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ACA Form 1095

Background

As part of the ACA’s individual shared responsibility, also known as the Individual Mandate, most individuals must have qualifying health insurance coverage for the year, either through employer coverage or through the Health Insurance Marketplace such as Covered California. Until January 1, 2019, individuals without minimum essential medical coverage (MEC) may be penalized for each full month the individual or his/her family member is uninsured. 

In addition, as part of the ACA employer mandate, Stanford is required to notify eligible employees and the IRS of available medical coverage. This notification is called the IRS Form 1095.

Notification of Coverage: IRS Form 1095

Below is a summary of the three Form 1095s you might receive and what you should do with the form. Stanford will send eligible employees the Form 1095-C notification at the end of January. The Form 1095-C will be sent by U.S. Mail unless you select electronic delivery.

Log into ACA 1095 Portal and elect e-delivery

1095 Forms Who you’ll receive it from What to do with it

1095-A

Provided by the Health Insurance Marketplace if you were enrolled in a Marketplace plan during the tax year. Use it to complete your U.S. Individual Tax Return and other forms. It is your "proof of coverage" for the ACA Individual Mandate. You are not required to submit it to the IRS with your tax filing. The Marketplace plan will file it with the IRS. You should keep it with your other important tax documents.

1095-B

Provided by non-Marketplace health plan insurers (e.g. Kaiser) if you were enrolled in a fully insured medical plan during the tax year or if you were enrolled in an employer self funded plan but were not employed by that employer in the tax year. Use it to complete your U.S. Individual Tax Return and other forms. It is your "proof of coverage" for the ACA Individual Mandate.  You are not required to submit it to the IRS with your tax filing. The medical plan insurer will file it with the IRS. You should keep it with your other important tax documents.

1095-C

Provided by your employer if you were enrolled as an employee in an employer's self-funded medical plan during the tax year or if you were a full-time employee of a large employer, regardless of whether or not you were enrolled in a medical plan. Use it to complete your U.S. Individual Tax Return and other forms. If you were enrolled in an employer self-funded plan, it is your  "proof of coverage" for the ACA Individual Mandate. You are not required to submit it to the IRS with your tax filing.  Stanford will file it with the IRS. You should keep it with your other important tax documents.

Please note:

It is possible to receive all three forms. For example, a new employee could receive 1095-A from any Marketplace plan that he or she was enrolled in during the prior year, a 1095-B from Kaiser if he/she enrolled in Stanford’s Kaiser Plan and a 1095-C if he/she was a full-time Stanford employee any time during the prior year. An employee could also receive multiple forms if he or she had multiple employers within the same tax year.