Form 1095-C Employer-Provided Health Insurance
Form 1095-C provides information about employer-provided health insurance coverage. This form is essential for employees eligible for premium tax credit through the Affordable Care Act. Keep this form for your records and reference it when filing your tax return.
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How do I fill this out?
To fill out Form 1095-C, ensure you have your personal and employer information ready. Carefully enter your details in the designated sections, following the instructions provided. Review the form for accuracy before submitting it to the IRS.

How to fill out the Form 1095-C Employer-Provided Health Insurance?
1
Gather all necessary personal and employer information.
2
Fill in your name and Social Security number in Part I.
3
Complete the employer information in Part I as well.
4
Indicate your coverage offer in Part II.
5
Review all entries for accuracy before submission.
Who needs the Form 1095-C Employer-Provided Health Insurance?
1
Employees receiving health coverage from an Applicable Large Employer need this form for tax purposes.
2
Individuals claiming premium tax credits require this form to verify eligibility.
3
Tax professionals may need the form to assist clients during tax preparation.
4
Employers must provide this form to employees as part of compliance with ACA requirements.
5
Spouses and dependents listed on the form may need it for their tax filings.
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What are the instructions for submitting this form?
To submit Form 1095-C, provide it to the IRS by the appropriate deadline, generally by April 15. You can submit it electronically through e-file if required. Alternatively, you can mail it to the address specified on the IRS instructions for 1095-C or your individual tax return, ensuring the correct documentation is attached.
What are the important dates for this form in 2024 and 2025?
Be aware that Form 1095-C must be issued by employers to employees by January 31, 2024, for the previous tax year. It is essential to keep this form for your tax filings before April 15, 2024, to ensure compliance. Always check for updates from the IRS regarding any changes to tax form deadlines.

What is the purpose of this form?
Form 1095-C is designed to provide essential information regarding health insurance coverage provided by employers. It serves as a record for employees about their coverage and assists them in filing their taxes accurately. The form also helps establish eligibility for premium tax credits under the Affordable Care Act.

Tell me about this form and its components and fields line-by-line.

- 1. Employee Name: First name, middle initial, and last name of the employee.
- 2. Social Security Number: The employee's SSN for tax identification.
- 3. Employer Name: The name of the employer providing insurance.
- 4. Employer Identification Number (EIN): The EIN of the employer.
- 5. Contact Information: Address and phone number of the employer.
- 6. Health Coverage Details: Information regarding the health coverage provided.
- 7. Covered Individuals: Names and SSNs of individuals covered under the health plan.
What happens if I fail to submit this form?
Failure to submit Form 1095-C may lead to complications with your tax return. The IRS utilizes this form to determine whether you qualify for premium tax credits and to confirm your health coverage. Not submitting it can result in penalties, so ensure timely submission.
- Tax Filing Delays: Missing this form may delay your ability to file taxes properly.
- Potential Penalties: You could face fines for failing to provide required information.
- Ineligibility for Premium Tax Credits: Without the form, you may not qualify for healthcare tax credits.
How do I know when to use this form?

- 1. Tax Reporting: Used to report health coverage during tax submissions.
- 2. Claims for Premium Tax Credits: Essential for claiming premium tax credits under the ACA.
- 3. Record Keeping: Serves as a record for personal health coverage information.
Frequently Asked Questions
What is Form 1095-C?
Form 1095-C is a tax document that provides information about health insurance coverage offered by employers.
Who needs to fill out Form 1095-C?
Employees of Applicable Large Employers need to fill out the form for tax reporting.
How do I edit my Form 1095-C?
You can edit your form by uploading it to PrintFriendly and using our PDF editing tools.
Can I save my edited Form 1095-C?
Yes, after editing, you can download your revised Form 1095-C.
What should I do if my form has errors?
You can correct errors using the PrintFriendly editor before saving the document.
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Is my Form 1095-C secure on PrintFriendly?
Our platform ensures that your documents are handled with care during edits.
Do I need multiple Form 1095-Cs?
You may need multiple forms if you had different employers offering you coverage during the year.
What if I don't receive Form 1095-C from my employer?
If your employer is an Applicable Large Employer, they are required to provide this form.
How can I sign my Form 1095-C?
You can electronically sign your form using the signing tools available on PrintFriendly.
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