IRS Form 1095-C Frequently Asked Questions (FAQs)

In January, full-time employees receive a tax form, Form 1095-C, that contains detailed information about their health care coverage. It is important to keep the form for your records because you will need it to file your tax returns.

The following frequently asked questions (FAQs) will help you gain a better understanding of the form and what to do when you receive one.

What is Form 1095-C?

Form 1095-C is a required tax document under the Affordable Care Act (ACA). It contains detailed information about the medical coverage offered to you and your dependents by Miami University. You will need the information from Form 1095-C as part of your federal tax return. The IRS will use this information, in part, to validate your compliance with the ACA's individual shared responsibility requirements. Think of the form as your "proof of insurance" for the IRS.

If you were considered a full-time employee at any point in the tax year, you will receive Form 1095-C, even if you were not enrolled in a Miami University health plan. You will need it to complete your tax return.

Why am I receiving Form 1095-C?

Miami University must file Form 1095-C with the IRS to report information about the offer of health coverage made to full-time employees during the previous calendar year, and provide copies of Forms 1095-C those employees. Similar to the requirement that employers offer coverage or face a penalty under the ACA, individuals who don't purchase their own health insurance coverage must pay a penalty to the IRS unless they fall within an exception. This is called the "Individual Mandate." The information provided on Part III of Form 1095-C contains information that enables the IRS to determine whether an individual has complied with the Individual Mandate or whether that person is subject to a penalty.

You will receive a copy of Form 1095-C because you were either a full-time employee for all or some months of the prior calendar year or are a former employee enrolled in one of our health plan(s). Form 1095-C will show you what information has been reported to the IRS about the offer of health coverage made to you and your family and the months you and/or your family members enrolled in coverage. If you and/or your family enrolled in health coverage under one of our plans for at least one day in the tax year, Part III of Form 1095-C will show whether you and/or your family complied with the Individual Mandate.

Isn't my health coverage information already included on my Form W-2 using Box 12, code DD?

The information included on your Form W-2, Box 12, code DD only states the total cost of employer-sponsored health insurance you actually enrolled in during a single calendar year. It does not show the months in which you enrolled in coverage or the lowest cost employee-only coverage offered to you. Form 1095-C shows information on a monthly basis and includes information about the lowest cost employee-only coverage offered to you, not information about the coverage in which you may have actually enrolled (unless you enrolled in the lowest cost employee-only coverage). Thus, your Form W-2 contains information that is different from your Form 1095-C.

When should I receive a copy of my form?

For active employees, the 1095-C form is available now through BannerWeb Employee Services Online. Paper copies will be mailed to terminated employees before the IRS deadline of March 31, 2017.

Should my spouse or dependents receive their own copies?

Generally, no. 1095-C forms are only required to be provided to full-time employees. However, in some instances, a spouse and/or dependent may receive his/her own copy of Form 1095-C if he/she independently enrolls in COBRA coverage and you do not enroll in COBRA coverage (e.g., in case of a divorce).

If you are a Miami employee, but covered under a Miami employee spouse, you will receive a 1095-C showing you did not carry coverage. Your coverage information will be provided on the form of the person who carries the coverage.

What should I do with my form?

You should retain your form for your records. In addition, you or your tax preparer may need to reference the information contained on your form while completing your federal income tax return to demonstrate that you satisfied the ACA's obligation to have health insurance.

The IRS will also receive copies of your form so they can verify the information you report on your federal income tax return about your health coverage.

What information is provided on Form 1095-C?

The form contains the following information:

Part I (Lines 1 - 13) includes information about you and your employer.
Part II (Lines 14-16) reports information about the coverage offered to you by Miami University, the affordability of the coverage offered, and the reason why you were or were not offered coverage.
Part III (Lines 17-22) reports information about the individuals covered under your plan. Please note the following:

  • A date of birth will be entered in column (c) only if the dependent's social security number is not on file with Benefits and Wellness.
  • Column (d) will be checked if the individual was covered in all 12 months of 2015.
  • For individuals who were covered for some but not all months, information will be entered in column (e), indicating the months for which these individuals were covered.
  • If more than six individuals are covered, see the additional covered individuals on Part III, Continuation Sheet(s).

On Form 1095-C, how will the IRS know that I enrolled in coverage that fulfills the Individual Mandate and allow me to avoid incurring a penalty with the IRS?

Part III of your Form 1095-C contains information indicating which month you and/or your family member(s) enrolled in coverage for any day in a particular month.

Part III contains the name, Social Security Number ("SSN") or other Taxpayer Identification Number (TIN), and coverage information for each covered individual. Please note the following:

  • A date of birth will be entered in column (c) only if a SSN or other TIN isn't entered in column (b).
  • Column (d) will be checked if an individual was covered for at least one day in every month of the year.
  • For individuals who were covered for some but not all months, information will be entered in column (e), indicating the months for which those individuals were covered.

Who can I contact for more information or if information on the form is incorrect?

Contact the Benefits office at 513-529-3926 or benefits@miamioh.edu.

If information is incorrectly entered on the form, will I receive corrected copies?

Yes, you will receive a corrected copy if any of the information is incorrect.