Affordable Care Act Form 1095
The IRS 1095 Form
The IRS 1095 Form is your “proof of insurance” to maintain with your federal income tax forms and documents. When filing your federal income taxes, you will be provided with a W-2 form, as well as the 1095 forms, but the 1095 forms should not be required as a part of the filing process. The 1095 does not replace your W-2.
If you were eligible for health benefits in the previous tax year, you will be provided this document. The Form 1095 reports information about your health care coverage as required by the Affordable Care Act.
1095 IRS Affordable Care Act Tax Form FAQ
What is the IRS 1095 Form?
This form is an annual tax document in addition to your W-2 and other tax documents. The university is required by the Affordable Care Act (ACA) to provide Form 1095 to everyone who worked at least 130 hours (full-time as defined by the ACA) for one month or more throughout the prior year. Additionally, any WSU employees who were offered/provided Public Employee Benefit Board (PEBB) benefits, even if they did not work 130 hours in a month, will also receive the 1095 form.
The ACA, or Health Care Reform, requires individuals to have health care coverage, and for employers to offer coverage that meets certain standards to their ACA defined full-time employees or potentially face a fine.
There are two forms that you could receive based on your employment with WSU, the 1095-C form or the 1095-B form.
1095-C
This form is issued by employers, and it provides information you will need to maintain with your federal income tax forms and documents. The 1095-C Decoder provides details about the information reflected on the form, which you may find helpful. The 1095-C form is given to all employees who worked at least one month for at least 130 hours in the prior year, as well as anyone enrolled on a Uniform Plan (regardless of how many hours worked). The form includes information on the coverage that WSU offered you, the amount of the lowest cost plan available to you, and enrollment details for you and your dependents (if covered). This form will be sent to your home mailing address and will be delivered by the Health Care Authority. See “Who will get a 1095 Form” below.
If you worked for more than one employer in the prior year, there is the possibility you will receive this form from them as well.
1095-B
The 1095-B forms are issued by insurance providers other than Uniform Medical. Therefore, if you are enrolled in a Kaiser plan, you can expect to receive a 1095-B form directly from them as well. You may receive only a 1095-B (if you did not work 130+ hours a month), or you may receive both the 1095-C and 1095-B. The 1095-B reports you had minimum essential coverage for yourself and any covered dependents, which is information you may need to report when you file your taxes.
Why is this important?
Think of these forms as your “proof of insurance” for the IRS. You should maintain them with your other important tax documents.
Do I need my 1095 Form to file my taxes?
No. Most people who had qualified employer coverage throughout the whole year will not need a 1095 Form to file their taxes. WSU’s health plans are all qualified health plans.
If you need tax advice or guidance, please contact a tax professional.
Who will get a 1095 Form?
There are two 1095 Forms WSU employees may receive, depending on if they work full-time (130+ hours a month as defined by the ACA) and depending on which plan they are enrolled in. Also, non-employees, such as people enrolled on COBRA benefits or retirees will receive them. The chart below explains who will get which forms:
| Hours Worked in Any Month | Uniform | Kaiser | Medical Waived | Not Benefit Eligible | Non-Employee (COBRA, Retiree) |
|---|---|---|---|---|---|
| 130 or More | 1095-C | 1095-C & 1095-B | 1095-C | 1095-C | N/A |
| Approximately 80-129 | 1095-C | 1095-B | No Form | No Form | N/A |
| Approximately 79 or less | N/A | N/A | N/A | N/A | 1095-C |
What information will I need to complete my tax return?
When completing your federal tax return, you will need to indicate whether or not you had minimum essential coverage for all of the prior year or qualified for a health coverage exemption.
Information on these forms may assist in preparing a return, however they are not required. Individual should file their returns as they normally would, and can prepare and file their returns using other information about their health insurance. You do not/should not attach any of the 1095 forms to your tax return.
Consult with a qualified tax advisor if you have questions about filing your tax return.
Why didn’t I get a Form 1095?
If you were not a PEBB benefit-eligible employee, or did not work more than 130 hours in a month (e.g. student employees, most non-student hourly employees, less than half time faculty) and were not enrolled in healthcare coverage through WSU/PEBB at any time during the calendar year, you should not receive a Form 1095 from WSU.
When will I get my Form 1095?
The 1095-C forms will be mailed out no later than the first week of March. They will be sent directly to employees’ homes from the Health Care Authority (HCA).
Kaiser participants should check with Kaiser directly to inquire about the expected release of their 1095-B forms.
Does the 1095 form impact when or how I will get my W-2?
No. Employee W-2s are slated to be sent mid-January.
The information on my Form 1095 is wrong or I need a new copy. Who can help me?
Contact Human Resource Services or call 509-335-4521.
Will dependents I cover on my health plan each get their own Form 1095?
No. The university will only provide a 1095 to qualified employees, although the form includes information about covered dependents. You may need to provide a copy to any covered family members for their tax records.
The dollar amounts shown on Form 1095-C don’t match what I paid for my health benefits, why not?
Line 15 of Form 1095-C shows how much you would have paid per month for single coverage under the least expensive WSU health plan available to you in the previous tax year. The IRS requires the university to report this information to demonstrate the affordability of your health plan options. It will not reflect your actual monthly premiums paid if you chose a higher-cost plan or covered any dependents.
Does Form 1095 replace my W-2?
No. Form 1095 does not replace your W-2 or any other tax documents. For more information, visit the IRS 1095 info page or consult with a qualified tax advisor.
Will my 1095 Form be available online/electronically?
No, they will not be available online or electronically.
I am enrolled in a Medicare Plan, will I receive a 1095 for that plan?
Some Medicare Plan participants may receive a 1095-B from the Department of Health and Human Services (DHHS). If you have questions about the form that DHHS has provided you, please contact DHHS directly.