Form 1095-C: Employer Health Coverage Form, Part by Part
Form 1095-C is the Employer-Provided Health Insurance Offer and Coverage statement that an Applicable Large Employer member (generally an employer with 50 or more full-time employees, including full-time equivalent employees, in the previous year) files with the IRS and, generally, furnishes to each employee who was full-time for any month; Part II reports the offer of coverage, the employee required contribution and a section 4980H code, and Part III lists covered individuals when the plan is self-insured. The form says not to attach it to the tax return. For calendar year 2025 the instructions set March 2, 2026, to furnish it.
Maintained by Archie Chang · Sources checked against IRS text on November 2, 2026 · Methodology & sources
Who files Form 1095-C and who gets one
The IRS About page and the instructions describe the form and the employers that use it:
“Form 1095-C is filed and furnished to any employee of an Applicable Large Employers (ALE) member who is a full-time employee for one or more months of the calendar. ALE members must report that information for all twelve months of the calendar year for each employee.”
“Employers with 50 or more full-time employees (including full-time equivalent employees) in the previous year use Forms 1094-C and 1095-C to report the information required under sections 6055 and 6056 about offers of health coverage and enrollment in health coverage for their employees. Form 1094-C must be used to report to the IRS summary information for each Applicable Large Employer (ALE Member) (defined below) and to transmit Forms 1095-C to the IRS. Form 1095-C is used to report information about each employee to the IRS and to the employee. Forms 1094-C and 1095-C are used in determining whether an ALE Member owes a payment under the employer shared responsibility provisions under section 4980H. Form 1095-C is also used in determining the eligibility of employees for the premium tax credit.”
“An ALE Member must file one or more Forms 1094-C (including a Form 1094-C designated as the Authoritative Transmittal, whether or not filing multiple Forms 1094-C), and must file a Form 1095-C for each employee who was a full-time employee of the ALE Member for any month of the calendar year. Generally, the ALE Member is required to furnish a copy of the Form 1095-C (or a substitute form) to the employee.”
“An ALE Member is, generally, a single person or entity that is an Applicable Large Employer, or if applicable, each person or entity that is a member of an Aggregated ALE Group. An Applicable Large Employer, generally, is an employer with 50 or more full-time employees (including full-time equivalent employees) in the previous year.”
The instructions treat self-insured and insured plans differently:
“ALE Members that offer health coverage through an employer-sponsored, self-insured health plan must complete Form 1095-C, Parts I, II, and III, for any employee who enrolls in the health coverage, whether or not the employee is a full-time employee for any month of the calendar year.”
“Note: If an ALE Member is offering health coverage to employees other than under a self-insured plan, such as through an insured health plan or a multiemployer health plan, the issuer of the insurance or the sponsor of the plan providing the coverage is required to furnish the information about their health coverage to any enrolled employees, and the ALE Member should not complete Form 1095-C, Part III, for those employees.”
“An employer that offers employer-sponsored, self-insured health coverage but is not an ALE Member should not file Forms 1094-C and 1095-C, but should instead file Forms 1094-B and 1095-B to report information for employees who enrolled in the employer-sponsored, self-insured health coverage.”
The form’s Instructions for Recipient say what the recipient receives and how the form is treated:
“You are receiving this Form 1095-C because your employer is an Applicable Large Employer subject to the employer shared responsibility provisions in the Affordable Care Act. This Form 1095-C includes information about the health insurance coverage offered to you by your employer. Form 1095-C, Part II, includes information about the coverage, if any, your employer offered to you and your spouse and dependent(s). If you purchased health insurance coverage through the Health Insurance Marketplace and wish to claim the premium tax credit, this information will assist you in determining whether you are eligible. If you or your family members are eligible for certain types of minimum essential coverage, you may not be eligible for the premium tax credit.”
“Do not attach to your tax return. Keep for your records.”
“If your employer is not an Applicable Large Employer, it is not required to furnish you a Form 1095-C providing information about the health coverage it offered.”
“You may receive multiple Forms 1095-C if you had multiple employers during the year that were Applicable Large Employers (for example, you left employment with one Applicable Large Employer and began a new position of employment with another Applicable Large Employer). In that situation, each Form 1095-C would have information only about the health insurance coverage offered to you by the employer identified on the form.”
“If your employer provided you or a family member health coverage through an insured health plan or in another manner, you may receive information about the coverage separately on Form 1095-B, Health Coverage.”
“If you or a family member enrolled in a qualified health plan through a Health Insurance Marketplace, the Health Insurance Marketplace will report information about that coverage on Form 1095-A, Health Insurance Marketplace Statement.”
“Tip: Employers are required to furnish Form 1095-C only to the employee. As the recipient of this Form 1095-C, you should provide a copy to any family members covered under a self-insured, employer-sponsored plan listed in Part III if they request it for their records.”
Form 1095-C, line by line
The table uses the 2026 Form 1095-C (catalog number 60705M, created 4/3/26). It has three parts: Part I for the employee and the employer (lines 1 to 13), Part II for the offer of coverage (lines 14 to 17) and Part III for covered individuals (lines 18 to 30). Each row gives the wording printed on the form and the matching text from its Instructions for Recipient.
| Line | As printed on the form | Instructions for recipient on the form |
|---|---|---|
| Part I, 1–6 | Name of employee (first name, middle initial, last name); Social security number (SSN); Street address (including apartment no.); City or town; State or province; Country and ZIP or foreign postal code | Lines 1–6. Part I, lines 1 through 6, reports information about you, the employee. |
| 2 | Social security number (SSN) | Line 2. This is your social security number (SSN). For your protection, this form may show only the last four digits of your SSN. However, the employer is required to report your complete SSN to the IRS. |
| 7–13 | Name of employer; Employer identification number (EIN); Street address (including room or suite no.); Contact telephone number; City or town; State or province; Country and ZIP or foreign postal code | Lines 7–13. Part I, lines 7 through 13, reports information about your employer. |
| 10 | Contact telephone number | Line 10. This line includes a telephone number for the person whom you may call if you have questions about the information reported on the form or to report errors in the information on the form and ask that they be corrected. |
| 14 | Offer of Coverage (enter required code) | Line 14. The codes listed next for line 14 describe the coverage that your employer offered to you and your spouse and dependent(s), if any. (If you received an offer of coverage through a multiemployer plan due to your membership in a union, that offer may not be shown on line 14.) The information on line 14 relates to eligibility for coverage subsidized by the premium tax credit for you, your spouse, and dependent(s). For more information about the premium tax credit, see Pub. 974. |
| 15 | Employee Required Contribution (see instructions) | Line 15. This line reports the employee required contribution, which is the monthly cost to you for the lowest-cost, self-only, minimum essential coverage providing minimum value that your employer offered you. For an individual coverage HRA, the employee required contribution is the excess of the monthly premium based on the employee’s applicable age for the applicable lowest cost silver plan over the monthly individual coverage HRA amount (generally, the annual individual coverage HRA amount divided by 12). See the Instructions for Forms 1094-C and 1095-C for more details. The amount reported on line 15 may not be the amount you paid for coverage if, for example, you chose to enroll in more expensive coverage such as family coverage. Line 15 will show an amount only if code 1B, 1C, 1D, 1E, 1J, 1K, 1L, 1M, 1N, 1O, 1P, 1Q, 1T, or 1U is entered on line 14. If you were offered coverage but there is no cost to you for the coverage, this line will report “0.00” for the amount. For more information, including on how your eligibility for other healthcare arrangements might affect the amount reported on line 15, visit IRS.gov. |
| 16 | Section 4980H Safe Harbor and Other Relief (enter code, if applicable) | Line 16. This code provides the IRS information to administer the employer shared responsibility provisions. Other than a code 2C, which reflects your enrollment in your employer’s coverage, none of this information affects your eligibility for the premium tax credit. |
| 17 | ZIP code | Line 17. This line reports the applicable ZIP code your employer used for determining affordability if you were offered an individual coverage HRA. If code 1L, 1M, 1N, or 1T was used on line 14, this will be your primary residence location. If code 1O, 1P, 1Q, or 1U was used on line 14, this will be your primary employment site. For more information about individual coverage HRAs, visit IRS.gov. |
| Part III, 18–30 | Part III Covered Individuals | Part III reports the name, SSN (or TIN for covered individuals other than the employee listed in Part I), and coverage information about each individual (including any full-time employee and non-full-time employee, and any employee’s family members) covered under the employer’s health plan, if the plan is “self-insured.” A date of birth will be entered in column (c) only if an SSN (or TIN for covered individuals other than the employee listed in Part I) is not entered in column (b). Column (d) will be checked if the individual was covered for at least 1 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 these individuals were covered. If there are more than 13 covered individuals, additional copies of page 3 may be used. |
Line 14 codes, 1A to 1Z
The Instructions for Recipient on the 2026 form list the line 14 codes below. Our table copies them in order; codes 1I and 1V through 1Z are printed as reserved for future use.
| Code | Printed meaning |
|---|---|
| 1A | Minimum essential coverage providing minimum value offered to you with an employee required contribution for self-only coverage equal to or less than 9.5% (as adjusted) of the 48 contiguous states single federal poverty line and minimum essential coverage offered to your spouse and dependent(s) (referred to here as a Qualifying Offer). This code may be used to report for specific months for which a Qualifying Offer was made, even if you did not receive a Qualifying Offer for all 12 months of the calendar year. For information on the adjustment of the 9.5%, visit IRS.gov. |
| 1B | Minimum essential coverage providing minimum value offered to you and minimum essential coverage NOT offered to your spouse or dependent(s). |
| 1C | Minimum essential coverage providing minimum value offered to you and minimum essential coverage offered to your dependent(s) but NOT your spouse. |
| 1D | Minimum essential coverage providing minimum value offered to you and minimum essential coverage offered to your spouse but NOT your dependent(s). |
| 1E | Minimum essential coverage providing minimum value offered to you and minimum essential coverage offered to your dependent(s) and spouse. |
| 1F | Minimum essential coverage NOT providing minimum value offered to you; or you and your spouse or dependent(s); or you, your spouse, and dependent(s). |
| 1G | You were NOT a full-time employee for any month of the calendar year but were enrolled in self-insured, employer-sponsored coverage for one or more months of the calendar year. This code will be entered in the All 12 Months box or in the separate monthly boxes for all 12 calendar months on line 14. |
| 1H | No offer of coverage (you were NOT offered any health coverage or you were offered coverage that is NOT minimum essential coverage). |
| 1I | Reserved for future use. |
| 1J | Minimum essential coverage providing minimum value offered to you, minimum essential coverage conditionally offered to your spouse, and minimum essential coverage NOT offered to your dependent(s). |
| 1K | Minimum essential coverage providing minimum value offered to you, minimum essential coverage conditionally offered to your spouse, and minimum essential coverage offered to your dependent(s). |
| 1L | Individual coverage health reimbursement arrangement (HRA) offered to you only with affordability determined by using employee’s primary residence ZIP code. |
| 1M | Individual coverage HRA offered to you and dependent(s) (not spouse) with affordability determined by using employee’s primary residence ZIP code. |
| 1N | Individual coverage HRA offered to you, spouse, and dependent(s) with affordability determined by using employee’s primary residence ZIP code. |
| 1O | Individual coverage HRA offered to you only using the employee’s primary employment site ZIP code affordability safe harbor. |
| 1P | Individual coverage HRA offered to you and dependent(s) (not spouse) using the employee’s primary employment site ZIP code affordability safe harbor. |
| 1Q | Individual coverage HRA offered to you, spouse, and dependent(s) using the employee’s primary employment site ZIP code affordability safe harbor. |
| 1R | Individual coverage HRA that is NOT affordable offered to you; employee and spouse or dependent(s); or employee, spouse, and dependents. |
| 1S | Individual coverage HRA offered to an individual who was not a full-time employee. |
| 1T | Individual coverage HRA offered to employee and spouse (no dependents) with affordability determined using employee’s primary residence ZIP code. |
| 1U | Individual coverage HRA offered to employee and spouse (no dependents) using employee’s primary employment site ZIP code affordability safe harbor. |
| 1V | Reserved for future use. |
| 1W | Reserved for future use. |
| 1X | Reserved for future use. |
| 1Y | Reserved for future use. |
| 1Z | Reserved for future use. |
Line 16 and the 9.5% in code 1A
Line 16 uses a different code series. The 2025 instructions for employers describe it this way:
“Code Series 2—Section 4980H Safe Harbor Codes and Other Relief for ALE Members. An ALE Member enters the applicable Code Series 2 indicator code, if any, on line 16 to report for 1 or more months of the calendar year that one of the following situations applied to the employee.
The employee was not employed or was not a full-time employee,
The employee enrolled in the minimum essential coverage offered,
The employee was in a Limited Non-Assessment Period with respect to section 4980H(b),
The ALE Member met one of the section 4980H affordability safe harbors with respect to this employee, or
The ALE Member was eligible for multiemployer interim rule relief for this employee.”
“Enter only one code from Code Series 2 per calendar month.”
“Note: There is no code to enter on line 16 to indicate that a full-time employee offered coverage either did not enroll in the coverage or waived the coverage.”
Code 1A refers to 9.5% (as adjusted). The 2025 instructions for employers give the adjusted percentage for two plan years, and the Required Contribution Percentage for plan years beginning in 2026 in Rev. Proc. 2025-25, which our ACA subsidy calculator page uses, is 9.96%. The figures do not conflict: each is for a different plan year (2024: 8.39%, 2025: 9.02%, 2026: 9.96%). The first quote is from the 2025 instructions; the second is from the early-release draft 2026 instructions (not for filing):
“Note: References to 9.5% in the section 4980H affordability safe harbors and Qualifying Offer Method are applied based on the percentage as indexed for purposes of applying the affordability thresholds under section 36B (the premium tax credit). The percentage, as adjusted, is 8.39% for plan years beginning in 2024, and 9.02% for plan years beginning in 2025.”
“The percentage, as adjusted, is 9.02% for plan years beginning in 2025, and 9.96% for plan years beginning in 2026.”
When employers furnish and file the form
The 2025 instructions set these dates for calendar year 2025, and describe a change to automatic mailing:
“An ALE Member must furnish a Form 1095-C to each of its full-time employees by March 2, 2026, for the 2025 calendar year.”
“The due date for furnishing Form 1095-C is automatically extended from January 31, 2026, to March 2, 2026. Thus, no additional extensions will be granted.”
“Generally, you must file Forms 1094-C and 1095-C by February 28 if filing on paper (or March 31 if filing electronically) of the year following the calendar year to which the return relates. For calendar year 2025, Forms 1094-C and 1095-C are required to be filed by March 2, 2026, or March 31, 2026, if filing electronically.”
“If the due date falls on a weekend or legal holiday, then the due date is the following business day. A business day is any day that is not a Saturday, Sunday, or legal holiday.”
“Employers no longer have to automatically send Form 1095-C to individuals. The requirement for furnishing the statement is met if the employer responsible for providing the statements provides clear, conspicuous, and accessible notice on its website that an individual may request a copy of their statement and the copy is timely furnished. For this purpose, the statement is timely furnished if provided to the individual no later than the later of January 31, 2026, or 30 days after the date of the request.”
The Form 8962 instructions for 2025 describe the same change for individuals:
“Reporting entities no longer required to send minimum essential coverage (MEC) forms automatically. In certain circumstances, reporting entities aren’t required to send tax forms to covered individuals showing proof of MEC (Forms 1095-B and 1095-C) unless a form is requested. If requested by the individual, the form must be provided by January 31, or 30 days after the date of request, whichever is later.”
Frequently asked questions
What is Form 1095-C?
The IRS About page says Form 1095-C is filed and furnished to any employee of an Applicable Large Employer member who is a full-time employee for one or more months of the calendar year, and the instructions say it is used to report information about each employee to the IRS and to the employee about offers of health coverage and enrollment. The instructions say it is used in determining whether an employer owes a payment under section 4980H and in determining the eligibility of employees for the premium tax credit.
Which employers file Form 1095-C?
Applicable Large Employer members. The instructions describe an Applicable Large Employer, generally, as an employer with 50 or more full-time employees (including full-time equivalent employees) in the previous year, and say an employer that offers self-insured coverage but is not an Applicable Large Employer member files Forms 1094-B and 1095-B instead. The instructions also say that when coverage is offered through an insured plan, the issuer or plan sponsor furnishes the coverage information and the employer does not complete Part III for those employees.
Do I attach Form 1095-C to my tax return?
The form says “Do not attach to your tax return. Keep for your records.” Its Instructions for Recipient say the information helps in determining eligibility if you purchased Marketplace coverage and wish to claim the premium tax credit, and that if your employer is not an Applicable Large Employer it is not required to furnish you a Form 1095-C.
When must employers furnish and file Form 1095-C?
The 2025 instructions have an Applicable Large Employer member furnish a Form 1095-C to each full-time employee by March 2, 2026, for the 2025 calendar year, after an automatic extension from January 31, 2026. They say forms are generally filed by February 28 on paper or March 31 if filing electronically, and for 2025 by March 2, 2026, or March 31, 2026, if filing electronically. The same instructions say employers no longer have to automatically send the form if they provide notice on a website and furnish a copy on request by the later of January 31, 2026, or 30 days after the request.
What do lines 14, 15, 16 and 17 show?
Per the Instructions for Recipient on the form: line 14 shows a code for the coverage offered to you and your spouse and dependents, line 15 shows the employee required contribution, line 16 shows a code that gives the IRS information to administer the employer shared responsibility provisions, and line 17 shows the ZIP code used for affordability if an individual coverage HRA was offered. FedRateCalc’s Form 1095-C page lists all line 14 codes from 1A to 1Z as printed on the 2026 form.
Why can the 9.5% in code 1A differ from other percentages?
Code 1A refers to 9.5% (as adjusted). The 2025 instructions say that percentage is applied as indexed for the premium tax credit and is 8.39% for plan years beginning in 2024 and 9.02% for plan years beginning in 2025; the early-release draft 2026 instructions (not for filing) repeat 9.02% for 2025 and give 9.96% for plan years beginning in 2026. Rev. Proc. 2025-25, used on our ACA subsidy calculator page, also gives 9.96% as the Required Contribution Percentage for plan years beginning in 2026.
Why might I get more than one form, or a Form 1095-B or 1095-A?
The Instructions for Recipient say you may receive multiple Forms 1095-C if you had multiple Applicable Large Employer employers, each with information only about the coverage that employer offered. They say coverage through an insured health plan or another manner may be reported separately on Form 1095-B, and that Marketplace coverage is reported on Form 1095-A.