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

Form 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns, is the Internal Revenue Service (IRS) form that transmits an Applicable Large Employer Member's (ALE Member's) Forms 1095-C and summarizes that employer's information. The IRS agency page says it is the transmittal form that must be filed with the Form 1095-C.

The printed form is issued under OMB No. 1545-2251 and the edition on this page is marked 2025. It has four parts:

• Part I, Applicable Large Employer Member (ALE Member): the employer's name and employer identification number (EIN), address and contact person, an optional Designated Government Entity block, the total number of Forms 1095-C submitted with the transmittal, and whether this is the authoritative transmittal for the ALE Member.
• Part II, ALE Member Information: the total number of Forms 1095-C filed by and/or on behalf of the ALE Member, whether it belongs to an Aggregated ALE Group, the certifications of eligibility and the signature block.
• Part III, ALE Member Information—Monthly: for all 12 months and for each month, the minimum essential coverage offer indicator, the Section 4980H full-time employee count, the total employee count and the aggregated group indicator.
• Part IV, Other ALE Members of Aggregated ALE Group: names and EINs of the other members.

The IRS agency page also lists Treasury Decision 9661, Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under Employer-Sponsored Plans, among related items. Form 1094-C is a transmittal; the individual coverage information is reported on Form 1095-C.

The form is for an Applicable Large Employer Member (ALE Member) that files Forms 1095-C. The IRS states that Form 1094-C is the transmittal form that must be filed with the Form 1095-C, so it travels with those returns.

Groups the form addresses:

• ALE Members submitting Forms 1095-C: complete Part I with the employer's name and EIN and the total number of Forms 1095-C submitted with the transmittal.
• ALE Members that belong to an Aggregated ALE Group: answer Yes on line 21 and list the other members, who were members at any time during the calendar year, in Part IV.
• ALE Members that do not belong to an Aggregated ALE Group: answer No on line 21. The form says not to complete Part IV in that case.
• Employers using a Designated Government Entity: complete lines 9 through 16 only if applicable.

The form prints a declaration under penalties of perjury above the signature, title and date lines, so the person who signs should have examined the return and accompanying documents. The form does not say who else may sign; see the instructions at www.irs.gov/Form1094C.

Form 1094-C is filed whenever the Forms 1095-C it covers are filed, because the IRS states that it must be filed with Form 1095-C. No separate due date is printed on the form itself.

The edition shown here is the 2025 form, and Part III reports the months January through December. For the filing deadline, any extension and the rules for corrected returns, which the form signals with a CORRECTED indicator at the top, use the IRS instructions and the latest information at www.irs.gov/Form1094C.

Form 1094-C has no address, portal or appointment rule printed on it; it is sent together with the Forms 1095-C it transmits.

• With the Forms 1095-C: the IRS says this transmittal must be filed with Form 1095-C, and line 18 asks for the total number of Forms 1095-C submitted with it.
• Instructions and current details: the form directs you to www.irs.gov/Form1094C for instructions and the latest information, which is where the IRS publishes the filing details for the form.

Before sending, check that Part I, Part II and the signature, title and date are complete, and that the counts on lines 18 and 20 match the returns you are filing. FillingPDF lets you fill out and download the PDF; submission follows the IRS channels described in the instructions.