Form 1095-C

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, as required by the Internal Revenue Service.  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 UT SELECT Medical Plan offer and months of UT SELECT 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.  This is a provision of 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 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
  • 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.

Academic Graduate Student (AGS) employees enrolled in the UT Student Health Insurance Plan (SHIP or Academic Blue) 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 on the BCBSTX website for more information.  AGS employees will also receive Form 1095-C from the university if they were full-time employees or were enrolled in UT SELECT Medical Plan during the same tax year.

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 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.

How will Form 1095-C be provided?

Electronic copies of Form 1095-C will be available in Workday.  By default, you will receive both electronic and paper copies.  The paper copy will be mailed to your payroll tax form or primary home address unless you opt out of receiving it.  To ensure secure delivery of your personal data, you may log into Workday to change your 1095-C printing election to receive an electronic copy only. 

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

  • In Workday, from the home page click on the Benefits Dashboard, then click My ACA Forms.
  • Enter your EID in the new window that opens, then click OK
  • Select View/Print to view the form and to save or print, select the Download PDF icon or the Print icon, both located in the upper right hand corner.

Former Employees will not see the Benefits application when they log in. Instead, they should search "My ACA Forms" in the Search Bar within Workday to locate their form. 

Follow these simple steps to opt out of receiving a paper copy of Form 1095-C:

  • In Workday, from the home page click on the Benefits Dashboard, then click Change 1095-C Printing Election.
  • Select Receive electronic copy of 1095-C, then click OK at the bottom of the page, then click Done.

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 Resource Service Center at HR Portal or 512-471-4772.