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Form 1095-C Frequently Asked Questions

Q: What is the 1095c Form?

A: This is a form that employers are required to send employees in accordance with the Affordable Care Act. It is used by the IRS to determine offer and election of health coverage.

Q: When will employees receive the 1095c?

A: They will be mailed no later than January 28, 2021 via U.S. Mail. Please allow appropriate time for delivery. If you are to receive one, it will be included with your W2.

Q: What do I do with the 1095c Form?

A: WWhen you file your income taxes this year, present the 1095c to your tax preparer who will offer guidance on the necessity of the 1095c. DO NOT THROW IT AWAY.

Q: I didn’t elect benefits through the Company in 2018. Why am I receiving a 1095c?

A: You are receiving the 1095c because you were eligible for health benefits in 2020, and were offered coverage by the Company. Whether you selected health benefits or not, the Company is required to provide you the 1095c if you were deemed full time, or if you elected a "Preventive Care" minimum essential coverage plan.

Q: Why did I receive more than one 1095c Form?

A: Like your W2, if you worked for more than one company in 2020, you will receive a 1095c from each employer. If you worked for more than one company under the Act1 Group of Companies, each 1095c will reflect information about your employment with that Company in 2019. The Act1 Group of Companies is the "control group". This means that the offer of coverage applies even if you transfer to an affiliated ActOne Group Company.

Q: What do the codes on the 1095c mean?

A: That information can be found in the appendix below, and on page 2 of the 1095c instructions.

Q: I didn’t select benefits last year but there’s a benefit cost on the 1095c. What does this mean?

A: The IRS will need to know the lowest cost minimum value plan available to you by your employer during 2020. This is what this amount reflects. It does not necessarily reflect an amount actually deducted.

Q: What do I do if there is incorrect information on my 1095c?

A: First, always contact your branch office to determine if they can assist you. If not, please email your concerns in detail to AvipEnrollment@ain1.com who will research the situation further.

Q: How do I obtain a duplicate 1095c form request?

A: The 1095c Request Form can be obtained through your local branch office, or you can obtain it online at: ain1.com/w2-1095c/W2/W2-1095-C-Request-Form.pdf

The form can be emailed to w2@mail.all-in-1.com

Or the form can be mailed to:

W2 Request Department
P.O. Box 29048
Glendale, CA 91209

Please allow 7–10 business days for processing.

Q: How do I obtain the FEIN Number?

A: That information will be on your W2 you will receive. The Company does not give that information out over the phone or email.

Appendix

Line 14 - Offer of Coverage

Offer of Coverage - The codes listed below for line 14 describe the coverage that your employer offered to you and your spouse and dependent(s), if any. (If you received an offer of coverage through a multiemployer plan due to your membership in a union, that offer may not be shown on line 14.) The information on line 14 relates to eligibility for coverage subsidized by the premium tax credit for you, your spouse, and dependent(s). For more information about the premium tax credit, see Pub. 974.

  • 1A. Minimum essential coverage providing minimum value offered to you with an employee required contribution for self-only coverage equal to or less than 9.5% (as adjusted) of the 48 contiguous states single federal poverty line and minimum essential coverage offered to your spouse and dependent(s) (referred to here as a Qualifying Offer). This code may be used to report for specific months for which a Qualifying Offer was made, even if you did not receive a Qualifying Offer for all 12 months of the calendar year. For information on the adjustment of the 9.5%, visit IRS.gov.
  • 1B. Minimum essential coverage providing minimum value offered to you and minimum essential coverage NOT offered to your spouse or dependent(s).
  • 1C. Minimum essential coverage providing minimum value offered to you and minimum essential coverage offered to your dependent(s) but NOT your spouse.
  • 1D. Minimum essential coverage providing minimum value offered to you and minimum essential coverage offered to your spouse but NOT your dependent(s).
  • 1E. Minimum essential coverage providing minimum value offered to you and minimum essential coverage offered to your dependent(s) and spouse.
  • 1F. Minimum essential coverage NOT providing minimum value offered to you, or you and your spouse or dependent(s), or you, your spouse, and dependent(s).
  • 1G. You were NOT a full-time employee for any month of the calendar year but were enrolled in self-insured employer-sponsored coverage for one or more months of the calendar year. This code will be entered in the All 12 Months box or in the separate monthly boxes for all 12 calendar months on line 14.
  • 1H. No offer of coverage (you were NOT offered any health coverage or you were offered coverage that is NOT minimum essential coverage).
  • 1I. Reserved for future use.
  • 1J. Minimum essential coverage providing minimum value offered to you; minimum essential coverage conditionally offered to your spouse; and minimum essential coverage NOT offered to your dependent(s).
  • 1K.Minimum essential coverage providing minimum value offered to you; minimum essential coverage conditionally offered to your spouse; and minimum essential coverage offered to your dependent(s).
  • 1L. Individual coverage health reimbursement arrangement (HRA) offered to you only with affordability determined by using employee’s primary residence location ZIP code.
  • 1M. Individual coverage HRA offered to you and dependent(s) (not spouse) with affordability determined by using employee’s primary residence location ZIP code.
  • 1N. Individual coverage HRA offered to you, spouse and dependent(s) with affordability determined by using employee’s primary residence location ZIP code.
  • 1O. Individual coverage HRA offered to you only using the employee’s primary employment site ZIP code affordability safe harbor.
  • 1P. Individual coverage HRA offered to you and dependent(s) (not spouse) using the employee’s primary employment site ZIP code affordability safe harbor.
  • 1Q. Individual coverage HRA offered to you, spouse and dependent(s) using the employee’s primary employment site ZIP code affordability safe harbor.
  • 1R. Individual coverage HRA that is NOT affordable offered to you; employee and spouse or dependent(s); or employee, spouse, and dependents.
  • 1S. Individual coverage HRA offered to an individual who was not a full-time employee.
  • 1T. Reserved for future use.
  • 1V. Reserved for future use.
  • 1W. Reserved for future use.
  • 1X. Reserved for future use.
  • 1Y. Reserved for future use.
  • 1Z. Reserved for future use.

Line 15

This line reports the employee required contribution, which is the monthly cost to you for the lowest-cost self-only minimum essential coverage providing minimum value that your employer offered you. For an individual coverage HRA, the employee required contribution is the excess of the monthly premium based on the employee’s applicable age for the applicable lowest cost silver plan over the monthly individual coverage HRA amount (generally, the annual individual coverage HRA amount divided by 12). See the Instructions for Forms 1094-C and 1095-C for more details. The amount reported on line 15 may not be the amount you paid for coverage if, for example, you chose to enroll in more expensive coverage such as family coverage. Line 15 will show an amount only if code 1B, 1C, 1D, 1E, 1J, 1K, 1L, 1M, 1N, 1O, 1P, or 1Q is entered on line 14. If you were offered coverage but there is no cost to you for the coverage, this line will report "0.00" for the amount. For more information, including on how your eligibility for other healthcare arrangements might affect the amount reported on line 15, visit IRS.gov.

Line 16

This code provides the IRS information to administer the employer shared responsibility provisions. Other than a code 2C, which reflects your enrollment in your employer’s coverage, none of this information affects your eligibility for the premium tax credit. For more information about the employer shared responsibility provisions, visit IRS.gov.

Line 17

This line reports the applicable ZIP code your employer used for determining affordability if you were offered an individual coverage HRA. If code 1L, 1M, or 1N was used on line 14, this will be your primary residence location. If code 1O, 1P, or 1Q was used on line 14, this will be your primary work location. For more information about individual coverage HRAs, visit IRS.gov.

Part III. Covered Individuals, Lines 18–30

Part III reports the name, SSN (or TIN for covered individuals other than the employee listed in Part I), and coverage information about each individual (including any full-time employee and non-full-time employee, and any employee’s family members) covered under the employer’s health plan, if the plan is "self-insured." A date of birth will be entered in column (c) only if an SSN (or TIN for covered individuals other than the employee listed in Part I) is not entered in column (b). Column (d) will be checked if the individual was covered for at least one day in every month of the year. For individuals who were covered for some but not all months, information