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Form 1095C: Employer-Provided Health Insurance Offer and Coverage
IRS Form 1095-C is an Employer-Provided Health Insurance Offer and Coverage form used to report health coverage offered by an Applicable Large Employer. This form must be kept for records, and it does not need to be attached to a tax return.
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IRS Form 1095C - Employer-Provided Health Insurance Offer and Coverage
IRS Form 1095-C is an Employer-Provided Health Insurance Offer and Coverage form used to report health coverage offered by an Applicable Large Employer. This form must be kept for records, and it does not need to be attached to a tax return.
Risk Radar
Scan points- 1Ensure you use the current edition (20/25) and do not attach it directly to your tax return.
- 2Failing to report the complete SSN on Part I, line 2 (even if only last four digits are shown).
- 3Using an outdated version of Form 1095-C instead of the current edition (20/25).
- 4Not providing a copy of the form to family members covered under a self-insured plan upon request.
- 5Incorrectly selecting the code on Part II, line 14 that describes the coverage offered.
Plain English
This form tells you what health insurance your employer offered you and possibly your family. It helps you determine if you qualify for the premium tax credit when filing taxes. If you bought coverage elsewhere, this document provides key information about the offer from your job.
Submission Date
- Filing date: 2025-10-01 22:10:16
- Preparation window: collect IDs, supporting records, and signatures in advance.
- Final review: verify names, dates, and required fields before submission.
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What this form is for
- Use this form when an Applicable Large Employer offers health insurance coverage to you or your family members.
- Do not use it when your employer is not an Applicable Large Employer, as they are not required to furnish Form 1095-C.
- Check Form 1095-B instead when the coverage information is reported separately on that form (e.g., for insured plans or miscellaneous coverage).
Form selector
Use this form or another form?
You purchased insurance through Health Insurance Marketplace
This information helps determine eligibility for the premium tax credit.
✓ Check Part II, Line 14.
Your employer provides self-insured health coverage
Part III details coverage for family members under a self-insured plan.
✓ Confirm Part III is present if applicable.
You received minimum essential coverage from another source
This indicates coverage not reported on this specific Form 1095-C.
✓ Verify the primary reporting form.
Deadline or filing window
The form itself does not state a specific filing deadline for the recipient. However, employers are required to furnish Form 1095-C only to the employee. Recipients should check instructions at www.irs.gov/Form1095C for any associated employer deadlines.
Checklist
What you need before filling it out
Employee Name
First name, middle initial, last name · Part I, Line 1
SSN
Social security number (complete) · Part I, Line 2
Offer of Coverage Code
Required code for coverage offered · Part II, Line 14
Employee Age
Age as of January 1 · Part II, (blank) field next to Employee's Age
Employer EIN
Employer identification number (EIN) · Part I, Line 8
Plan Start Month
Two-digit month number (Jan=01) · Part II, next to Plan Start Month field
Employer Contact Number
Telephone number for questions/errors · Part I, Line 10
Before you submit
- 1Verify that the form is dated under the 20/25 edition.
- 2Confirm you are receiving this Form 1095-C because your employer is an Applicable Large Employer.
- 3Ensure Part I lists your complete name and Social Security Number (SSN).
- 4Check Part II, Line 14 to confirm the correct code describes the coverage offered to you.
- 5If applicable, verify that Part III contains information about family members covered under a self-insured plan.
- 6Confirm all required fields in Part I and Part II are populated before filing/sending.
- 7Keep a copy of the completed Form 1095-C for your records.
How to file this form
- 1Complete Part I by entering your name, SSN (lines 1-2), address details (lines 3-6), and your employer's information (lines 7-13).
- 2Fill out Part II by providing your age as of January 1, the Plan Start Month (line 14), selecting the Offer of Coverage code (line 14), and listing required contributions (line 15) if applicable.
- 3If provided, complete any necessary details in Part III regarding family members' coverage under a self-insured plan.
- 4Sign the form (implied requirement; sign before sending) and retain a copy of the completed Form 1095-C for your records.
Known limitations
- 1If an employer is not an Applicable Large Employer, it is not required to furnish Form 1095-C.
- 2The form reports information about coverage offered by the specific employer identified on the form, which applies even if a recipient has multiple employers during the year.
- 3A recipient may receive multiple Forms 1095-C if they had multiple Applicable Large Employers during the year.
- 4Line 15 (Employee required contribution) will show an amount only if code 1B, 1C, 1D, 1E, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1T, or 1U is entered on line 14.
Field map
Compact field-by-field guide
Payer Info
1 items
Identifying information of the business or person making the payment.
Recipient Info
1 items
Identifying information of the person or entity receiving the payment.
Amounts
1 items
The payment amount subject to reporting for the applicable box category.
Withholding
1 items
Backup withholding amount if applicable.
Signatures
1 items
Name and phone number of the person to contact about this return.
Almost done reviewing the fields?
Fillable formOpen in Editor->The current edition is 20/25, and the form was created on May 21, 2025; readers should check www.irs.gov/Form1095C for the latest information.
What changed or needs a fresh check
- Edition date — confirm the revision reads 20/25.
- Creation date — confirm the date reads 5/21/25.
- Form number — confirm it is Form 1095-C (2025).
- Recipient notice — confirm the form states, 'Do not attach to your tax return.'
- Employer status — confirm Part I reports information for an Applicable Large Employer.
Quick Facts
Downloads
After you file
- 1Keep the Form 1095-C for records.
- 2Provide a copy of Form 1095-C to any family members covered under a self-insured employer-sponsored plan if they request it.
- 3If purchasing coverage through the Health Insurance Marketplace, use this form's information (Part II) to determine eligibility for the premium tax credit.
- 4If you had multiple employers, review each Form 1095-C individually to see which employer provided the coverage reported on that specific form.
Sources
- SRCForm 1095-C is titled Employer-Provided Health Insurance Offer and Coverage (20/25) [Form p.1]
- SRCThe form must be kept for records and does not attach to a tax return [Form p.1]
- SRCPart I reports employee information on lines 1 through 6, including the SSN (Line 2) [Form p.2] / [Form p.2]
- SRCPart II reports coverage details, including Employee’s Age and Plan Start Month [Form p.1]
- SRCA recipient should provide a copy of Form 1095-C to family members covered under a self-insured plan if requested [Form p.2]
- SRCLine 15 reports the employee required contribution for the lowest cost self-only minimum essential coverage offered by the employer [Form p.4]
Common confusion points
What if I was covered for some months but not all?
The form will enter information in column (e) indicating the months an individual was covered.
Why might Line 15's contribution amount be different from what I actually paid?
Line 15 reports the cost for the lowest cost self-only minimum essential coverage; this may not match if you chose family coverage.
What is the difference between Form 1095-C and Form 1095-B?
Form 1095-C includes information about coverage offered to you, your spouse, and dependent(s) in Part II.
Workflow map
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- Not stated in the official source — verify on the agency site
Questions about IRS Form 1095C
What is IRS Form 1095C used for?
This form tells you what health insurance your employer offered you and possibly your family. It helps you determine if you qualify for the premium tax credit when filing taxes. If you bought coverage elsewhere, this document provides key information about the offer from your job.
Who must file IRS Form 1095C?
The recipient of Form 1095-C is required to keep it for their records and should provide a copy to any family members covered under a self-insured employer-sponsored plan if those individuals request it.
What information does IRS Form 1095C require?
Part I reports details about the employee (lines 1–6) and the Applicable Large Employer/Member (lines 7–13). Part II covers the Offer of Coverage, detailing codes describing the coverage offered to the employee and spouse/dependents. Part III lists covered individuals under a self-insured plan.
Where do I file IRS Form 1095C?
The form does not specify a mailing address or service center. Recipients should refer to instructions at www.irs.gov/Form1095C for routing information.
How do I complete IRS Form 1095C?
The employee fills out Part I with their personal and employer details. They then complete Part II by selecting the appropriate code on line 14 describing the offer of coverage. Finally, if applicable, Part III lists each covered individual along with their SSN/TIN and other relevant data.
What happens if IRS Form 1095C is filed incorrectly?
While the source does not detail specific penalties, failing to correctly report the coverage information can affect eligibility for the premium tax credit when filing taxes.
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