What Is Form 1095‑C?
Form 1095‑C, Employer‑Provided Health Insurance Offer and Coverage, is an IRS information return that Applicable Large Employers (ALEs) use to report the health coverage they offered (or didn’t offer) to full‑time employees and to report which employees enrolled in employer‑sponsored coverage. ALEs are generally employers with 50 or more full‑time (or full‑time equivalent) employees. The form helps employees and the IRS determine eligibility for provisions of the Affordable Care Act (ACA), including the premium tax credit. (Internal Revenue Service, “About Form 1095‑C”; Investopedia)
Key takeaways
– Who files: ALEs (typically 50+ full‑time employees) must prepare Form 1095‑C for each full‑time employee. (IRS, ACA Information Center for ALEs)
– What it shows: employer identifying information, whether an offer of coverage was made for each month, and who was covered under the employer’s plan. (IRS, Form 1095‑C)
– For taxpayers: Form 1095‑C is a reference document. You do not attach it to your tax return, but you may use its information to claim the premium tax credit or to verify coverage. (IRS, About Form 1095‑C)
– Other related forms: 1095‑A (Marketplace statements) and 1095‑B (coverage from insurers or small employers) may also be issued depending on the source of coverage. (IRS, Forms 1095‑A / 1095‑B)
Who must file Form 1095‑C (and who receives it)
– Employers: Applicable Large Employers (ALEs)—generally those with 50 or more full‑time employees or equivalents—must prepare and file Forms 1095‑C (and the transmittal Form 1094‑C) with the IRS and furnish Form 1095‑C to their full‑time employees. ALE members in aggregated groups follow common‑employer rules. (IRS, ACA Information Center for ALEs; Instructions for Forms 1094‑C and 1095‑C)
– Employees: Full‑time employees who worked one or more months during the calendar year receive Form 1095‑C. Employers must report information for all 12 months or the entire calendar year for each full‑time employee. (IRS, Form 1095‑C)
What information is on Form 1095‑C
– Part I: Employer and employee identification (names, addresses, EIN, SSN).
– Part II: Offer of coverage information — codes for each month showing whether coverage was offered, what type, and if the employer claimed an affordability or MEC safe harbor. (Employers use IRS‑defined codes.)
– Part III (if applicable): Data about individuals covered under the employer’s plan (names, SSNs, months covered).
(IRS, Form 1095‑C and Instructions)
What is Form 1095‑C used for?
– For individuals: To verify whether an employer offered minimum essential coverage and whether the individual enrolled. The form is used to help determine eligibility for the premium tax credit if the employee or family members apply for marketplace subsidies. It’s a reference — not a form you file with your tax return. (IRS, About Form 1095‑C; IRS, The Premium Tax Credit)
– For the IRS: To administer ACA employer shared responsibility provisions and to reconcile employer reporting with individual tax filings and Marketplace subsidies.
Is Form 1095‑C required for filing taxes?
– No. You do not attach Form 1095‑C to your individual federal income tax return. However, keep it with your tax records and use it to support claims for the premium tax credit or to document coverage. (IRS, About Form 1095‑C)
How to get your Form 1095‑C
– Employer: Your ALE employer must furnish Form 1095‑C to full‑time employees for the prior calendar year. If you didn’t receive it, contact your employer’s HR or benefits administrator. (IRS, About Form 1095‑C)
– IRS copy: The IRS publishes blank forms and instructions on IRS.gov; employers use software or IRS filing systems to submit returns. (IRS, Form 1095‑C)
Practical steps — For employers (ALEs)
1. Determine ALE status and aggregation rules.
– Confirm whether you meet the 50+ full‑time employee definition and whether you are part of an aggregated ALE group. (IRS, ACA Information Center for ALEs)
2. Gather data for each full‑time employee and covered individuals.
– Employee name, address, SSN; employer name, EIN; monthly offer/enrollment status; identity and SSNs of covered dependents and months covered.
3. Complete Forms 1095‑C and the transmittal Form 1094‑C.
– Use the IRS instructions to assign the correct offer and other codes for each month and to complete Part III if you provided coverage and must report covered individuals. (IRS, Instructions for Forms 1094‑C and 1095‑C)
4. Furnish to employees.
– Provide each full‑time employee with Form 1095‑C by the furnishing deadline set by the IRS (employers are responsible for checking the current year’s deadline and any extensions). Historically the furnishing deadline to employees has fallen around January 31 each year; verify current deadlines on IRS.gov. (IRS, Form 1095‑C / Instructions)
5. File with the IRS.
– File Forms 1094‑C and 1095‑C with the IRS. Small volumes may be submitted on paper; larger filers generally must file electronically. Check current IRS filing thresholds and deadlines; historically the IRS deadline for paper filing has been late February and for electronic filing late March (confirm current year dates). (IRS, Instructions for Forms 1094‑C and 1095‑C)
6. Correct errors promptly.
– If you discover mistakes after filing or furnishing, follow IRS guidance to correct returns and re‑furnish corrected forms to affected employees.
7. Maintain records.
– Keep copies of filed forms and supporting records as required by IRS recordkeeping rules.
Practical steps — For employees / taxpayers
1. Expect the form.
– If you were a full‑time employee of an ALE during the year, expect Form 1095‑C from your employer. If you didn’t get it by the timeframe your employer normally uses or by the IRS furnishing deadline, contact HR/benefits.
2. Review the form for accuracy.
– Check your name, SSN, employer info, the months showing an offer of coverage, and any listed covered individuals. If incorrect, request correction from your employer.
3. Use for tax planning and Marketplace credits.
– If you applied for or are claiming the premium tax credit, use the Form 1095‑C information to prepare or amend Marketplace and tax return information. If you received advance premium tax credit payments through a Marketplace, reconcile them on Form 8962 when filing your return. (IRS, The Premium Tax Credit; HealthCare.gov, How to Use Form 1095‑A)
4. Keep it with your tax records.
– Retain Form 1095‑C for at least several years (follow IRS recordkeeping guidance). You don’t file it with your return unless instructed otherwise.
5. If covered through the Marketplace or an insurer:
– If you had Marketplace coverage, you receive Form 1095‑A from the Marketplace (not 1095‑C). If your coverage was through an insurer or small employer, you may receive Form 1095‑B. Don’t confuse these different forms; use the form appropriate to your coverage source. (IRS, Form 1095‑A; Form 1095‑B)
How to fill out Form 1095‑C (employer guidance)
– Employers should consult the official Instructions for Forms 1094‑C and 1095‑C for step‑by‑step guidance and the monthly offer codes for Part II. The IRS instructions contain:
– Definitions (ALE, full‑time employee, affordability safe harbors).
– Code lists for lines that indicate the type of offer and affordability status.
– Reporting rules for multiple employer plans and aggregated groups.
(IRS, Instructions for Forms 1094‑C and 1095‑C)
Penalties and compliance
– The IRS may assess penalties for failure to file correct information returns, failure to furnish correct statements to employees, or intentional disregard of the filing requirements. Penalty amounts and safe harbors can change over time; consult current IRS instructions and consider seeking payroll/tax counsel to manage compliance. (IRS, Instructions for Forms 1094‑C and 1095‑C)
Other relevant forms (and when you’ll see them)
– Form 1094‑C: Transmittal of Employer‑Provided Health Insurance Information Returns — summary transmittal filed with the IRS when submitting Forms 1095‑C. (IRS)
– Form 1095‑B: Health Coverage — used by insurers and small employers to report individuals who are covered by minimum essential coverage. (IRS, About Form 1095‑B)
– Form 1095‑A: Health Insurance Marketplace Statement — sent to individuals who enroll in coverage through the Marketplace; used to reconcile advance premium tax credits. (HealthCare.gov; IRS, Health Insurance Marketplace Statements)
Where to find official forms and instructions
– IRS forms and instructions (current year): https://www.irs.gov/forms-pubs
– Form 1095‑C and Instructions (official): https://www.irs.gov/forms-pubs/about-form-1095-c
– ACA Information for ALEs: https://www.irs.gov/affordable-care-act/employers
– Form 1095‑A (Marketplace): https://www.healthcare.gov/how-to-use-form-1095-a
(See IRS and HealthCare.gov pages for authoritative, up‑to‑date details.)
Sources
– Internal Revenue Service, “About Form 1095‑C, Employer‑Provided Health Insurance Offer and Coverage.” https://www.irs.gov/forms-pubs/about-form-1095-c
– Internal Revenue Service, “Form 1095‑C, Employer‑Provided Health Insurance Offer and Coverage” (form & instructions). https://www.irs.gov/forms-pubs
– Internal Revenue Service, “ACA Information Center for Applicable Large Employers (ALEs).” https://www.irs.gov/affordable-care-act/employers
– Internal Revenue Service, “The Premium Tax Credit — The Basics.” https://www.irs.gov/credits-deductions/individuals/the-premium-tax-credit
– Internal Revenue Service, “About Form 1095‑B, Health Coverage.” https://www.irs.gov/forms-pubs/about-form-1095-b
– HealthCare.gov, “How To Use Form 1095‑A.” https://www.healthcare.gov/how-to-use-form-1095-a
– Investopedia, “Form 1095‑C.” https://www.investopedia.com/terms/f/form-1095c.asp
If you’d like, I can:
– Summarize the meaning of the specific offer codes commonly used on line 14 and line 16 of Part II (with the official IRS code list), or
– Create a checklist template you can use as an employer to gather the data needed to complete Forms 1095‑C and 1094‑C. Which would be most helpful?