DIY 1095

View Video

Welcome to the Do-It-Yourself 1095
Form Generation engine.

You may be here because your in-house payroll or third-party payroll administrator doesn't provide Form 1094/1095 reporting. Or perhaps this forms-reporting is available, but simply cost-prohibitive. Whatever your situation, one thing is certain— your employee benefits broker has your back.

Through the DIY1095 Form Generator, your benefits broker offers a tool that can help reduce the stress associated with administering the complexities of the Affordable Care Act (ACA). In addition, this tool helps ensure you are compliant with the ACA new regulations.

The DIY1095 Form Generator delivers a simple, easy-to-use mechanism to help you produce the 1094/1095 forms—without unnecessary headache or exorbitant cost.

This website also includes tools and resources to help you complete the process. However, if you have any questions about ACA, or how to apply the appropriate codes, please don't hesitate to contact your broker.

Do-It-Yourself…Today!

Simple as 1, 2, 3

Enter Employer Information

1. Enter Employer Information

Enter Employee Information

2. Enter Employee Information

Enter Employer Information

3. Generate 1094 and 1095!

Contact Us

The DIY1095 Form Generator is licensed by employee benefit brokers who, in turn, make the site available to their clients to support the filing of Forms 1094/1095. If you are a broker and are interested in licensing DIY1095 for your clients, please send us an e-mail (margaret@millsonjames.com). If you are an employer currently utilizing DIY1095 and have questions regarding the 1094/1095 forms or process, please contact your broker.

Which version of Employee forms would you like to print?
Masked Forms will only show the last 4 digits of the employee's SSN.

The electronic-filing threshold for information returns required to be filed on or after January 1, 2024, has been decreased to 10 or more returns (aggregated across the year including forms W2). Do you wish to proceed printing IRS forms?

You have incomplete employee forms. Are you sure you want to continue printing?

Congratulations! You have successfully uploaded your employee list. You can review, confirm and make corrections to your data by clicking the button below.

You have successfully updated your employee list zip codes. You can review, confirm and make corrections to your data by clicking the button below.

Oops! You have selected a locked input field that may not be changed. If the displayed information is incorrect you must delete this record and manually add a new employee. If the information is correct please click 'Cancel' to close this window.

To view a snapshot of the data you have loaded to the DIY1095 system, please click on the applicable button below.

To view a snapshot of the data you have loaded to the DIY1095 system, please click on the applicable button below.

Congratulations! Your Forms are currently being processed and should be ready within 1 hour. You can visit the Download Center within the Dashboard to download your Forms. Note: The system will not automatically complete the IRS or employee mailings. You must ensure to print and mail (or eFile) your own forms.

Congratulations! Your eFile are currently being processed and should be ready within 3 hours. Once complete, you can visit the Download Center within the Dashboard to download your Forms. In order to prevent extra processing time, please do not click “Print Forms” again until your request is complete (approximately 3 hours).

Please follow the prompts to submit Step 1 of your eFile payment.

Note: A PayPal account is not required.

Hi

Attention: You have at least one loaded zip code with only 4 digits. Would you like to automatically add a leading zero to all 4 digit zip codes or check the data manually?

Attention: Please note that by clicking on the Continue button below, you will be transmitting your data from the DIY1095 system to a third party administrator (Nelco) site in order to complete the efiling and/or fulfillment process (additional fees apply). This data transfer process may take several minutes, please be patient and do not close any windows while the system processes the data (a new tab will open once complete).

Additional fees apply for eFiling and Fulfillment services. The fee is paid in a two-step process. You paid a base fee to initiate the process and upon checkout you will complete your payment through an online checkout process based on the exact number of forms processed. For a full fee schedule, please reference the Administrative User’s Guide found on the Dashboard.

Please note that Third Party Materials and links thereto are provided solely as a convenience to you and you access and use them at entirely at your own risk and subject to such third parties' terms and conditions. As such, we recommend you review the third party’s website terms, privacy, and security policies to understand how they apply to you.

Attention: Please note that additional fees apply. You can view a fee schedule within the Admin User’s Guide found on the Dashboard (Helpful Resources). If you have any specific questions about fees, please contact your benefit broker.

By clicking on the Continue button below, you will be transmitting your data from the DIY1095 system to a third party administrator (Nelco) site via secure transfer in order to complete the efiling and/or fulfillment process. This data transfer process may take several minutes, please be patient and do not close any windows while the system processes the data (a new tab will open once complete).

Please note that Third Party Materials and links thereto are provided solely as a convenience to you and you access and use them at entirely at your own risk and subject to such third parties' terms and conditions. As such, we recommend you review the third party's website terms, privacy, and security policies to understand how they apply to you.

Attention: Please note that additional fees apply. You can view a fee schedule within the Admin User’s Guide found on the Dashboard (Helpful Resources). If you have any specific questions about fees, please contact your benefit broker.

By clicking on the Continue button below, you will be logging into a third party administrator (Nelco) site via secure transfer in order to complete the efiling and/or fulfillment process.

Please note that Third Party Materials and links thereto are provided solely as a convenience to you and you access and use them at entirely at your own risk and subject to such third parties' terms and conditions. As such, we recommend you review the third party's website terms, privacy, and security policies to understand how they apply to you.

We are experiencing higher than normal usage as the ACA deadline approaches. If you have the opportunity, please process your forms during off hours. Also, when it is time to print your forms, please only press the print button once as selecting print more than once will only further delay the production of your forms.

Privacy Policy

This is the main privacy policy for DIY1095.com and for certain services provided through this and other websites and applications ("our sites") by MillsonJames.

MillsonJames takes your privacy very seriously. We share a commitment to protect your privacy and the confidentiality of your personal information.

This Policy is provided to help you better understand how we at MillsonJames obtain, use, share, and protect your personal information. As a provider of services to you as a client, we often collect personal and sometimes sensitive information. Protecting the confidentiality of that information has been and will continue to be, a top priority at MillsonJames. We believe that you should know about the information we collect, the measures we take to safeguard it, and the situations in which we might share information.

Your Personal Information

We collect only the information necessary to consistently deliver responsive services to you as the client. Information we collect may include, but is not necessarily limited to, the following: your name, address, phone number, Employer Identification Number (EIN) as well as information about your employees including, but not limited to, name, address, Social Security Number (SSN), dependent information, and other information provided on benefit plan details as required to fulfill requested services.

Collecting your Personal Information

The information above may be obtained from you using data gathering software when you are completing information on our sites.

Protecting Your Personal Information

We have implemented and maintain physical, electronic, and procedural safeguards to protect your non-public personal information. We use and share your non-public personal financial information to the extent minimally necessary and only with those employees who use your information as a means to service your account. They are required to respect the confidentiality of all client information. We also require each unaffiliated third party with whom we contract to assist in servicing your account to agree to abide by safeguards and privacy standards that are the same or substantially similar to those followed by MillsonJames.

The privacy and security of your non-public personal information will be maintained beyond the termination of your relationship with MillsonJames.

Sharing Personal Information

First and foremost, we do not sell lists of our clients, nor do we disclose client information to marketing companies.

We may also share information about you with our service providers, affiliates, and representatives to help us service your accounts. Our service providers, affiliates, and representatives may include your broker and third party services providers. The information provided to these service providers, affiliates, and representatives may include the categories of information described above under “Your Personal Information,” and is limited to the information that we deem appropriate for these third parties to carry out their functions.

We will not intentionally collect any personal information from children under the age of 13 through our sites without receiving verifiable parental consent. If you think that we have collected personal information from a child under the age of 13 through this website, please contact us.

Changes to this Privacy Policy

We may change this Privacy Policy. If we do so, such change will appear on this page of our website. We will also provide appropriate notice and choices to you, on this website and in other appropriate locations, based on the scope and extent of changes. You may always visit this policy to learn of any updates.

Contact Us

If you have any questions regarding this Privacy Policy, you may contact us at scott@MillsonJames.com.

Effective Date

The Effective Date of this Privacy Policy is May 1, 2015.

Please contact your broker/ACA contact, you may not need to file forms 1094 and 1095.

Delete Employee Confirmation

Are you sure you want to delete this employee? All employee form data will also be deleted.

Delete Employee(s) Confirmation

Are you sure you want to delete the selected employee(s)? The employee(s) form data will also be deleted.

Delete All Employees Confirmation

Are you sure you want to delete all uploaded employees? All employee form data will also be deleted.

Terms and Conditions

IMPORTANT - READ CAREFULLY: THIS END USER LICENSE AGREEMENT (THE “EULA”) IS A LEGAL AGREEMENT BETWEEN YOUR COMPANY (“YOU”) AND MILLSONJAMES ON BEHALF OF ITSELF AND ITS AFFILIATES (“MILLSONJAMES”), FOR THE USE OF MILLSONJAMES'S AUTOMATED DOCUMENT COMPLETION SOFTWARE (THE “SOFTWARE”) AND TO THE BENEFIT OF YOUR BROKER AS A THIRD-PARTY BENEFICIARY.

MILLSONJAMES PROVIDES THE SOFTWARE SOLELY ON THE TERMS AND CONDITIONS SET FORTH IN THIS EULA AND ON THE CONDITION THAT YOU ACCEPT AND COMPLY WITH THEM. BY CLICKING ON THE "ACCEPT TERMS AND CONDITIONS" BUTTON BELOW, OR IN ANY OTHER WAY ACCESSING OR USING THE SOFTWARE, YOU ARE CONSENTING TO THE TERMS AND CONDITIONS OF THIS EULA. YOUR ACCEPTANCE REPRESENTS THAT YOU HAVE THE AUTHORITY TO BIND YOUR COMPANY TO THESE TERMS. IF YOU DO NOT AGREE WITH THESE TERMS, OR IF YOU DO NOT HAVE THE AUTHORITY TO BIND YOUR COMPANY, DO NOT CLICK THE “ACCEPT TERMS AND CONDITIONS” BUTTON BELOW.

1. License Grant. Subject to the terms and conditions of this EULA, MillsonJames hereby grants you a revocable, non-exclusive, non-transferable, non-sublicensable, limited license (hereinafter, the “License”) during the Term to access and use the Software for the automated preparation of Internal Revenue Service Forms 1094-B, 1094-C, 1095-B and 1095-C (the “IRS Forms”). By clicking the “Accept Terms and Conditions” button below, you confirm that you understand and acknowledge the Software is NOT a form of legal, accounting, tax, compliance, or any other form of advice to assist you in determining what information to input into the IRS Forms, but rather that the Software is to be used only for the purpose of automating your own preparation of the IRS Forms.

2. Restrictions on Use. You shall not: (i) copy the Software; (ii) modify, translate, adapt or otherwise create derivative works or improvements of the Software; (iii) reverse engineer, disassemble, decompile, decode or otherwise attempt to derive or gain access to the source code of the Software or any part thereof; (iv) remove, delete, alter or obscure any trademarks or any copyright, trademark, patent or other intellectual property or proprietary rights notices from the Software, including any copy thereof; (v) rent, lease, lend, sell, sublicense, assign, distribute, publish, transfer or otherwise make available the Software or any features or functionality of the Software, to any third party for any reason, including by making the Software available on a network where it is capable of being accessed by more than one device at any time; or (vi) remove, disable, circumvent or otherwise create or implement any workaround to any copy protection, rights management or security features in or protecting the Software.

3. Reservation of Rights. You acknowledge and agree that the Software is provided under license, and is not sold, to you. You do not acquire any ownership interest in the Software under this EULA, or any other rights thereto other than to download and use the Software in accordance with the license granted, and subject to all terms, conditions and restrictions, under this EULA. MillsonJames reserves and shall retain its entire right, title and interest in and to the Software, including all copyrights, trademarks and other intellectual property rights therein or relating thereto, except as expressly granted to you in this EULA.

4. Collection and Use of Your Information. You acknowledge that when you download and use the Software, MillsonJames may use automatic means, including, for example, cookies and web beacons, to collect information about your use of the Software. You also may be required to provide certain information about yourself as a condition to using the Software. All information MillsonJames collects through or in connection with the Software is subject to our Privacy Policy. By using and providing information to or through this Software, you consent to all actions taken by us with respect to your information in compliance with the Privacy Policy. MillsonJames will assume that any and all data and other requested information you provide to MillsonJames is complete and accurate. MillsonJames is under no duty to review, edit, censor, control or question the completeness or accuracy of any data. MillsonJames will not be responsible for any losses or expenses that arise due to your submission of incorrect or incomplete data.

5. Term and Termination. This EULA and the License are effective upon clicking the “Accept Terms and Conditions” button and shall remain in effect until terminated by either party. You may terminate this EULA at any time by ceasing to use or access the Software. This EULA shall automatically terminate without further action by MillsonJames, immediately upon any material breach by you. Upon termination of this EULA for any reason, the License will terminate immediately and you shall destroy all copies of any form or other material you accessed or downloaded through your use of the Software.

6. Updates. MillsonJames may from time to time in its sole discretion develop and provide Software updates, which may include upgrades, bug fixes, patches and other error corrections new features (collectively, "Updates"). Updates may also modify or delete in their entirety certain features and functionality. You agree that MillsonJames has no obligation to provide any Updates or to continue to provide or enable any particular features or functionality. If MillsonJames creates any Update, you may download and install such Update and acknowledge and agree that the Software or portions thereof may not properly operate should you fail to do so. You further agree that all Updates will be deemed part of the Software and are subject to all terms and conditions of this EULA.

7. Third Party Products and Services. The Software may display, include or make available third-party content, including data, information, applications and other products, services or materials, or provide links to third-party websites or services ("Third Party Materials"). You acknowledge and agree that MillsonJames is not responsible for Third Party Materials, including their accuracy, completeness, timeliness, validity, copyright compliance, legality, decency, quality or any other aspect thereof. MillsonJames does not assume and will not have any liability or responsibility to you or any other person or entity for any Third Party Materials. Third Party Materials and links thereto are provided solely as a convenience to you and you access and use them at entirely at your own risk and subject to such third parties' terms and conditions. By way of example, the Nelco e-filing and fulfillment products and services referenced on the Software are Third Party Materials. MillsonJames is not responsible for any products or services provided by Nelco.

8. Disclaimer of Warranties. EXCEPT AS OTHERWISE SET OUT IN THIS EULA, SOFTWARE IS PROVIDED TO YOU ON AN "AS IS" BASIS AND MILLSONJAMES DISCLAIMS ALL OTHER WARRANTIES, REPRESENTATIONS AND CONDITIONS, EXPRESS, IMPLIED, STATUTORY OR OTHERWISE, INCLUDING WITHOUT LIMITATION, ANY WARRANTY OR CONDITION OF MERCHANTABILITY, MERCHANTABLE QUALITY, OR FITNESS FOR A PARTICULAR PURPOSE, OR ARISING FROM A COURSE OF DEALING, USAGE OR TRADE PRACTICE. IN PARTICULAR, MILLSONJAMES DOES NOT WARRANT OR REPRESENT THAT THE SOFTWARE WILL OPERATE UNINTERRUPTED OR ERROR FREE OR THAT DEFECTS IN THE SOFTWARE ARE CORRECTABLE OR WILL BE CORRECTED.

9. Limitation of Liability. NOTWITHSTANDING ANY OTHER TERM OR PROVISION OF THIS EULA, IN NO EVENT WILL MILLSONJAMES, OR ANY THIRD PARTY BROKER OF RECORD/AGENT OF RECORD FOR GROUP HEALTH INSURANCE THAT PROVIDES YOU ACCESS TO THE SOFTWARE (A “BROKER”), BE LIABLE FOR ANY EXEMPLARY, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL OR PUNITIVE DAMAGES OR DAMAGES FOR LOSS OF PROFITS OR REVENUES, BUSINESS INFORMATION OR OTHER PECUNIARY LOSS, ARISING UNDER OR IN CONNECTION WITH THIS EULA, EVEN IF ADVISED OF THE POSSIBILITY OF SUCH DAMAGE.

10. Indemnification. You agree to indemnify, defend, and hold harmless MillsonJames, its affiliates, officers, directors, employees, and agents, and any Broker, from and against any claim, cost or liability, including reasonable attorneys’ fees, arising out of or relating to any: (i) breach of this EULA by you or related third parties; (ii) content you create, transmit, or display while using the Software; or (iii); negligent or willful misconduct by you or related third parties while using or accessing the Software. You further agree that the Broker shall not be responsible for the performance of the Software, except to the extent the Broker provides any Third Party Materials that impact the performance of the Software.

11. Modifications. MillsonJames reserves the right to modify the terms and conditions of this EULA, including any additional terms as may arise out of any Update, or any other terms that apply to the Software (the “Additional Terms”). If you use the Software after any such change, you will be deemed to have accepted them. If you do not agree to any modified term of the EULA or changes to other policies, you should discontinue your use of the Software, which termination is your sole and exclusive remedy. If there is a conflict between this EULA and the most current version of this EULA, the most current version will prevail.

12. Miscellaneous. This EULA and any Additional Terms, which are all hereby incorporated by reference as if set forth fully herein, represent the entire agreement between you and MillsonJames with respect to the services provided by MillsonJames and any use of the Software. This EULA shall be governed by and construed in accordance with the laws of the state of Florida, without regard to its conflict of law provisions. If any part of this EULA is held invalid or unenforceable, that part will be construed to reflect the parties' original intent, and the remaining portions will remain in full force and effect. A waiver by either party of any term or condition of this EULA or any breach thereof, in any one instance, will not waive such term or condition or any subsequent breach thereof. You may not assign this EULA or any right or interest hereunder, by operation of law or otherwise, without MillsonJames's express prior written consent. Any attempt to assign this EULA, without such consent, will be null and of no effect. This EULA will be binding upon and inure to the benefit of the parties, their successors and permitted assigns.

13. Governing Law. This EULA is governed by and construed in accordance with the laws of the State of Florida. You waive any and all objections to the exercise of jurisdiction over you by any applicable Florida court, or to venue in such Florida court.

14. EULA Acceptance. By clicking the “Accept Terms and Conditions” button below, you acknowledge that you have read and understood the terms and conditions of this EULA and agree to be legally bound hereunder. If you are not authorized to enter into this EULA or if you do not agree to all the terms of this EULA, do not click the “Accept Terms and Conditions” button below.