Safe harbor code

Part II - Employer Offer and Coverage

Line 16: Applicable Section 4980H Safe Harbor Code

Line 16, Applicable Section 4980H Safe Harbor, is used to indicate the ALE’s eligibility for Section 4980H Safe Harbor Relief. If applicable, you’ll need to enter the corresponding code from Code Series 2 of Form 1095-C, listed below. If one code applies for all 12 months, you can enter the code in just the first box (“All 12 Months”). Only one code may be used for each calendar month.

Code Series 2 - Section 4980H Safe Harbor Codes and Other Relief for Employers

Lines 14 through 16 are used to indicate the offer of coverage for the employee as well as the employee’s share of the monthly premium and any applicable Section 4980H Safe Harbor relief. On Line 16 of Form 1095-C, one of the following Safe Harbor Codes must be entered to reflect the Safe Harbor situation with regards to the employee.

Note:For the 2016 filing year (and future years), Code 2I, non-calendar year transition relief applies to this employee, has been removed and may no longer be entered. To learn more about the other codes that may apply, click the corresponding links above.