FORM 1095-B CI (Covered Individuals) File Schema

Sample File = Schema\2019\TEXT\T1095B CI.txt


String fields are displayed within quotations

CRLF=Carriage Return Line Feed (Hex 0D0A)

 

"Import ID"

"First name"

"Middle initial"

"Last name"

"Suffix"

"Name control"

"Social Security Number"

"Date of birth" ²

12 months coverage indicator ¹

January coverage indicator ¹

February coverage indicator ¹

March coverage indicator ¹

April coverage indicator ¹

May coverage indicator ¹

June coverage indicator ¹

July coverage indicator ¹

August coverage indicator ¹

September coverage indicator ¹

October coverage indicator ¹

November coverage indicator ¹

December coverage indicator ¹

"Client ID"

CRLF

 

¹ "X" if applicable, otherwise, enter a null string ""

² Use format MMDDYYYY or MMDDYY