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1095C Form Department of the Treasury Internal Revenue Service Part I Information OMB No. 15452251 CORRECTED about Form 1095C and its separate instructions is at www.irs.gov×form1095c Employee 600116
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How to fill out 2015 form 1095-c

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How to fill out 2015 form 1095-c:

01
Obtain a copy of the 2015 form 1095-c from the Internal Revenue Service (IRS) website or request it from your employer.
02
Provide your personal information, including your name, address, and social security number in the designated spaces on the form.
03
Fill out Part I of the form, which requires you to provide information about the employer and the coverage offered to you. This section includes questions about the employer's name, address, employer identification number (EIN), and the months in which coverage was offered.
04
Fill out Part II of the form, which requires you to provide information about the employee. This section includes questions about your name, social security number, and the months in which you were eligible for coverage.
05
Fill out Part III of the form, which requires you to report the coverage offered to you and your dependents. This section includes questions about the type of coverage offered, whether it meets minimum essential coverage requirements, and the months in which coverage was provided.
06
Double-check all the information provided on the form to ensure accuracy and completeness.
07
Sign and date the form.
08
Submit the completed form either to your employer or as instructed by the IRS.

Who needs 2015 form 1095-c:

01
Full-time employees who were eligible for employer-sponsored health coverage during 2015 need to fill out the 2015 form 1095-c.
02
Employers who are considered applicable large employers (ALEs) and provided health coverage to their full-time employees during 2015 need to provide the 2015 form 1095-c to their eligible employees.
03
Individuals who received a 2015 form 1095-c from their employer need to keep it for their records and use it when filling out their individual tax returns or providing information to the IRS regarding their health coverage for the tax year 2015.
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Form 1095-C is used by applicable large employers to report information about offers of health coverage to full-time employees.
Applicable large employers with 50 or more full-time employees are required to file form 1095-C.
Form 1095-C should be filled out accurately with information about offers of health coverage to full-time employees, coverage provided, and the months the coverage was available.
The purpose of form 1095-C is to provide employees with information about the health coverage offered by their employer and to assist the IRS in enforcing the employer shared responsibility provisions.
Form 1095-C requires information on offers of health coverage, employee enrollment, and the affordability of the coverage offered.
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