Form 1095-C

In accordance with the federal Paperwork Burden Reduction Act, the University is no longer required to mail Form 1095-C, Employer-Provided Health Insurance Offer and Coverage. Beginning with the 2025 tax year, we will only provide an electronic copy of this form.

Follow these simple steps to access your electronic Form 1095-C in Workday:

  • Navigate to ACA Forms.
  • Click View/Print for the desired year to view your form.
  • To download or print your form, select either the Download or Print icon, both located in the upper right-hand corner.

Former Employees should search "My ACA Forms" in the Search Bar within Workday to locate their form.  

You may request a paper copy of your Form 1095-C through the options below.

If you are a resident of California, New Jersey, Rhode Island, or Washington D.C., this federal act does not apply and you will be mailed a paper copy, unless you have opted out. You may secure your personal information by following these simple steps to opt out of receiving a paper copy:

  • From ACA Forms, click Change 1095-C Printing Elections.
  • In the "New Election" section, select Receive electronic copy of 1095-C.
  • Select Receive electronic copy of 1095-C.
  • Click OK at the bottom of the page.
  • Click Done to confirm. 

What is Form 1095-C?

This form provides information about the University’s UT SELECT Medical Plan offer and months of UT SELECT coverage for employees, retirees, other covered individuals, and their enrolled family members, if applicable.  The Affordable Care Act (ACA) requires most individuals to have qualifying health coverage, also referred to as minimum essential health coverage. 

For those who purchased health insurance coverage in the Health Insurance Marketplace, this form will assist with determining eligibility for the premium tax credit.  Learn more about the Premium Tax Credit.

Who will be provided Form 1095-C?

The following individuals will be provided Form 1095-C:

  • Employees enrolled in UT SELECT Medical Plan during the tax year, and employees not enrolled, but considered full-time as defined by the ACA during the tax year*
  • A retiree or surviving dependent enrolled in UT SELECT Medical Plan during the tax year
  • A non-employee graduate student fellow or non-employee postdoctoral fellow enrolled in UT SELECT Medical Plan during the tax year
  • A COBRA participant enrolled in UT SELECT Medical Plan during the tax year

Employees, retirees and other covered individuals are responsible for providing a copy of Form 1095-C to covered family members listed on the form, if they request it.

UT Student Health Insurance Plan

Academic Graduate Student (AGS) employees enrolled in the UT Student Health Insurance Plan (UT SHIP or AcademicBlue) are eligible to receive Form 1095-B from BlueCross BlueShield of Texas (BCBSTX).  Form 1095-B will only be mailed if requested.  Review Health Insurance and Your Tax Return for more information.  AGS employees will also receive Form 1095-C from the University if they were full-time employees or were enrolled in the UT SELECT Medical Plan during the same tax year.

UT CARE Medicare Plan

Retirees, surviving dependents and other covered individuals enrolled in the UT CARE Medicare Plan are eligible to receive Form 1095-B from Medicare.  If you need a replacement form, call Medicare at 1-800-633-4227 to request the form.  Review Qualifying Health Coverage Notice & IRS Form 1095-B for more information. These individuals will also receive Form 1095-C from the University if they were enrolled in the UT SELECT Medical Plan during the same tax year.    

Must I wait until I receive Form 1095-C to file my return?

No, the Internal Revenue Service states that you should file your return as you normally would. You can prepare and file your return using other information about your health insurance. Other forms of documentation that would provide proof of insurance include insurance cards, explanation of benefits forms, enrollment confirmation statements, W-2 or payroll statements reflecting health insurance deductions, and other statements indicating that you or your family members had health coverage.

Whom do I contact with questions about Form 1095-C and filing my tax return?

The Internal Revenue Service has prepared Questions and Answers about Health Care Information Forms for Individuals. For additional assistance, contact the Internal Revenue Service or your tax advisor.

Whom do I contact with questions about my UT SELECT Medical Plan coverage?

Contact the Human Resources Service Center.