IRS Form 1095-C

2025 Printable Template

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Form last updated: 03/2024. Please verify this is the current version before use.

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What is a 1095-C used for?

Form 1095-C is used by Applicable Large Employers (ALEs) to report information about health insurance coverage offered to their full-time employees. It helps the IRS determine compliance with the Affordable Care Act's employer mandate and assists employees in determining their eligibility for the premium tax credit.

Who needs to fill out a 1095-C form

Applicable Large Employers (ALEs) with 50 or more full-time employees must complete this form for their full-time employees.

How to fill out a 1095-C online?

Follow these steps to complete your 1095-C form online.

Step 1
Step 1
Access the form in the PDF editor without uploading.
Step 2
Step 2
Fill in the employee's personal information in Part I.
Step 3
Step 3
Provide employer details including address and EIN.
Step 4
Step 4
Report health plan details in Part II.
Step 5
Step 5
Specify eligible months for coverage.
Step 6
Step 6
Include information about covered family members in Part III, if applicable.
Step 7
Step 7
Download the completed form as a PDF.
IRS Form 1095-C Instructions

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Frequently Asked Questions

Find quick answers to common questions about our PDF editor.

Form 1095-C is a document that outlines the health insurance coverage offered by large employers to their full-time employees.

This form is necessary for verifying your health insurance coverage when filing your taxes and determining eligibility for the premium tax credit.

Employers must provide Form 1095-C to employees by the applicable return due date, and file with the IRS by the applicable deadline for paper or electronic submissions.

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