FAQs About ACA Forms for Employees

Not necessarily! You need the information on Form 1095-C or B, rather than the form itself, to determine whether you had minimum essential coverage for the entirety of the year. In place of the form, you can use other sources of information (examples here) to determine whether you can claim full-year coverage.

No. You don't need to send proof that you had health insurance coverage to the IRS with your return. However, you should keep any documentation with you other tax records. This includes records of your family’s employer-provided coverage, premiums paid, and type of coverage.

If you received one or more Forms 1095-A, you'll use the information on the form(s) to determine whether you (and your family) had minimum essential coverage that met the shared individual responsibility provision for the entire year. If so, you can check the full-year coverage box on your personal return. If not, you may claim an exemption or make an individual shared responsibility payment.

You'll also use it to complete Form 8962, Premium Tax Credit (PTC) in order to claim the premium tax credit or to reconcile advance credit payments on your federal tax return.

If you received one or more Form(s) 1095-B, you'll use it the form(s) to determine whether you (and your family) had minimum essential coverage that met the shared individual responsibility provision for the entire year. If so, you can check the full-year coverage box on your personal return. If not, you may claim an exemption or make an individual shared responsibility payment.

If you received one or more Form(s) 1095-C, you'll use the form(s) to determine whether you (and your family) had minimum essential coverage that met the shared individual responsibility provision for the entire year. If so, you can check the full-year coverage box on your personal return. If not, you may claim an exemption or make an individual shared responsibility payment. You'll also use Form 1095-C to help determine your eligibility for the premium tax credit.

If you haven't received your Form 1095-B or C before filing your return, you can rely on the coverage information provided by your employer to determine your eligibility for the premium tax credit and to determine whether you received minimum essential coverage. Other forms of documentation that would provide proof of insurance coverage include:

  • insurance cards

  • explanation of benefits (EOB)

  • statements from the insurer

  • W-2 or payroll statements reflecting health insurance deductions

  • records of advance payments of the premium tax credit

  • other statements indicating that you, or a member of your family, had health care coverage

There's no need amend or submit additional materials (e.g., if the Form is received) after the return is filed.

For more information, see this IRS article.

Once your primary administrator generates and approves your company's Forms 1095-C, you can download a PDF of the form by logging in to Zenefits, then clicking on the Personal Information app. Then, click Documents from the left-side menu and find the form in the list of documents.

What if I don't see the form there?

  • Your primary administrator may not have completed the necessary prework required for the form distribution yet.
  • Your company may not be eligible to complete and distribute Form 1095-C. If they aren't considered an AALE, you won't see a 1095-C in your account.

Where can I find a form from a previous year?

  • If your company has been with Zenefits for multiple years of ACA filing, only the most recently completed 1095-C will be available.
  • For example, if your company completed ACA filing for 2018  and 2017, only the 2018 Form 1095-C will be available in your Documents section.
  • To receive a previous year's 1095-C, please contact Zenefits Customer Care and we would be happy to send to you.

You can find the number of months for which you had coverage for a given year on Form 1095-B or 1095-C, or by contacting your HR administrator.  Zenefits does not currently list this number in your profile.

Form 1095-A will be mailed out and/or made available online for individuals who purchased coverage through the state Marketplace (state insurance exchange). If you purchased your coverage through your state's Marketplace, but didn't receive a 1095-A (or lost it), you can visit the Marketplace website from which you purchased the plan (or call the Marketplace's support center) and see if the 1095-A is available to download.

The 1095-B form is generated by medical insurance carriers and used to report enrollee coverage status to the IRS. Your 1095-B  form will indicate the months that you met the minimum essential coverage for the previous tax year.

Carriers send 1095-B forms directly to enrollees, so brokers do not have access to these forms. If you did not receive your 1095-B form in the mail you can get your form either through the carrier portal or by calling the carrier and requesting a new form.

How can I contact the carrier?

The phone number for your insurance carrier's Member Services department can always be found on your medical ID card.

Alternatively, from your Medical Overview page in Zenefits we provide contact information for each carrier on the right panel. Select "Member Services & Claims Info" and the panel will expand to reveal carrier contact information.

Any employee who was a full-time employee of an Applicable Large Employer for any month of the calendar year, or any employee who is enrolled in an Applicable Large Employer’s self-insured health plan, should receive Form 1095-C.

If your company’s plans are self-funded or level-funded, Part III should be filled out with the covered individuals.  Part III will only include the employee and dependent(s) who enroll in the self-insured health coverage.

A company that offers coverage to an employee other than under its own self-insured health plan, such as through an employer-sponsored insured health plan, will not have any information entered into Part III. 

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