Form 1095-C FAQ

In addition to the following FAQ, click here to watch a 1095-C video with additional helpful information.

The Affordable Care Act, or Obamacare, includes both the individual mandate and the employer mandate. The individual mandate requires that most Americans have qualifying health care coverage or potentially face a fine. The employer mandate requires employers with 50 or more full-time equivalent employees to offer health care coverage to their full-time employees or potentially face a fine. Much like the Form W-2 is used to determine whether or not you owe taxes, the IRS will use the information reported from your Form 1095-C to determine whether you (or your employer) may have to pay a fine for failing to comply with the Affordable Care Act.

The Form 1095-C contains important information about the health care coverage offered or provided to you by your employer. Information from the form may be referenced when filing your tax return and/or to help determine your eligibility for a premium tax credit. Think of the form as your “proof of insurance” for the IRS.

If you or a family member enrolled in health care coverage at any time in 2018, you will receive a Form 1095 in 2019 from the entity that provided the coverage. For example, if you were determined to be a full-time employee or were enrolled in coverage through your employer, you will receive a 1095-C from your employer.
If you were a full-time employee working an average of 30 or more hours per week and/or were enrolled in health insurance through your employer at any time during 2018, you will receive a Form 1095-C in 2019. You’ll need this form to complete your tax return for the 2018 tax year.
If you worked at more than one company, you may receive a Form 1095-C from each company. For example, if you changed jobs in 2018 and were enrolled in coverage with both employers, you should receive a 1095-C from each employer. Or, if you work for an employer with different franchises or companies, you may receive a 1095-C from each company.
If you were not full-time (working an average of 30 or more hours per week in any month) and were not enrolled in health care coverage through your employer at any time during 2018, you should not receive a Form 1095-C in 2019. You may also not receive a 1095-C if you were not the primary insured. For example, you should not receive a form if you were listed as a spouse or dependent under another family member’s plan.
Keep your 1095-C for your records with your other important tax documents. While you will not need to attach your 1095-C to your tax return or send it to the IRS, you may use information from your 1095-C to help complete your tax return.
There are three parts to the form:

  1. Employee and Employer Information (Part 1) reports information about you and your employer.
  2. Employee Offer and Coverage (Part 2) reports information about the coverage offered to you by your employer, the affordability of the coverage offered, and the reason why you were or were not offered coverage by your employer.
  3. Covered Individuals (Part 3) reports information about the individuals (including dependents) covered under your self-insured plan.
Part 3 of your 1095-C will be left blank if:

  • No one was enrolled in coverage for any month of the year
  • The coverage is through a fully-insured plan
  • The coverage is through COBRA
  • You are a union employee
If you do not have health care coverage and do not qualify for an exemption, you may be subject to a fine when you file for your 2019 tax return. Or, if there’s a discrepancy in the information that you and your employer report to the IRS about the health care coverage offered to you, your tax return may be delayed.
No, you do not need to send a copy of your 1095-C to the IRS when filing your tax return. However, you should keep the form with your tax records.

Part I – Includes information about you and your employer

Part II - Includes information about the coverage offered to you by your employer, the affordability of the coverage offered, and the reason why you were or were not offered coverage by your employer. The information must be reported on a month-by-month basis unless the information is the same for all 12 months.

Line 14 is used to report whether an offer of coverage was made to an employee for each month of the year.

Code What it means:
1A Your employer made a qualifying offer of health care coverage that is affordable based on the federal poverty line to you, your spouse, and your dependent(s), if any.
1B Your employer made a qualifying offer of health care coverage to you.
1C Your employer made a qualifying offer of health care coverage to you and your dependent(s).
1D Your employer made a qualifying offer of health care coverage to you and your spouse, and your dependent(s).
1E Your employer made a qualifying offer of health care coverage to you, your spouse, and your dependent(s).
1F Your employer made an offer of health care coverage to you, your spouse, and your dependent(s), if any, that does not qualify as providing “minimum value.”
1G You were not a full-time employee but were enrolled in health care coverage.
1H Your employer did not make an offer of coverage or the offer was not a qualified offer.
1I Your employer did not make an offer of coverage to you, your spouse, or your dependent(s), the offer was not a qualified offer, or the offer was qualified but was for less than 12 months.

Line 15 is used to report your share of the lowest-cost monthly premium for self-only qualifying coverage.

The amount reported on line 15 may not be the amount you paid for coverage if, for example, you chose to enroll in more expensive coverage such as family coverage. Line 15 will show an amount only if code 1B, 1C, 1D, or 1E is entered on line 14.

If you were offered coverage but not required to contribute any amount towards the premium, this line will report a “0.00” for the amount.

Line 16 explains why your employer did or did not offer you coverage. This line provides the IRS information needed to determine whether your employer satisfied the employer mandate.

None of this information affects your eligibility for the premium tax credit.

Line 15

Code What it means:
2A You did not work any day in the month.
2B You were not full-time during the month.
2C You were enrolled in coverage for the entire month.
2D You were in a waiting period and not yet eligible for coverage per the Affordable Care Act regulations.
2E You were covered by a Union plan.
2F Your employer offered you coverage that was considered affordable based on your W-2 wages, but you did not enroll.
2G Your employer offered you coverage that was considered affordable based on the federal poverty line, but you did not enroll.
2H Your employer offered you coverage that was considered affordable based on your rate of pay, but you did not enroll.
2I Because your coverage plan year went into effect after January 2018, your employer was not obligated to offer coverage.