IRS Form 1095-C

irs form 1095-c
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In the United States, some entities must provide their workers with medical insurance by law. Such entities are usually called “applicable large employers” and have features of relatively big companies: for instance, there should be no less than 50 full-time workers.

These specific employers must not only provide insurance coverage but also report details about it to the US Internal Revenue Service (or IRS) by filling out and submitting the IRS Form 1095-C. Besides such entities, no one else should bother about this record.

The form declares basic data about each worker whose insurance is covered, the coverage degree and amount used each month, and other details. It does not describe the applied insurance plan; other templates exist as well for such purposes.

If you have doubts about your company’s status, you should know that the worker is considered “full-time” if they spend no less than 30 hours a week at work, averagely. There is also a term “full-time equivalent”: for example, if two employees work 15 hours per week each, together they are such an equivalent. Check the number of workers and how much they work before completing and submitting the form.

Who Files the Form?

The document is filled out and filed but the employer. Workers should not write or send anything. They must only keep the received document in their personal archive.

Each worker to whom this form may concern must receive its copy. So, employers should pay attention to the full list of those employees whose insurance is covered.

How to Fill Out the Template

The IRS Form 1095-C is rather simple compared to other templates issued by the Service. So, it is not necessarily your entity’s accountant who should fill the form out. Most likely, your human resources personnel may help with the form creation because this department usually has the most current and full information about every worker and their perks.

However, sending such forms is a huge responsibility, and the Service applies penalties to those who state incorrect information in their documents. So, we recommend taking the template seriously, asking for help via the Service’s official website and reading instructions thoroughly, or contacting your company’s accountant or tax assistant if something seems unclear. You may see the general instructions on the document creation below.

Get the Template

You cannot fill the template out without having the current version of it. So, you need to get one first. While the IRS furnishes all forms they require, and you can download them from their official website, we also offer our exemplary form-building software that will help you generate an already customized template for you in seconds. Download the file and proceed to the completion.

Specify the Employee

On the left, write the details about the employee for whom you are creating this form. You need to add their name, social security number (or SSN), and full address.

step 2 specify the employee - filling out an irs form 1095-c
Introduce the Employer

Insert details about the employer on behalf of which this document is being completed. Enter the employer’s name, employer identification number (or EIN), full address, and phone number.

step 3 introduce the employer - filling out an irs form 1095-c
Describe the Insurance Coverage

In the following section, you will describe the employee’s insurance coverage throughout the year. Above the chart, write the employee’s age on January 1 in the designated line. Nearby, enter the month when the coverage started (use two digits).

step 4.1 describe the insurance coverage - filling out an irs form 1095-c
In the chart, you can add data in boxes for each month separately or the year as a whole, depending upon the used insurance plan. Write the applicable “Offer of Coverage” code (these codes define the insurance type and are proposed by IRS; you can find all of them on the form’s second page). There are almost 20 codes to choose from.

step 4.2 describe the insurance coverage - filling out an irs form 1095-c
Complete the following section, “Employee Required Contribution,” only if the code you added to the previous section requires it. You can easily comprehend it by reading the Service’s instructions. This section states the compulsory employee’s sum to pay for the insurance per month; it also can be zero.

step 4.3 describe the insurance coverage - filling out an irs form 1095-c
The next section should be filled out in conformity with the Service’s instructions and requires codes from Code Series 2. In some cases, you will leave it blank. Situations, when the employers need to use this section, are listed in the guidelines. Those may include cases when the worker was not employed in the company or was not a full-time employee during certain months of the fiscal year, had basic minimum insurance coverage for a specific period, and other reasons.

step 4.4 describe the insurance coverage - filling out an irs form 1095-c
The following line also must be used only for certain insurance types. Here, you will enter a postal code: either from the worker’s address or the official workplace’s address. Check with the Service’s guide to ensure that you have inserted the correct code here.

step 4.5 describe the insurance coverage - filling out an irs form 1095-c
Complete Part III (If Applicable)

If the employer has opted for the plan defined as “self-insured,” they must fill out Part III of the form. Here, they will list every insured worker.

Check the box on top of the page before completing the offered chart. By checking, you verify that you are using the mentioned insurance plan.

step 5.1 complete part iii (if applicable) - filling out an irs form 1095-c
Then, list the workers, including the one you have described previously: add their full names along with SSN or other tax ID numbers. If neither SSN nor other numbers are available, write their birth date. Then, mark the boxes that identify the months when each worker’s insurance was covered.

step 5.2 complete part iii (if applicable) - filling out an irs form 1095-c

When Should I Submit the Record?

There are two deadlines for the employers to submit this form. One states the last day when workers may receive the document; another is for submission to the IRS.

Each concerned worker must get their copy no later than January 31. The last day of February is the Service’s deadline if you file your form by mail. If you decide to submit it online, your deadline is March 31.