Section 11 Reporting Business Rule Validation Errors

AIR will process health coverage data received via Issuer Information Returns (Forms 1094-B, Transmittal of Health Coverage Information Returns and 1095-B, Health Coverage) and Employer Information Returns (Forms 1094-C, Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns and 1095-C, Employer-Provided Health Insurance Offer and Coverage). AIR will ensure that all data is processed according to approved requirements and validated according to IRS business rules. The business rules are applied in order to validate the received data and perform error analysis.

11.1 | Overview

The structure and content of the transmission file and each included Information Return is validated to ensure it conforms to the published structure and rules established by IRS. Structural validation includes validating a transmission against a schema which was covered in the previous section. Data validation of information returns includes validating a transmission against IRS business rules.

Sets of business rules specify the validation rules for Forms 1094/1095-B and Forms 1094/1095-C Information Returns. The business rules are tailored to accommodate unique data elements/schema items, various potential error conditions and other particulars of the ACA Information Returns.

11.2 | Data Validation and Error Reporting

IRS business rules specify the potential error conditions for each Information Return element and indicate if the error is reported (via error statement and/or code) to the transmitter. It must be noted that “faults” (described in the next section) differ from validation errors – a fault is an issue during transmission whereas a validation error is the result of business rules processing.

When data elements fail business rules, errors are generated and reported to the transmitter via a status request. Structural/Schema errors result in the transmission being rejected. Information Return Business Rule validation will result in the errors being reported to the transmitter (when requested). Rejections could occur at the submission/transmittal level (Form 1094 with associated Forms 1095) depending on the error condition.

Transmitters should not include optional XML elements if they do not have data for the elements.

11.2.1 | Processing Status

When a transmitter requests the Acknowledgement for their transmission, IRS returns one of the following statuses:

Accepted Accepted with Errors Partially Accepted Rejected Processing Not Found

In addition, any errors that were found when the transmission was processed are provided in the Error Data File. Table 12-1 discusses the error codes and their respective descriptions.

Guide for ACA Information Returns Submission Composition and Reference Guide 123

Reporting Business Rule Validation Errors

11.2.2 | Error and Business Rule Library

The AIR Error Code Library contains the error codes and descriptions that may be returned to the transmitter and is aligned with the XML Schema and the ACA AIR Business Rules for each major and minor release TY2017, TY2018, TY2019, TY2020, TY2021, TY2022, TY2023, TY2024, TY2025 and TY2026

Example: The AIR TY2026 Business Rules can be found on the following irs.gov web site: AIR TY2026 Business Rules (See Business Rules Version PDF and CSV Formats).

Guide for Electronically Filing ACA Information Returns for Software Developers and Transmitters 124

Reporting Business Rule Validation Errors