Form 1095-C, A New Tax Document

Form 1095-C, Employer-Provided Health Insurance Offer and Coverage will be mailed to current and former employees, retirees and other covered individuals by March 2, 2017, as required by the Internal Revenue Service.  You should watch for Form 1095-C and keep it with your other important tax documents.  Form 1095-C may be helpful when filing your federal income tax return, but you are not required to wait for it before filing. 

What is Form 1095-C?

This form provides information about the university’s health insurance offer and months of coverage for employees, retirees, and other covered individuals, and if applicable, their enrolled family members.  The Affordable Care Act (ACA) requires most individuals to have qualifying health coverage, also referred to as minimum essential health coverage, or pay a penalty when filing their tax return.  This form will assist employees, retirees and other covered individuals with completing their income tax return by reporting the months they and their enrolled family members had qualifying health coverage from the university during 2016.  Learn more about the Individual Shared Responsibility Provision.

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 university health coverage during 2016, and employees not enrolled, but considered full-time as defined by the ACA during 2016,
  • A retiree or surviving dependent enrolled in university health coverage during 2016,
  • non-employee graduate student fellow or non-employee postdoctoral fellow enrolled in university health coverage during 2016, and
  • A COBRA participant enrolled in university health coverage during 2016.

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.

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.  Like last year, 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.

How will Form 1095-C be provided?

Form 1095-C will be mailed by the university’s third-party ACA vendor.  If you are an employee, it will be mailed to your W-2 address on record with the university.  For all others, it will be mailed to the U.S. mail address on record with the university.  The form will be mailed in a perforated envelope, labeled “Important Tax Return Document Enclosed,” with the return address below.

The University of Texas at Austin
101 East 27th Street, STOP J5600
Austin TX 78712-1573

picture of Form 1095-C envelope

How do I request a reprint of Form 1095-C?

If you do not receive the printed form at your mailing address by March 2, 2017, please contact the Human Resource Service Center (HRSC) at or 512-471-4772 to request a reprint.  If you receive your form, but lose it, contact the HRSC as soon as possible to request a reprint.  In all cases, if you would like to receive a reprint before the April 15 tax filing deadline, we strongly recommend that you contact the HRSC no later than March 17, 2017.

Form 1095-C is not electronically available.  Reprints may be mailed, faxed or picked up in person from the HRSC in the second-floor lobby of North Office Building A (NOA) with a photo ID.  After making your reprint request, please allow at least three business days for your reprint to be mailed, faxed or available for pick-up.

Whom do I contact with questions about Form 1095-C and filing my 2016 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 health coverage?

Contact the Human Resource Service Center at or 512-471-4472.