Form 1095-C

Information Reporting by Applicable Large Employers on Health Insurance Coverage Offered Under Employer-Sponsored Plans

OMB: 1545-2251

IC ID: 214082

Documents and Forms

Document Name Document Type
Form Form 1095-C Form 1095-C Form
Form 1095-C Employer-Provided Health Insurance Offer and Coverage 2023 Form 1095-C.pdf Form
2023 Instructions for Forms 1094-C and 1095-C.pdf Instruction