Tax Form 1095-C

As required by the Affordable Care Act (ACA), Indiana University reports information about the medical insurance offered to employees and dependents on Form 1095-C. These forms are distributed to employees each year.

1095-C statements for the 2021 tax year will be distributed no later than the IRS deadline, March 2, 2022. USPS mail delivery is the default delivery method, but employees are strongly encouraged to sign up for electronic delivery through the 1095-C Electronic Consent task at One.IU. This method saves paper and allows employees to receive their statement much sooner. Regardless of the delivery method, all employees will receive an email notification to their IU email address when their 1095-C is available.

You do not need this form to file your taxes; however, you are encouraged to keep it with your tax records.

For questions or to request a correction to your 1095-C, contact IU Human Resources at or (812) 856-1234.

FAQs about Form 1095-C

What is Form 1095-C?

Form 1095-C (also called a 1095-C statement) contains information about the medical coverage offered to you and your dependents by Indiana University.

Although individuals are no longer required to report whether or not they had health insurance on their federal tax returns, the ACA still requires large employers to offer affordable medical coverage to their employees. The information on Form 1095-C is provided to the IRS to demonstrate Indiana University’s compliance with these provisions. You receive a copy of the form as a record of the information the university provided to the IRS about you and your covered dependents.

Delivery of Form 1095-C

Who will receive a Form 1095-C from Indiana University?

The following individuals will receive a 1095-C from IU:

  1. Employees who were full-time (defined by the ACA as 30 service hours per week) for one month or more in 2021
  2. Individuals who were enrolled in any of the following IU-sponsored medical plans for one month or more in 2021:
    • Employee plans (Anthem PPO HDHP, IU Health HDHP, or Anthem PPO $500 Deductible Plan)
    • IU Graduate Appointee (GA) PPO Plan
    • IU Resident PPO Plan (Medical and Optometry Residents)
    • COBRA plans
    • Anthem Under 65 PPO HDHP (for IU Retirees under age 65)

The following individuals will not receive a 1095-C statement from IU:

  • Fellowship Recipients. You will receive a 1095-B directly from Anthem.
  • Anthem Blue Retiree participants (for IU Retirees age 65 and over). Assuming you are enrolled in Medicare, you will receive a 1095-B from Medicare. However, for your first year of Medicare eligibility, if you were enrolled in an employee plan (including COBRA) for any part of the year, you can expect to receive a 1095-C from IU for those months.
Will dependents who are covered on my medical insurance also get a Form 1095-C?

No. 1095-C statements are only sent to the primary subscriber. Information about covered dependents is included on the primary subscriber’s Form 1095-C.

How do I sign up for electronic delivery of my Form 1095-C?

To sign up for electronic delivery, visit the 1095-C Electronic Consent task in One.IU.

If you choose electronic delivery, you will receive a message in your IU email account when the statement is available to view and download. You will not receive a paper copy of the form if you select electronic consent. However, as long as you are employed by Indiana University, you will be able to access and print your 1095-C statements at any time.

How do I sign up for mail delivery of my Form 1095-C?

Mail delivery is the default method of delivery for 1095-C statements. If you signed up for electronic delivery and wish to instead receive your statement through the mail, you can withdraw your consent in one of two ways:

  1. Visit the 1095-C Electronic Consent in the Employee Center at One.IU and select the option to withdraw your consent (if the option to withdraw your consent is not available, you are already signed up for mail delivery).
  2. Submit a paper Withdrawal of Consent for Electronic Delivery of IRS Tax Form 1095-C.
How can I get a copy of my 1095-C statement?

If you are the primary statement recipient, you can obtain a duplicate statement in one of two ways:

  1. Log in to the 1095-C Statement task in One.IU (ACTIVE employees only)
  2. Request a paper statement through the mail by submitting a Duplicate Statement Request Form.
Why did I receive more than one 1095-C?

If you worked for an employer other than Indiana University during any part of 2021, you may receive a Form 1095-C from that employer in addition to the Form 1095-C from Indiana University.

Using Form 1095-C

What should I do with my Form 1095-C?

Upon receipt, please check the form for accuracy. If any of the information on your Form 1095-C is incorrect, please contact IU Human Resources at or (812) 856-1234. You do not need Form 1095-C to complete your tax return, but should retain it with your tax records.

Do I need my Form 1095-C to file my taxes?

No. According to the IRS, you do not have to wait for Form 1095-C from your employer to file your individual income tax return, but you should retain it with your tax records.

Information on the Form 1095-C

What information is on Form 1095-C?

The following are brief descriptions of each section of Form 1095-C. Instructions, provided by the IRS, are included with the form.

  • Part I reports information about you and your employer.
  • Part II reports information about the coverage offered to you by your employer, the affordability of the coverage offered, and the reason why you were or were not offered coverage for each month.
  • Part III reports information about the individuals covered under your plan, including dependents.
The dollar amount listed in Part II, Line 15, is not what I paid for medical insurance. Is this a mistake?

No. The dollar amount listed on Line 15 is the lowest monthly cost for self-only coverage that was available to you in that calendar month. It is not necessarily what you actually paid for coverage that month.

What do the codes mean in Part II, Column 14 and 16 of my 1095-C?

These codes provide information to the IRS about the coverage offered to you by Indiana University, the affordability of the coverage offered, and the reason why you were or were not offered coverage for each month. Explanations for each code can be found in the instructions on the back of Form 1095-C.

Information on my 1095-C is incorrect. How do I report this?

Report any errors to IU Human Resources at or (812) 856-1234.