Blank Months of Coverage for Dependent in Part III of 1095-C form in PDF

For some of our employees who have over 4 dependents enrolled in self-insured coverage, the dependents are listed as expected in Part III with the correct name and masked SSN or DOB, but the months that they are enrolled in the coverage are not checked off. If the employee has less than 4 dependents, it doesn't appear to be an issue. The employee and the other dependents have Xs in the months they are enrolled in the coverage, but one or more dependents after the 4 line (under the fold for the self-mailer form) do not have any Xs in