What Is Form 1095-C: Employer-Provided Health Insurance Offer and Coverage?

Form 1095-C: Employer-Provided Health Insurance Offer and Coverage is an Internal Revenue Service (IRS) tax form reporting information about an employee's health coverage offered by an Applicable Large Employer (ALE). ALEs typically have 50 or more full-time employees.

Information from this form also helps determine a taxpayer's eligibility for credits, such as the premium tax credit.

An individual enrolled in a marketplace health care plan will receive Form 1095-A: Health Insurance Marketplace Statement.

Who Can File Form 1095-C: Employer-Provided Health Insurance Offer and Coverage?

This form is provided by Applicable Large Employers to full-time employees who have been working for one or more months of the calendar year. ALE members must report that information for all 12 months or the entire calendar year for each employee.

How to File Form 1095-C: Employer-Provided Health Insurance Offer and Coverage

Form 1095-C is a reference document not completed by the taxpayer. It is not filed with a tax return. Instead, it should be kept with the taxpayer's records.

  • Part I of the form provides information about the ALE member, including their name, address, and phone number, for questions about the validity of the form or to report errors. 
  • Part II provides information about the health care coverage, if any, provided to the employee. In addition to information about the plan, it also reports employee required contributions.
  • Part III is completed only if the employer offers a self-insured plan. It lists the names of the covered individuals along with their Social Security numbers and dates of birth. This section also confirms uncovered months for the participants. 

If Parts I and II are the only sections filled, the employee may also receive a form 1095-B: Health Coverage, which provides proof of coverage from the insurer chosen by the employer. 

Form 1095-C vs. Form 1095-B

Form 1095-B is used by employers to report information to the IRS and to taxpayers about individuals covered by minimum essential coverage and who are not liable for the individual shared responsibility payment.

Download Form 1095-C: Employer-Provided Health Insurance Offer and Coverage

Click this link to download a copy of Form 1095-C: Employer-Provided Health Insurance Offer and Coverage.

Key Takeaways

  • Form 1095-C is a tax form reporting information about an employee's health coverage offered by an Applicable Large Employer.
  • The taxpayer does not fill out the form and does not file it with a tax return. It should be kept with the taxpayer's records.