Under the Affordable Care Act, certain large employers are required to provide this form to their full-time employees (as defined by the ACA). Depending on your employment and coverage circumstances, you may receive similar forms: the 1095-A comes from a Health Insurance Marketplace, the 1095-B comes from Insurers, and Form 1095-C comes from your employer or from your ACA compliance provider.

In the guide below, we will take a look at the 1095-C form and how to read and understand it.

The information in this guide is for information purposes only and is not intended to be legal or tax advice.

Form 1095-C Frequently Asked Questions

What is a 1095-C Form?

A 1095c form is a record of the health insurance coverage that you were offered by your employer.

What actions do you need to take?

Information contained on the 1095-C may be of assistance when completing your federal income tax return for the applicable tax year; however, the IRS has made clear that the 1095-C is not required for filing the Form 1040.

Important Terms to Know

Minimum Essential Coverage – Coverage that AT LEAST meets the Affordable Care Act standards for what is considered adequate coverage.

Minimum Value – Coverage that generally pays at least 60% of the total cost of medical services. Taken together these terms mean that coverage provides adequate financial coverage for essential health services.

Taken together these terms mean that coverage provides adequate financial coverage for essential health services. Think of it this way: If the law requires that a policy covers an X-ray – that’s Minimum Essential Coverage; if the law also says that the policy must cover at least 60% of the cost of the X-ray – that’s Minimum Value.

Form 1095-C Instructions: How to Read and Understand This Form

The 1095 c is broken into three parts, let’s look at each part separately.

Part I:

This part contains information identifying the Employee and the Employer

form 1095-c part 1

Lines 1–6 contain all of your individual information such as name, address and Social Security Number.

Lines 7–13 contain information about your employer such as name, address, identification number and contact information.

Part II:

This part contains information on the offer of coverage made by your Employer.

form 1095-c part 1

Part II of Form 1095-C is a monthly accounting of when you were offered health insurance, the cost of the plan, information about the plan value, and who was included in the offer of coverage. The good news is that your employer will already have populated the codes.

Employee’s Age on January 1 – Used for employers offering Individual Coverage Health Reimbursement Arrangements (HRA).

Plan Start Month – Displays the earliest plan start month as it applies to your offer of coverage. If you were not offered 00 would be entered as the plan start month.

Line 14 – This is where your employer communicated information about the coverage that you were offered. It reports whether your employer made an offer of coverage, the type of coverage and to whom the offer was made.

The IRS has assigned 18 different codes that might appear. Here they are with simple descriptions:

  • 1A Minimum essential coverage providing minimum value, does not exceed the IRS affordability threshold for Federal Poverty Rate for single coverage. Offered to you, your spouse and your dependents.
  • 1B Minimum essential coverage providing minimum value offered to you, but NOT your spouse or dependents  1C Minimum essential coverage providing minimum value offered to you and your dependents, but NOT to your spouse.
  • 1D Minimum essential coverage providing minimum value offered to you, and your spouse, but NOT your dependents.
  • 1E Minimum essential coverage providing minimum value offered to you, and minimum essential coverage offered to your dependents and spouse.
  • 1F Minimum essential coverage NOT providing minimum value offered to you, you and your spouse, or you, your spouse and your dependents.
  • 1G You were NOT a full-time employee during any month BUT you were enrolled in self-insured employer sponsored coverage for one or more months.
  • 1H No offer of coverage.
  • 1J Minimum essential coverage providing minimum value was offered to you and minimum essential coverage was conditionally offered to your spouse. Minimum essential coverage was not offered to dependents A conditional offer is subject to reasonable, objective conditions such as an offer to cover a spouse only if the spouse is not eligible for Medicare or a group health plan sponsored by another employer.
  • 1K Minimum essential coverage providing minimum value was offered to you and your dependents and minimum essential coverage was conditionally offered to your spouse. A conditional offer is subject to reasonable, objective conditions such as an offer to cover a spouse only if the spouse is not eligible for Medicare or a group health plan sponsored by another employer.
  • 1L Individual coverage health reimbursement arrangement (HRA) offered to you only with affordability determined by using employee’s primary residence location ZIP code.
  • 1M Individual coverage health reimbursement arrangement (HRA) offered to you and dependent(s) (not spouse) with affordability determined by using employee’s primary residence location ZIP code.
  • 1N Individual coverage health reimbursement arrangement (HRA) offered to you, spouse and dependent(s) with affordability determined by using employee’s primary residence location ZIP code.
  • 1O Individual coverage health re