-Agg. Group Ind Column (d) Aggregated Group Indicator Enter an "X" if the box is checked.
Tax Year 2015 and 2016 ONLY
Line 23-12 months-Sec. 4980H Ind.
Column (e) Section 4980H Transition Relief Indicator Only valid for tax years 2015 and 2016.
Enter the alpha character line 23 column (e) if present.
  • Valid entries are "A" or "B" or blank.

  • Only one entry is allowed.

  • If multiple entries are present enter the first valid character unless the characters present spell a word.

  • If the characters present spell a word suspend for lead review.

Line 24-Jan-Essential Coverage-Yes
through
Line 35-Dec-Essential Coverage-Yes
First check box in column (a) "Yes" row 24 Minimum Essential Coverage Offer Indicator labeled Yes Enter "X" if the "Yes" box is marked.
Line 24-Jan-Essential Coverage-No
through
Line 35-Dec-Essential Coverage-No
Second check box in column (a) "No" row 24 Minimum Essential Coverage Offer Indicator labeled No Enter "X" if the "No" box is marked.

Note:

Instructions repeat for all entries on line 23, All 12 Months, (row 2) to line 35, Dec, (row 14).

Line 24-Jan-Full Time count
through
Line 35-Dec-Full Time count
Column (b)Full-Time Employee Count for ALE Member Enter the number from line 24 column (b) if present.
Line 24-Jan-Total Emp. Count
through
Line 35-Dec-Total Emp. Count
Column (c) Total Employee Count for ALE Member Enter the number from line 24 column (c) if present.
Line 24-Jan-Agg. Group Ind
through
Line 35-Dec-Agg. Group Ind
Column (d) Aggregated Group Indicator Enter an "X" if the box is checked.
Tax Year 2015 and 2016 ONLY
Line 24-Jan-Sec. 4980H Ind.
through
Line 35-Dec-Sec. 4980H Ind.
Column (e) Section 4980H Transition Relief Indicator Only valid for tax years 2015 and 2016.
Enter the alpha character line 23 column (e) if present.
  • Valid entries are "A" or "B" or blank.

  • Only one entry is allowed.

  • If multiple entries are present enter the first valid character unless the characters present spell a word.

  • If the characters present spell a word suspend for lead review.

Note:

Instructions repeat for all entries on line 23, All 12 Months, (row 2) to line 35, Dec, (row 14).

OE/DV Screen Prompt
Page 3
Description
Page 3
Instructions
Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns - Page 3
Line 36-Name Name of Other ALE Members of Aggregated ALE Group Enter the full name shown if present. Enter a space for any illegible characters. Do not leave two consecutive spaces.
Line 36-EIN EIN of Other ALE Members of Aggregated ALE Group Enter the EIN if present.
  • Enter a period for illegible characters.

  • If more than nine digits enter the first nine digits.

Line 37-65
-Name
Name of Other ALE Members of Aggregated ALE Group Utilize instruction for Line 36-Name for any entries present for Line 37-65-Name.
Line 37-65
-EIN
EIN of Other ALE Members of Aggregated ALE Group Repeat instruction for Line 36-EIN for any entries present for Line 37-65-EIN.
OE/DV Screen Prompt
Page 1
Description
Page 1
Instructions
Form 1095-C, Employer-Provided Health Insurance Offer and Coverage - Page 1
Tax Year (located top right hand of form) The tax year is a must enter field entry.
  • Enter the tax year printed/present in the upper right hand corner of the form.

  • Requires 2 consecutive matching entries to leave the field.

  • Enter "00" when an invalid tax year is present or the year does not match the transmittal.

Example:

Tax year 2014 is an invalid year.

Then select "yes" when prompted to delete the return.

Note:

The system will 1) recognize the tax year present and 2) present the year for site verification before releasing from the field.

VOID Box VOID Box Enter "X" if marked or if the document is blank.

Note:

All data on the form is invalid if the filer marks the void box, writes void on the form, marks through the entire form or the SCRIPS operator has voided the return due to duplication within the submission.

CORRECTED Box CORRECTED Box Enter "X" if marked.
Line 1-Employee Name Name of employee Enter the full name shown.
If any character in the name is illegible enter a space for the illegible character. Do not leave two consecutive spaces.
Line 2-SSN Social security number (SSN) Enter the nine digit SSN present.
  • If the SSN is more than nine digits enter the first nine digits.

  • If any digit is illegible or missing enter a period for the illegible or missing digit.

  • If blank, single repeating digit such as 111111111, 222222222, etc., or sequential 123456789 do not make an entry. Press <Enter>.

Line 3-Address Street address Enter the street address from the form.
If a foreign address, enter the address.
Line 4-City City or town Enter the name of the city.
If a foreign address is present, enter the city.
Line 5-State/Province State or province Enter the two character code for the state listed on the document.
If a foreign address, enter the province.
Line 6-Zip/Foreign Postal Code Country and ZIP or foreign postal code Enter the five digit ZIP Code. If missing, press <Enter> to bypass this field.
If a foreign address, enter the Country and/or foreign postal code.
Line 7-Employer Name Name employer Enter the full name shown. If any character in the name is illegible enter a space for the illegible character. Do not leave two consecutive spaces.
If the name is missing and is not present press <Enter>.
Line 8-EIN Employer identification number Enter the nine digit EIN present.
If the EIN is missing or is more than or less than nine digits press <F11> to perfect the EIN.
Line 9-Address Street address Enter the street address from the form.
If a foreign address, enter the address.
Line 10-Contact Phone Contact telephone number Enter up to the first twelve numbers if present.
Must be blank, 7, 10, or 12 numerics.

Note:

Extensions are not required to be entered.

Line 11-City City or town Enter the name of the city.
If a foreign address is present, enter the city.
Line 12-State/Province State or province Enter the two-character code for the state listed on the document.
If a foreign address, enter the province.
Line 13-Zip/Foreign Postal Code Country and ZIP or foreign postal code Enter the five digit ZIP Code. If missing, press <Enter> to bypass this field.
If a foreign address, enter the Country and/or foreign postal code.
Part II-Plan Month Plan Start Month (Enter a two digit number): Enter the one or two digit number on the right of the colon. Valid digits are 00-12. Enter 00 if no entry is present.
If month is written in (January through December) or an abbreviation for a month (Jan through Dec) enter the corresponding two digit month.

Caution:

Scan the entire Plan Start Month area for an entry.

Line 14-All 12 months Offer of Coverage (enter required code) Enter the numeric alpha combination present on the document.
  • The only valid combinations are: "1A" , "1B" , "1C" , "1D" , "1E" , "1F" , "1G" , "1H" , "1I" , "1J" , and "1K" .

  • If multiple codes are present enter the first code combination in the column being transcribed.

  • Remove invalid combinations.

Line 14-Jan
through
Line 14-Dec
Offer of Coverage (enter required code) Enter the numeric alpha combination present on the document.
  • The only valid combinations are: "1A" , "1B" , "1C" , "1D" , "1E" , "1F" , "1G" , "1H" , "1I" , "1J" , and "1K" .

  • If multiple codes are present enter the first code combination in the column being transcribed.

  • Remove invalid combinations.

Note:

Instructions repeat for all entries on line 14, All 12 Months, (column 2) to Dec (column 14).

Line 15-All 12 months Employee Share of Lowest Cost Monthly Premium, for Self-Only Minimum Value Coverage Enter the dollar amount from line 15 column "All 12 Months" .
Enter the amount in dollars only.
Enter a single zero if 0 or 00 is present.
Blank the field if a negative figure or a negative 0 is present.
Line 15-Jan
through
Line 15-Dec
Employee Share of Lowest Cost Monthly Premium, for Self-Only Minimum Value Coverage Enter the dollar amount from line 15 column "Jan" .
Enter the amount in dollars only.
Enter a single zero if 0 or 00 is present.
Blank the field if a negative figure or a negative 0 is present.

Note:

Instructions repeat for all entries on line 15, All 12 Months, (column 2) to Dec (column 14).

Line 16-All 12 months Applicable Section 4980H Safe Harbor (enter code, if applicable) Enter the numeric alpha combination present on the document.
  • The only valid combinations are: "2A" , "2B" , "2C" , "2D" , "2E" , "2F" , "2G" , "2H" , "2I" , and "2J" .

  • If multiple codes are present enter the first code combination in the column being transcribed.

  • Remove invalid combinations.

Line 16-Jan
through
Line 16-Dec
Applicable Section 4980H Safe Harbor (enter code, if applicable) Enter the numeric alpha combination present on the document.
  • The only valid combinations are: "2A" , "2B" , "2C" , "2D" , "2E" , "2F" , "2G" , "2H" , "2I" , and "2J" .

  • If multiple codes are present enter the first code combination in the column being transcribed.

  • Remove invalid combinations.

Note:

Instructions repeat for all entries on line 16, All 12 Months, (column 2) to Dec (column 14).

Part III-Employer-provided self-insure coverage If Employer provided self-insured coverage, check the box and enter the information for each covered individual. Enter "X" if marked.
Line 17(a)-Covered Ind.
through
Line 22(a)-Covered Ind.
Name of covered individual(s) Enter the full name shown. If any character in the name is illegible enter a space for the illegible character. Do not leave two consecutive spaces.

Note:

Instructions repeat for all entries for each covered individual listed on line 17 (columns a, b, c, d, and e) through line 22 (columns a, b, c, d, and e).

Line 17(b)-SSN
through
Line 22(b)-SSN
SSN Enter the nine digit SSN present.
  • If the SSN is more than nine digits enter the first nine digits.

  • If any digit is illegible or missing enter a period for the illegible or missing digit.

  • If blank, single repeating digit such as 111111111, 222222222, etc., or sequential 123456789 do not make an entry. Press <Enter>.

Exception:

If name matches line 1 and the SSN is present on line 2 mirror the entry for line 2.

Caution:

Do not enter any data present in columns (b, c, d, or e) if there is no corresponding name present in column (a).

Line 17(c)-DoB
through
Line 22(c)-DoB
DOB (If SSN is not available) Enter the date of birth if present in MM-DD-YYYY format if a complete date is present.

Caution:

If any of one of MM, DD, or YYYY are missing the remaining combination "is not" a DoB. Do not enter any data in the field if all three things are not able to be determined.

Caution:

Do not enter any data present in columns (b, c, d, or e) if there is no corresponding name present in column (a).

Line 17(d)-12 Months
through
Line 22(d)-Dec
Covered all 12 months Enter "X" if marked.

Caution:

Do not enter any data present in columns (b, c, d, or e) if there is no corresponding name present in column (a).

Line 17(e)-Jan
through
Line 17(e)-Dec
Months of coverage Jan through Dec Enter "X" if marked.

Caution:

Do not enter any data present in columns (b, c, d, or e) if there is no corresponding name present in column (a).

OE/DV Screen Prompt
Page 3
Description
Page 3
Instructions
Form 1095-C, Employer-Provided Health Insurance Offer and Coverage - Page 3
Employee Name Name of employee Enter the full name present if shown. Enter a space for any illegible characters. Do not leave two consecutive spaces.
SSN Social security number (SSN) Enter the nine digit SSN present.
  • If the SSN is more than nine digits enter the first nine digits.

  • If any digit is illegible or missing enter a period for the illegible or missing digit.

  • If blank, single repeating digit such as 111111111, 222222222, etc., or sequential 123456789 do not make an entry. Press <Enter>.

Line 23(a)-Covered Ind.
through
Line 34(a)-Covered Ind.
Name of covered individual(s) Enter the full name shown. If any character in the name is illegible enter a space for the illegible character. Do not leave two consecutive spaces.

Note:

Instructions repeat for all entries for each covered individual listed on line 23 (columns a, b, c, d, and e) through line 34 (columns a, b, c, d, and e).

Line 23(b)-SSN
through
Line 34(b)-SSN
SSN Enter the nine digit SSN present.
  • If the SSN is more than nine digits enter the first nine digits.

  • If any digit is illegible or missing enter a period for the illegible or missing digit.

  • If blank, single repeating digit such as 111111111, 222222222, etc., or sequential 123456789 do not make an entry. Press <Enter>.

Caution:

Do not enter any data present in columns (b, c, d, or e) if there is no corresponding name present in column (a).

Line 23(c)-DoB
through
Line 34(c)-DoB
DOB (If SSN is not available) Enter the date of birth if present in MM-DD-YYYY format if a complete date is present.

Caution:

Do not enter any data present in columns (b, c, d, or, e) if there is no corresponding name present in column (a).

Caution:

If any of one of MM, DD or YYYY are missing the remaining combination "is not" a DoB. Do not enter any data in the field if all three things are not able to be determined.

Line 23(d)-12 Months
through
Line 34(d)-Dec
Covered all 12 months Enter "X" if marked.

Caution:

Do not enter any data present in columns (b, c, d, or, e) if there is no corresponding name present in column (a).

Line 23(e)-Jan
through
Line 34(e)-Dec
Months of coverage Jan through Dec Enter "X" if marked.

Caution:

Do not enter any data present in columns (b, c, d, or, e) if there is no corresponding name present in column (a).

Note:

Instructions repeat for all entries for each covered individual listed on line 23 (columns a, b, c, d, and e) through line 34 (columns a, b, c, d, and e).

Valid Characters

OE/DV Screen Prompt Valid Characters
Name Line
  1. Alphas (A through Z)

  2. Numerics (0 through 9)

  3. Hyphen (-)

  4. Blank/Space

  5. Ampersand (&)

  6. Maximum 35 characters

Caution:

No other characters are to be entered even if they are present on the form.

Address Line
  1. Alphas (A through Z)

  2. Numerics (0 through 9)

  3. Hyphen (-)

  4. If blank, enter Z

  5. Slash (/)

  6. Asterisk (*) only valid in first position for PO Box

  7. Space

  8. Maximum 35 characters

Caution:

No other characters are to be entered even if they are present on the form.

City Line
  1. Alphas (A through Z)

  2. If blank, enter ZZZ

  3. Space

    Note:

    Space for all special characters in the city/state line with exception of an apostrophe. Never enter two consecutive spaces and leave no space for the apostrophe.

  4. Maximum 25 characters

Caution:

No other characters are to be entered even if they are present on the form.

State Line
  1. Alphas (A through Z)

  2. Blank/Space

  3. Maximum 2 characters

Note:

Domestic addresses take precedent over foreign addresses if multiple are present.

Province Line
  1. Alphas (A through Z)

  2. Blank/Space

  3. Maximum 17 characters

Note:

Domestic addresses take precedent over foreign addresses if multiple are present.

ZIP Code
  1. Numerics (0-9)

  2. Space

  3. Maximum five or nine numerics

Reminder:

The Zone Improvement Plan (ZIP) Code must be consistent with the ZIP Code tables listed in Exhibit 3.41.267-2, Exhibit 3.41.267-3, Exhibit 3.41.267-4, and Exhibit 3.41.267-5.

Country/Foreign postal code
  1. Alphas (A through Z)

  2. Numerics (0-9)

  3. Maximum 35 characters

Reminder:

The ZIP Code must be consistent with the ZIP Code tables list in Exhibit 3.41.267-2, Exhibit 3.41.267-3, Exhibit 3.41.267-4, and Exhibit 3.41.267-5.

Contact Phone
  1. Seven, ten or twelve digits (numbers).

  2. Numeric (0-9)

  3. Space

Date of Birth (DoB, DOB)
  1. Numeric (0-9)

  2. Format MMDDYYYY

  3. Blank/Space

Checkboxes
  1. Alpha "X"

  2. Blank

Unit Production Card (UPC) Inputs for Batch/Block Tracking System (BBTS)

SCRIPS Report Number
or
Source
Report Name Identifier Applicable Program Number BBTS Receipts
(Yes or No)
BBTS Production
(Yes or No)
IPS0083 Workstation Operator Statistics Program and Function Summary Report   460-44320
470-44320
480-44320
Yes Yes
Receipt and Control release to SCRIPS Local Reports   500-44320 Yes No
IPS01119 Run Balance Report Total Records Processed 500-44320 No Yes
IPS06440 Throughput Statistics Report Total Documents for all scandrivers
minus
Total records deleted on IPS01119
450-44320 Yes No
IPS01119
Total Records Processed
Run Balance Report Data Records Output 450-44320 No Yes