In the coming weeks, UC employees and retirees will receive forms verifying their health coverage for 2016 – one of the requirements of the Affordable Care Act (ACA).  You can read the details on UCnet and follow up with these FAQs.

IRS Form 1095

IRS Form 1095

Why am I getting this form?

The Patient Protection and Affordable Care Act (ACA) requires every U.S. Citizen, or resident alien to have health insurance coverage. If an individual does not have health insurance, or a health coverage exemption, they will be required to pay an individual shared-responsibility payment or “penalty”. This penalty is assessed and deducted when the individual files his/her income taxes. IRS Form 1095 allows an individual to submit proof of having health insurance coverage, thus eliminating the potential of this penalty. Depending on the type of coverage you have, you may receive one or more of Form 1095-B or 1095-C; all of them accomplish the same purpose.

Who will send me this form?

As a full-time employee or as a member of one of UC's self-insured medical plans, you will receive this form from UnifyHR, on behalf of the University of California. UC has engaged Unify HR to produce and mail the Form 1095 from data provided by UC.

If you’re enrolled in one of UC’s insured plans (Health Net Blue & Gold, Kaiser, WHA, UC Health Savings Plan), you'll receive the form from your plan. If you're in Medicare, you may receive the form from CMS (Centers of Medicare and Medicaid Services).

Why is Form 1095 important?

IRS Form 1095 includes information that will identify which months an employee and any dependents were offered health coverage and whether that coverage met the ACA requirements. Coverage that meets the ACA requirements is called Minimum Essential Coverage (MEC). The Form 1095 also shows the months for which the individual and enrolled dependents participated in health coverage.

Do I need to wait until I receive this form to complete my taxes?

You do not need to wait for Forms 1095-B or 1095-C in order to file your taxes. The IRS has confirmed that you can use other information about your health insurance to verify that you have the coverage you need when preparing your returns. You do not need to submit a copy of the 1095 form with your individual income tax return.

However, just as it is critical to keep other important tax documents, you should retain the Form 1095 in the event it is needed to provide proof of coverage in response to any future IRS inquiries.

If you are expecting to receive a Form 1095-A, sent to individuals who enrolled for health coverage through the Health Insurance Marketplace (in California, Covered California), you should wait to file your 2016 income tax return until you receive that form.

How many of these forms will I receive?

UC employees who worked for more than one campus or more than one employer during the course of the tax year may receive more than one Form 1095-C. Employees who are enrolled in fully insured plans (all plans except Core and UC Care) will also receive a Form 1095-B from their insurance plan.

Additionally, if you retired from UC during the tax year and now have retiree coverage, you may receive more than one form. UC retirees with UC retiree insurance who were on Medicare for any part of the tax year may not receive a form for those months, as CMS (Centers of Medicare and Medicaid Services) is the responsible reporting entity for Medicare plans and it is only reporting to certain Medicare beneficiaries.

Why are my covered family members listed in Part III of Form 1095-C, but my co-worker’s are not?

Part III of the 1095-C is only populated for each month you and/or your dependents were enrolled in UC-sponsored, self-insured health coverage, such as UC Care or Core. Family members of those enrolled in other plans will be listed on Form 1095-B from the insurance plan.

Why aren’t my family members listed on my 1095-C?

Family members are only listed on the 1095-C for employees in self-insured plans (UC Care and Core). For those in insured plans (Health Net, Health Savings Plan, Kaiser, WHA) the family members are listed on the 1095-B form which you received from your plan. Therefore, a 1095-C without family members is correct if the employee is enrolled in an “insured” plan.

What if I need to make a change to my Form 1095 information or have questions?

If you think information about your UC-sponsored plan on your Form 1095 is incorrect, please contact your location’s Benefits department to find out how to get a corrected Form 1095. If you are a retiree, please contact RASC at 800-888-8267. For more information about Form 1095, you can also read FAQs available on irs.gov.

Will UC be filing the 1095 data with the IRS?

UC is required to transmit the 1095 information to the IRS — the employer filing is due March 31. Therefore, if corrections need to be made, the changes should be made in PPS/UCPath/Retiree Insurance, as well as a new 1095 issued. Going through the correction process for the 1095 will ensure the employee has an accurate form and that the employer transmittal is correct.

Why does my 1095 form from UC have a return address in Texas?

The vendor that UC used to print and mail its 1095 forms is called UnifyHR and it is located in Texas. The actual envelopes are being postmarked from St. Louis, Missouri.

I’m a UC retiree in UC Care and I cover my spouse, who is eligible for Medicare and enrolled in the Medicare PPO. Why is (or isn’t) my spouse listed on the 1095-B form I received from UC?

Anyone with Medicare coverage will receive his or her 1095 form from Centers of Medicare and Medicaid Services (CMS). However, CMS is only reporting to certain Medicare beneficiaries. See Medicare and the Marketplace on CMS.gov for more information.  

I’m a UC retiree and I had coverage all year, but my 1095-B only shows me enrolled in UC Care through March — why is it wrong? I became eligible for Medicare and was in the UC Medicare PPO starting in April through the end of 2016.

The 1095-B only reports membership in UC Care. If an individual transitioned to Medicare mid-year, the Medicare plan enrollment should be reported by Centers of Medicare and Medicaid Services (CMS).