
Get the free 2016 Form 1095-C Distribution
Show details
STATE OF CALIFORNIABETTY T. YES
California State ControllerSTATE CONTROLLERS OFFICE
PERSONNEL AND PAYROLL SERVICES DIVISION
P.O. BOX 942850
SACRAMENTO, CA 942505878
DATE:March 2, 2017PERSONNEL LETTER
We are not affiliated with any brand or entity on this form
Get, Create, Make and Sign 2016 form 1095-c distribution

Edit your 2016 form 1095-c distribution form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.

Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.

Share your form instantly
Email, fax, or share your 2016 form 1095-c distribution form via URL. You can also download, print, or export forms to your preferred cloud storage service.
Editing 2016 form 1095-c distribution online
To use the services of a skilled PDF editor, follow these steps:
1
Set up an account. If you are a new user, click Start Free Trial and establish a profile.
2
Prepare a file. Use the Add New button to start a new project. Then, using your device, upload your file to the system by importing it from internal mail, the cloud, or adding its URL.
3
Edit 2016 form 1095-c distribution. Add and change text, add new objects, move pages, add watermarks and page numbers, and more. Then click Done when you're done editing and go to the Documents tab to merge or split the file. If you want to lock or unlock the file, click the lock or unlock button.
4
Get your file. When you find your file in the docs list, click on its name and choose how you want to save it. To get the PDF, you can save it, send an email with it, or move it to the cloud.
pdfFiller makes working with documents easier than you could ever imagine. Register for an account and see for yourself!
Uncompromising security for your PDF editing and eSignature needs
Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
How to fill out 2016 form 1095-c distribution

How to fill out 2016 form 1095-c distribution
01
To fill out 2016 form 1095-c distribution, follow these steps:
02
Start by entering your employer's information in Part I of the form. Include the employer's name, address, and employer identification number (EIN).
03
Next, move to Part II and fill in the employee's information. Provide your full name, address, and social security number.
04
In Part III, you'll need to report the months in which you were covered under an employer-sponsored health plan. Check the appropriate boxes to indicate your coverage for each month.
05
If you had a covered family member, indicate their information in Part IV. Provide their full name, social security number, and the months they were covered under the health plan.
06
In Part V, you may need to report information about the affordability of your employer-sponsored coverage. Consult the instructions provided with the form to determine if this section applies to you.
07
After completing all the necessary sections, review the form for accuracy and make sure all required fields are filled out.
08
Sign and date the form, then distribute copies as instructed by your employer or the IRS.
09
Make sure to consult the instructions for the form and seek professional assistance if needed.
Who needs 2016 form 1095-c distribution?
01
Certain employers, called applicable large employers (ALEs), are required to distribute form 1095-c to their employees for the 2016 tax year.
02
An applicable large employer is one that employed an average of at least 50 full-time employees (including equivalents) during the prior calendar year.
03
Form 1095-c provides information about the health insurance coverage offered by the employer and is used by the IRS to verify individuals' compliance with the Affordable Care Act's employer mandate.
04
Employees who receive an employer-sponsored health plan or are eligible for such coverage may need to receive this form from their employer.
05
It is important to consult the IRS guidelines and consult a tax professional to determine if you meet the requirements for receiving form 1095-c distribution.
Fill
form
: Try Risk Free
For pdfFiller’s FAQs
Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.
How can I send 2016 form 1095-c distribution to be eSigned by others?
Once your 2016 form 1095-c distribution is ready, you can securely share it with recipients and collect eSignatures in a few clicks with pdfFiller. You can send a PDF by email, text message, fax, USPS mail, or notarize it online - right from your account. Create an account now and try it yourself.
Can I create an electronic signature for the 2016 form 1095-c distribution in Chrome?
Yes, you can. With pdfFiller, you not only get a feature-rich PDF editor and fillable form builder but a powerful e-signature solution that you can add directly to your Chrome browser. Using our extension, you can create your legally-binding eSignature by typing, drawing, or capturing a photo of your signature using your webcam. Choose whichever method you prefer and eSign your 2016 form 1095-c distribution in minutes.
How do I fill out 2016 form 1095-c distribution using my mobile device?
Use the pdfFiller mobile app to fill out and sign 2016 form 1095-c distribution on your phone or tablet. Visit our website to learn more about our mobile apps, how they work, and how to get started.
What is form 1095-c distribution?
Form 1095-C is a tax form used by applicable large employers to report information about health insurance coverage offered to their employees, as required by the Affordable Care Act (ACA).
Who is required to file form 1095-c distribution?
Applicable large employers (ALEs) that have 50 or more full-time employees, including full-time equivalent employees, are required to file Form 1095-C.
How to fill out form 1095-c distribution?
To fill out Form 1095-C, employers must provide information about the employer, the offer of health coverage, and employee details, including months of coverage offered. It can be completed using tax software or manually based on IRS instructions.
What is the purpose of form 1095-c distribution?
The purpose of Form 1095-C is to inform employees about their health insurance coverage and to provide the IRS with necessary information to enforce the ACA's employer mandate.
What information must be reported on form 1095-c distribution?
Form 1095-C requires reporting of information such as the employer's name, address, Tax ID number, employee's details, coverage offered, and the months during which the coverage was available.
Fill out your 2016 form 1095-c distribution online with pdfFiller!
pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

2016 Form 1095-C Distribution is not the form you're looking for?Search for another form here.
Relevant keywords
Related Forms
If you believe that this page should be taken down, please follow our DMCA take down process
here
.
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.