IRS Form 1095-C for Calendar Year 2021

The Form 1095-C contains detailed information about the health care coverage provided by UT Dallas. If you enrolled in health care coverage from UT Dallas or worked an average of 30 or more hours per week, or you were a full-time employee at any point in 2021, then you should receive a Form 1095-C. The information from the Form 1095-C will provide proof that you have health care coverage. This is required by the Patient Protection and Affordable Care Act. Think of the form as your “proof of insurance” or “Benefits W2” for the IRS.

Employees who worked an average of 30 or more hours per week or enrolled in the health insurance plan through UT Dallas at any time during 2021 should receive a Form 1095-C. The information on the form will be your documentation to prove your insurance coverage status and will serve as your supporting documentation for your records. You do not need to send this form with your tax return.

The forms will be available online on or around January 31, 2022 for those who provided an online consent by January 17, 2022.  Printed forms will be distributed by Equifax, a UT Dallas vendor, on or before the January 31, 2022 deadline imposed by the Internal Revenue Services (IRS). If you believe you should have received a Form1095-C but did not, please send an email to benefits@utdallas.edu.

UT Dallas is providing Form 1095-C online access through our third-party administrator, Equifax. If you wish to receive your Form 1095-C electronically, you must provide your consent by January 17, 2022. To provide your consent, login to Galaxy. Then go to Self Service and select ACA Form 1095-C and follow the on-screen instruction. If you do not provide the consent, you will receive your form via U.S. Mail at your home address. Written instructions are available.

If you worked at more than one company or organization during 2021 and were full time or enrolled in health insurance at each company, you may receive Form 1095-C from each company/employer.

If you were not full-time (worked an average of 30 or more hours per week) and not eligible or enrolled in health care coverage through UT Dallas at any time during 2021, you should not receive a Form 1095-C. You may also not receive a Form 1095-C if you were not the primary insured.

Individual shared responsibility payment is not applicable in 2021. We have not seen any information related to fines for employees.  Employers are still required to comply with providing the 1095-C.  Please visit www.irs.gov or www.healthcare.gov learn more.

There are three parts to the form:

• Part 1 reports information about you and your employer.
• Part 2 reports information about the coverage offered to you by UTD, the affordability of the coverage offered, and the reason why you were or were not offered coverage.
• Part 3 reports information about the individuals (dependents) covered under your plan

The form will help you in responding to the questions when preparing for your federal income tax filing. If there is a discrepancy in the information that you and UTD report to the IRS about the health care coverage offered to you, your tax return may be delayed. Contact UT Dallas immediately at benefits@utdallas if you notice a discrepancy on your 1095-C.

IRS confirms that taxpayers do not need to wait until they receive a Form 1095-C to file their taxes. Taxpayers comply with minimum essential coverage filing requirements if they simply check a box on their 1040 if they had coverage for the year; they do not need to file any evidence of coverage with their tax forms. However, you should keep the Form 1095-C for your income tax records.

If you have any questions, email benefits@utdallas.edu or contact the Office of Human Resources – Employee Benefits Team.  If you have additional questions about your Form 1095-C, you may also visit the IRS Website and/or the UT System Office of Employee Benefits Website.