What is Form 1095-C?

The Affordable Care Act (ACA) includes both an employer mandate and individual mandate. If you enrolled in your company's healthcare coverage in 2018, you may receive a Form 1095-C from your employer. The form serves as "proof of insurance" and contains information about the healthcare coverage your employer offered or provided to you. 

You may also receive:

  • Form 1095-A: provides information regarding any Marketplace coverage you had and any Premium Tax Credits you received.
  • Form 1095-B: provides information from a health insurance company or a multi-employer plan.

FAQs

Wasn't the individual mandate repealed?

The individual mandate requires that most Americans have healthcare coverage or face a penalty (referred to as a "shared responsibility payment") through the 2018 tax year. For the 2019 tax year, the financial penalty for non-compliance has been removed (zeroed out).

When will I receive these forms?

The IRS has extended the due date for employers to provide 2018 health coverage information forms to individuals. You will receive a physical copy postmarked no later than March 4, 2019.

The extension means you may not receive Forms 1095-B or 1095-C by the time you are ready to file your 2018  income tax returns. 

Do I need the forms to file my federal income taxes?

While the information may assist in preparing tax returns, the forms are not submitted with your tax return and are not generally required to file. That said, there may be circumstances where you need information from the form to file. Such as:

  • You received an advance premium tax credit or wish to take the premium tax credit on your return, or
  • You had a gap in coverage of more than 3 consecutive months.

Does every employer provide a Form 1095-C?

Only employers with 50 or more employees are required to furnish Forms 1095-C. These employers are referred to as "Applicable Large Employers" (ALEs) in the forms.

Who receives a Form 1095-C?

Employers are only required to furnish Form 1095-C to the employee. When you receive one, you should provide a copy to applicable family members for their records.

What's included on the Form 1095-C?

  • Part I (Lines 1-13): information about you and your employer.
  • Part II (Lines 14-16): information about the coverage offered to you, your spouse, and your dependents by your employer, if any; the affordability of the coverage offered; and the reason why you were or were not offered coverage by your employer. If you enrolled in a health plan through a Marketplace (for example, Covered California), the information in Part II of Form 1095-C could help determine if you're eligible for the premium tax credit.
  • Part III (Lines 17-22): reports information about each individual (including any employee and their family members) covered under the employer's heath plan, if the plan is "self-insured."

Additional resources:

IRS Form 1095-C, page 2
Form 1095-C: What You Need to Do with this Form
Affordable Care Act Tax Provisions for Individuals and Families

The information provided in this summary does not constitute legal or tax advice.  Furthermore, this document contains only a brief summary of certain issues relating to the IRS forms mentioned.  Individuals and employers should consult their legal or tax advisors concerning the individual and employer shared responsibility penalties, the content and use of the referenced IRS forms, and the tax implications of the Affordable Care Act on employers and individuals.

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