IRS 1094-C form

This form is the transmittal form that must be filed with the Form 1095-C

2023 1094-C form

2023 1094-C form

1201181094CTransmittal of EmployerProvided Health Insurance Offer and Coverage Information ReturnsFormDepartment of the Treasury Internal Revenue ServicePart IOMB No. 15452251CORRECTED2023Go to www.irs.gov/Form1094C for instructions and the latest...

2022 1094-C form

2022 1094-C form

1201181094CTransmittal of EmployerProvided Health Insurance Offer and Coverage Information ReturnsFormDepartment of the Treasury Internal Revenue ServicePart IOMB No. 15452251CORRECTED2023Go to www.irs.gov/Form1094C for instructions and the latest...

2021 1094-C form

2021 1094-C form

1201181094CTransmittal of EmployerProvided Health Insurance Offer and Coverage Information ReturnsFormDepartment of the Treasury Internal Revenue Serviceman I Go OMB No. 15452251CORRECTED2021to www.irs.gov/Form1094C for instructions and the latest...

2020 1094-C form

2020 1094-C form

1201181094CTransmittal of EmployerProvided Health Insurance Offer and Coverage Information ReturnsFormDepartment of the Treasury Internal Revenue Serviceman I Go OMB No. 15452251CORRECTED2020to www.irs.gov/Form1094C for instructions and the latest...

2019 1094-C form

2019 1094-C form

1201181094CTransmittal of EmployerProvided Health Insurance Offer and Coverage Information ReturnsFormDepartment of the Treasury Internal Revenue Serviceman I Go OMB No. 15452251CORRECTED2019to www.irs.gov/Form1094C for instructions and the latest...

2018 1094-C form

2018 1094-C form

1201181094CTransmittal of EmployerProvided Health Insurance Offer and Coverage Information ReturnsFormDepartment of the Treasury Internal Revenue Serviceman I Go OMB No. 15452251CORRECTED2018to www.irs.gov/Form1094C for instructions and the latest...