1095-C Information

The following information does not apply to temporary classified employees, student help employees, and most adjunct faculty.

Most employees who are eligible for Los Rios-sponsored health coverage will receive informational statements from Los Rios and/or their health plan carrier. These statements are copies of Forms 1095-C and 1095-B (or substitute forms).

Who Will Receive a Form 1095-C from Los Rios?

Employees who meet the Affordable Care Act (ACA) definition of a full-time employee will receive a Form 1095-C.

Since 2016, Los Rios has been required to report to the Internal Revenue Service (IRS) about the health coverage, if any, that we offer to our employees who meet the ACA definition of a full-time employee, generally defined as working 30 or more hours per week during the previous year. We are also required to provide an informational statement (Form 1095-C) to these employees about the information we will report to the IRS.

Who Will Receive a Form 1095-B from Their Health Plan?

All employees (subscribers) enrolled in a Los Rios health plan, regardless of full-time status, will receive a Form 1095-B. Since 2016, health plan carriers have been required to report to the IRS about the coverage provided to subscribers and their dependents during the previous year. Los Rios health plan carriers (Kaiser, Sutter Health Plus, and Western Health Advantage (WHA)) are also required to provide an informational statement (Form 1095-B) to each subscriber about the information they will report to the IRS.

When Will I Receive My Statements?

Generally, employers and health plan carriers must issue statements to you by the end of February for the prior tax reporting year.

Why Didn't I Receive Both Statements?

Employers will provide statements (1095-C) to full-time employees as defined in the law as working 30 hours or more per week. If you are not a full-time employee, you will not receive this statement, even if enrolled in a Los Rios health plan.

Health plan carriers will provide statements (1095-B) to each subscriber enrolled in a Los Rios health plan. If you are not enrolled in a Los Rios health plan, you will not receive form 1095-B from a Los Rios health plan carrier.

Must I Wait Until I Receive the Statement(s) Before I File My Federal Taxes?

No. You may not have received Form 1095-B or Form 1095-C by the time you are ready to file your federal tax return. While the information on these forms may assist in preparing a return, the forms are not required. You can prepare and file your federal return using other information about your health insurance. You should not attach either of these forms to your tax return.

Below is a sample 1095-C for a full-time employee who worked all 12 months and enrolled in Los Rios medical insurance (explanation of codes used on the form follows). (Log in to Employee Self-Service to access your 1095-C form.)

More Information About 1095 Statements

• Form 1095-C Column 14 Codes used by Los Rios:
  • 1E – Health coverage was offered to the employee, spouse, and dependents.
  • 1H – Health coverage was not offered.
• Form 1095-C Column 15 contains your share of the lowest cost monthly health plan premium available to you (usually $0.00 for Western Health Advantage 1800 HSA HMO), not necessarily the premium for the coverage in which you are enrolled.
• Form 1095-C Column 16 Codes used by Los Rios:
  • Blank – Employee was offered health coverage but waived the benefit.
  • 2A – Employee not employed any day of the month.
  • 2B – Employee was not a full-time employee that month.
  • 2C – Employee elected health coverage.
  • 2D – Employee is in a "non-assessment" period. This code is used for the new hires in their first month unless health coverage was offered that month, and for employees with variable hours in a "measurement period" used to determine part-time or full-time status.

Form 1095-C Part III will be blank. The health plan carrier will report actual enrollees, including dependents, on Form 1095-B.

Form 1095-B may be used to show that you meet the ACA's individual mandate regarding health coverage and should be retained with your income tax records. Visit IRS.gov for questions and answers related to Forms 1095-C and 1095-B.