In the coming weeks, you may receive a tax document called the 1095-C that will contain detailed information about your healthcare coverage if you were eligible in 2018. While you will not need to include your 1095-C with your 2018 tax return, or send it to the IRS, you may use information from your 1095-C to help complete your tax return.
The Affordable Care Act includes an individual mandate that requires most Americans to obtain and maintain health insurance each month or pay a tax penalty. The penalty for not having coverage will be paid on your Federal Income Tax Returns for each full month you, or a family member, does not have health insurance.
The Affordable Care Act requires employers to send Form 1095-C to certain employees. This form contains detailed information about your health care coverage. The IRS will use the information reported on your 1095-C to determine whether you will pay a penalty for failing to have health care coverage as required by the Patient Protection and Affordable Care Act. If you received an Advance Premium Tax Credit, the information on the form will also help the IRS determine if you should repay any of the tax credit or receive an additional credit.
Questions about the 1095-C?
If you did not receive a 1095-C but believe you should have, or if you have additional questions, please contact the University of Pittsburgh’s Benefits Department at firstname.lastname@example.org. You may also visit www.irs.gov or www.healthcare.gov to learn more.
If you’re not sure what the codes on the document mean, you can use an interactive Form 1095-C Decoder at www.mytaxform.com/form-1095-decoder.
What is a Form 1095-C?
The Affordable Care Act, or Obamacare, includes both the individual mandate and the employer mandate. The individual mandate requires that most Americans have qualifying healthcare coverage or potentially face a fine. The employer mandate requires employers with 50 or more full-time equivalent employees to offer healthcare 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.
Who receives a Form 1095-C?
Any employee who was full-time (worked an average of 30 or more hours per week) or who was enrolled in their health insurance plan in 2018.
Why did I get a Form 1095-C?
If you were full-time (worked an average of 30 or more hours per week) or were enrolled in health insurance through the University of Pittsburgh’s employer group health plan at any time during 2018, you may receive a 1095-C.
Why did I get more than one Form 1095-C?
If you worked at more than one company, you may receive a 1095-C from each employer.
Why didn’t I get a Form 1095-C?
If you were not full-time (worked an average of 30 or more hours per week) and were not enrolled in health care coverage through the University of Pittsburgh at any time during 2018, you should not receive a 1095-C. You may also not receive a 1095-C if you were not the primary insured.
Will I be fined if I did not receive a Form 1095?
If you don’t have qualifying health insurance, in some cases you can claim a health care coverage exemption. You can use the IRS Health Coverage Exemptions Form 8965 to find out if you qualify. Please visit www.irs.gov or www.healthcare.gov to learn more.
When will I get my Form 1095-C?
Form 1095-C’s for the University of Pittsburgh employees for the 2018 tax year are to be mailed in January 2019. If you believe you should have received a Form 1095-C but did not, please contact the University of Pittsburgh’s Benefits Department at email@example.com.
What should I do with my Form 1095-C?
As with any important tax document, you should keep your 1095-C for your records. You may reference your 1095-C to attest that you had insurance coverage when completing your taxes for the 2018 tax year.
What information is on the Form 1095-C?
There are three parts to the form:
- Part 1 reports information about you and your employer.
- 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.
- Part 3 reports information about the individuals covered under your plan, including dependents.
How will the Form 1095 impact my taxes?
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 2018 tax return.
Can I file my tax return if I have not received a Form 1095-C?
Yes. If you and your entire family were covered for the entire year, you may check the full-year coverage box on your return. If you or your family members did not have coverage for one or more months of the calendar year, you may claim an exemption or make an individual shared responsibility payment.
You will not need to send the IRS proof of your health coverage. However, you should keep any documentation with your other tax records. This includes records of your family’s employer-provided coverage, premiums paid, and type of coverage.
What is the difference between a 1095-A, 1095-B, and 1095-C?
The forms are very similar. The main difference is who sends the form to you. The entity that provides you with health insurance will be responsible for sending a Form 1095.
- You will receive a 1095-A if you were covered by a federal or state marketplace (also called an exchange)
- You will receive a 1095-B if you were covered by other insurers such as small self-funded groups or employers who use the Small Business Health Options Program (SHOP)
- You will receive a 1095-C if you were covered by your employer
If I am a student worker, will I receive a Form 1095-C?
Any student employee who was full-time (worked an average of 30 or more hours per week) or who was enrolled in the student health insurance plan in 2018 may receive a Form 1095-B from UPMC Health Plan. Because the IRS extended the mailing deadline, UPMC Health Plan will be mailing the forms to subscribers by March 4, 2019.
What if I need to request a duplicate copy of my 1095-C?
If you need to request a duplicate copy of your 1095-C or if you have additional questions, please contact the University of Pittsburgh’s Benefits Department at firstname.lastname@example.org.