Affordable Care Act (ACA) Information
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IRS Form 1095-C
Statement of Employer-Provided Health Insurance Offer and Coverage
As part of the Patient Protection and Affordable Care Act applicable large employers (ALE) are required to send Form 1095-C to employees who meet specified criteria. The form will contain detailed information about your health care coverage. It is important to keep the form with your tax records.
On or before January 31, each year, some employees will receive the 1095-C form that will contain detailed information about their health care coverage. We have created this FAQ document to provide a better understanding of the form and what to do when/if you receive one.
What is a Form 1095-C?
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 during the calendar year, 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.
Who receives a Form 1095-C?
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 the calendar year 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.
Is there a Form 1095 for Graduate Student (RA/TA/GA) Employees?
Graduate Student employees who are covered under the UT Student Health Insurance Plan can download a 1095-B form from the Blue Access for Members (BAM) website. Members can also call 1-855-247-7587 to request a physical copy or visit the 1095-B information page.
Will retirees under UT CARE receive 1095-C forms from UT Dallas?
Enrollees in the UT CARE Medicare Advantage plan will not receive a 1095-C form from Blue Cross or UT Dallas. Medicare will send you a Form 1095. If you need a replacement form, please contact Medicare at 1-800-MEDICARE (1-800-633-4227). For more information, visit the Medicare website.
Will retirees under UT SELECT receive 1095-C forms from UT Dallas?
Yes, retirees covered under UT SELECT will receive 1095-C Forms from UT Dallas within the IRS deadline.
How do I access my 1095c if I’m a Retiree/Dependent of Retiree covered under UT SELECT or I’m a former 2023 employee of UT Dallas?
To access, please follow these step-by-step instructions:
When will I receive the Form 1095-C?
The forms will be available through My UT Benefits on or around January 31 for those who provided an online consent as indicated in the email notice. Once you are logged in to My UT Benefits, click “Enroll Now” and go to Quick Links. Printed forms will be distributed by Tango Health, a UT System vendor, on or before the January 31 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.
How will I receive the Form 1095-C?
UT Dallas is providing Form 1095-C online access through our third-party administrator, Tango Health. If you wish to receive your Form 1095-C electronically, you must provide your consent by the deadline date as indicated in the email notice. To provide your consent, login to Galaxy. If you do not provide the consent, you will receive your form via U.S. Mail at your home address. Written step-by-step instructions on how to provide online consent are available.
Why did I get more than one Form 1095-C?
If you worked at more than one company or organization during a calendar year and were full time or enrolled in health insurance at each company, you may receive Form 1095-C from each company/employer.
Why didn’t I get a Form 1095-C?
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 the calendar year, you should not receive a Form 1095-C. You may also not receive a Form 1095-C if you were not the primary insured.
Will I be fined if I did not receive a Form 1095-C?
Individual shared responsibility payment is no longer applicable. We have not seen any information related to fines for employees. Employers are still required to comply with providing the 1095-C. Please visit the IRS website or HealthCare.gov learn more.
What information is on the Form 1095-C?
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 UT Dallas, 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
How will the Form 1095-C impact my taxes?
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.edu if you notice a discrepancy on your 1095-C.
Do I need my Form 1095-C and my W-2 to file my taxes?
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.
What if I have questions?
If you have any questions, email benefits@utdallas.edu. 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.