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Retiree - Form 1095-C

In accordance with a new requirement under the Affordable Care Act, (ACA) insurance eligible Non-Medicare Retirees will receive a Form 1095-C for tax year 2016. Non-Medicare Retirees do not need to wait to receive these forms to file their tax return. This form includes the Non-Medicare Retiree's name, Non-Medicare Retiree's dependents' names, the months of the year the Non-Medicare Retiree was eligible for health insurance coverage and the cost of the least expensive monthly premium the Non-Medicare Retiree could have paid under the insurance plan.

However, due to a change in the IRS employer deadline, the form will be received via USPS mail by March 31, 2017. It does NOT need to be filed with 2016 taxes (just retained with 2016 tax records). This form will not be available electronically this year. For additional information, click on the "Forms 1095-B and 1095-C" link.

If insured Non-Medicare Retirees do not receive a 1095-C by March 31, 2017, online users may submit a request to the OHR Health Insurance Team by clicking on the "Create Service Request" button below. Please complete all of the fields in the Contact Information section and provide a brief description of the request in the Brief Description field.