Certification of eligibility

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Part II - ALE Member Information


Line 22:

A. Qualifying Offer Method
C. Section 4980 transition Relief
D. 98% Offer Method


Reminder: Lines 20-22 should only be completed on the Authoritative Transmittal for the employer.

In Line 22, check the appropriate box to indicate any eligibility requirements the ALE meets, or if the ALE is using one of the Offer Methods and/or Transition Relief. If none of these Certifications of Eligibility apply, leave Line 22 blank.


A. Qualifying Offer Method


Check this box if you're eligible for and are reporting the Qualifying Offer Method on one or more of your 1095-C Forms. In order to check this box, you must have made a Qualifying Offer to one or more of your full-time employees during the entirety of their employment that year. You're not required to use the Qualifying Offer Method even if you're eligible to use it.


If you check Box A to indicate a Qualifying Offer, don't complete Part II, line 15 of Form 1095-C for any month for which a Qualifying Offer is made. Instead, enter code 1A on Form 1095-C, line 14 for each month a Qualifying Offer was made, and leave Line 15 blank.


C. Section 4980H Transition Relief


    Check this box if you're eligible for Section 4980H Transition Relief under either:
  • 2016 Section 4980H Transition Relief for ALEs with Fewer than 100 Full-Time Employees (including full-time equivalents, also known as 50-99 Transition Relief) or
  • 2016 Transition Relief for Calculation of Assessable Payments Under Section 4980H(a) for ALEs with 100+ Full-Time Employees (including full-time equivalents, also known as 100 or More Transition Relief).

If you check Box C, you must also complete Part III, column (e) of Form 1094-C, Section 4980H Transition Relief Indicator.


D. 98% Offer Method


Check this box if you're eligible for and using the 98% Offer Method. In order to check this, you must have offered affordable health coverage to at least 98% of your full-time employees during their employment (excluding Limited Non-Assessment Periods). This coverage must meet the Minimum Value of coverage as outlined by the ACA, and the Minimum Essential Coverage must have also been offered to the employee's dependents.