1095 Frequently Asked Questions

What is Form 1095-C?

The IRS uses information on Form 1095 to determine whether you or your employer may have to pay a fine for failing to comply with the Affordable Care Act (ACA), also known as Obamacare, by not having health care coverage for 2018.

If you are eligible for health care coverage from your employer, Form 1095-C contains information about that health care coverage offered to you and your dependents by your employer.

Form 1095-C contains information about the offer of health insurance coverage to employees and their dependents, the employee’s share of the lowest-cost premium, and other information related to employer responsibility provisions.

Why did I get a 1095-C from my employer?

You were, at any time, or still are, a full-time employee and/or enrolled in your employer’s health insurance plan during 2018. Full-time employee means those who work/ed on average of 30+ hours per week during the year.

I’m not covered under my employer’s health plan. Why did I receive a Form 1095-C?

Even if you decided not to enroll for coverage under your employer’s health plan, your employer is still required by law to provide a form to the IRS indicating whether or not they offered coverage to you as a full-time employee. Full-time employee means those who work/ed on average 30+ hours per week during the year.

When will I get my 1095-C?

The 1095-C related to the 2018 tax year will be sent to you on or before March 4, 2019.

How can I file my taxes before I receive Form 1095?

Your individual tax return (Form 1040) asks you to identify if you had qualifying health care coverage, also known as minimum essential coverage for the full year in 2018. Most people will be able to answer this question without receiving a Form 1095-C, and the IRS has declared that individuals may file their Form 1040 before they receive Form 1095-C. Employer-sponsored group health plans typically satisfy the definition of minimum essential coverage.

Why did I get more than one Form 1095?

If you and/or your spouse were a full-time employee with more than one company or were on more than one employer’s health insurance plan in any manner in 2018 you should receive a Form 1095-C from each employer. In combination, these forms will help you validate your health care coverage for 2018 when preparing and filing your tax return.

Who receives Form 1095-C?

Employees who work for Applicable Large Employers (“ALEs”) or employers with 50+ full-time-equivalent employees and employees already enrolled in an employer health insurance plan will received Form 1095-C.

Why is Part III of my 1095-C missing dependent information?

If your company’s plans are self-funded, Part III should be filled out with the covered individuals. KUSD has a fully insured plan so no dependent information will be listed in Part III of the 1095- C.

What do I do with Form 1095-C, 1095-B or 1095-A?

Each form provides information you need to prepare and file your annual federal income tax return. Keep a copy of each form for your files, along with your other tax documentation, and provide a copy of all forms received to your tax preparer.

Do I need to submit Form 1095-C to the IRS?

If you were employed and enrolled in coverage from your employer(s) at any point in 2018, you will need both your W-2 form(s) and information from your 1095-C form(s) to prepare, complete and file your tax return.

Form 1095-C is submitted to the IRS directly by your employer. You do not have to submit a copy of the form to the IRS. It is recommended that you always keep a copy of each Form 1095 for your files, just in case you need to reference them in the future.

What do the codes in Part II, Line 14 mean?

These codes describe the offer of coverage for each month, or for the full year, an employee is covered. There may be some months that an employee was not covered pending being a new ire or termination date.

What do the codes in Part II, Line 16 mean?

These codes help the IRS determine if your employer was in compliance with the ACA’s Employer Mandate. For example, did your employer comply with the “Employer Shared-Responsibility Provisions” mandated by the IRS?

The dollar amount in Part II, Line 15 is not the same amount as the amount I pay for medical insurance. Why not?

This amount is the monthly employee contribution for single coverage in the lowest-cost plan offered to you. The IRS uses this amount to determine if your employer offers an “affordable” plan that meets the requirements of the ACA law. You may have actually enrolled in a different plan and/or you may cover family members under a different plan that may be more expensive.

Who should you call if you did not receive your 1095-C?

If you did not receive your 1095-C or you think a correction is needed, please contact the Office of Human Resources at 262-359-6333.