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The 1095-C form plays a critical role in the healthcare reporting process under the Affordable Care Act (ACA). It is an important document that helps both employees and employers fulfill their obligations under the ACA. If you’ve received a 1095-C or are about to, it’s essential to understand what it is, how to get it, and the role it plays in health insurance coverage reporting. In this guide, we will cover everything from what the form is, its instructions, how to get it online, and the important deadlines that you must adhere to, especially as we approach 2025.

What Is the 1095-C Form?

The 1095-C form is part of the Internal Revenue Service (IRS) requirements under the Affordable Care Act (ACA). It is a form that employers must provide to their full-time employees to report the health insurance coverage offered to them. If you are employed by a company with 50 or more full-time employees. You are likely to receive a 1095-C form. The form provides the IRS with data about the health insurance coverage your employer offers and whether that coverage meets the ACA’s standards.

What Is the Purpose of the 1095-C Form?

The primary purpose of the 1095-C form is to inform the IRS whether an employee has had access to health insurance that meets the minimum essential coverage standards required by the Affordable Care Act. This is important because:

1. Tax Reporting:. The IRS uses the information from this form to ensure that both employees and employers comply with the ACA’s health insurance requirements. If an employer does not provide adequate coverage, employees might qualify for a tax subsidy under the ACA.

2. Employer Mandate Compliance:. For employers, it serves as proof that they have complied with the ACA’s employer mandate, which requires companies with 50 or more full-time employees to offer affordable health insurance coverage.

3. Tax Penalties:. Both employees and employers may face penalties if the requirements for providing or receiving adequate coverage are not met. Therefore, the 1095-C form is essential for avoiding those penalties.

What Information Does the 1095-C Form Include?

The 1095-C form contains detailed information about your health insurance coverage, including:

1. Employee Information:. The form includes basic details about you (the employee), such as your name, address, and social security number (or taxpayer identification number).

2. Employer Information: It also includes the name, address, and Employer Identification Number (EIN) of your employer.

3. Offer of Coverage:. The form will show whether your employer offered health insurance coverage and, if they did, whether it met the ACA’s standards for affordability and minimum essential coverage.

4. Coverage Details: The form will list the months in which you were offered health coverage. If you were enrolled in health coverage, it will indicate the specific months you had coverage.

5. Code for Coverage Type:. There will be specific codes that indicate the type of health coverage offered, such as whether it was affordable or if you were eligible for the health insurance tax credits.

6. Affordable Care Act Compliance:. The form may also contain information indicating whether or not the coverage your employer provided complies with the ACA’s affordability requirements.

How to Get the 1095-C Form Online

If you’re looking for your 1095-C form, there are a few ways to obtain it:

1. Employer’s HR Portal: Most large employers make the 1095-C form available to employees electronically through their HR portal. Check with your employer to see if you can access the form through their online systems.

2. Request a Copy:. If you cannot find the form online, you can always contact your employer’s HR department and ask them to provide a copy. The IRS requires companies to send out these forms, so they should be able to assist you.

3. E-Filing Services: In some cases, tax preparers or third-party services might offer e-filing services to get the form. However, always ensure you are using trusted, reputable platforms to access such sensitive information.

4. IRS Website:. While the IRS does not directly issue the 1095-C form, it’s a good idea to check the IRS website for any changes or updates to the form and filing process.

1095-C Form Instructions: How to Fill It Out

If you are an employer who needs to issue a 1095-C form or if you need to file it with your tax return, understanding the instructions is crucial.

For Employers:

1. Fill Out Part I:. This part covers basic employee and employer information, including the employee’s name, SSN, address, and the employer’s name and EIN.

2. Fill Out Part II: This section is used to report the type of coverage offered. You’ll need to provide codes that indicate the type of coverage offered during the year and whether it was affordable.

3. Fill Out Part III: This is optional and applies to employers who are offering self-insured plans. It involves listing the months when the employee was covered by the self-insured health plan.

4. File with the IRS:. Employers must submit Form 1095-C to the IRS by February 28 (or March 31 if filing electronically). Additionally, a copy of the form must be provided to the employee by January 31 of the following year.

For Employees:

Employees generally do not need to “fill out” the form in the traditional sense. Instead, the form is used to report information about the health coverage you were offered or received. However, it is important to:

1. Review the Form: Make sure the information about your health coverage is accurate. If there is an error, contact your employer’s HR department to correct it.

2. Use for Tax Filing: You will need to include this form when filing your taxes. The 1095-C helps you complete Form 1040 to verify if you met ACA requirements and to determine if you owe any penalties or qualify for any tax subsidies.

When Are 1095-C Forms Due to Employees in 2025?

In 2025, just like in previous years, there are specific deadlines that both employers and employees must keep in mind:

1. Employer’s Deadline: Employers must send out Form 1095-C to employees by January 31, 2025. If this date falls on a weekend or holiday, the deadline is extended to the next business day.

2. Employee Deadline for Tax Filing: If you’re an employee, you will use this form when filing your tax return, which is due by April 15, 2025 (unless you file for an extension).

3. IRS Filing Deadline: Employers must submit their 1095-C forms to the IRS by February 28, 2025 if filing by paper, or March 31, 2025 if filing electronically.

It is important to meet these deadlines to avoid penalties and ensure that your health insurance coverage is correctly reported. Be mindful that missing the deadline may result in IRS penalties for both the employer and employee.

What Is the 1095-C Form Used For?

The 1095-C form serves several essential functions in the health insurance and tax reporting process:

1. Verifying Coverage: It confirms whether an employee had access to minimum essential health coverage as required by the ACA.

2. Determining ACA Penalties: For employees, the form helps determine if you qualify for an ACA tax subsidy or if you’re exempt from the individual mandate penalty.

3. Employer Compliance: It verifies whether the employer has fulfilled the ACA’s employer mandate by offering affordable and adequate health insurance coverage to full-time employees.

4. Tax Filing: The form is a necessary document for tax preparation. Employees use it to report health insurance coverage when filing taxes, while employers file it to meet IRS reporting requirements.

FAQs About the 1095-C Form

What happens if I don’t receive a 1095-C form?

If you don’t receive your 1095-C form, contact your employer’s HR department. They should provide you with the form. If there are issues with your health coverage or if you believe the form should have been sent, make sure to address it with them promptly.

Do I need to attach the 1095-C to my tax return?

You do not need to attach the form to your tax return, but you must keep it for your records. You’ll use the information from the 1095-C to complete your tax filing.

Can I file my taxes without the 1095-C?

Yes, you can file your taxes without the form, but it is not recommended. If your health coverage is reported correctly, you can avoid penalties. The IRS doesn’t require the form to file, but it will help you avoid issues down the road.

Can I get the 1095-C form online?

Yes, you can get your 1095-C form online through your employer’s HR portal. You can also contact your HR department directly to request a copy.

Conclusion

Understanding the 1095-C form is essential for both employees and employers, particularly as we approach the 2025 deadline. Whether you’re confirming your healthcare coverage or ensuring that your company complies with the ACA’s requirements, this form plays a critical role in health insurance reporting. By staying informed about the 1095-C form, its purpose, and the deadlines, you’ll be better prepared to navigate the complexities of the Affordable Care Act and file your taxes accurately and on time.