Fill out Form 1095-C Online in 2026

What is Form 1095-C?

Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, is the form applicable large employers use to report, month by month, the health coverage they offered each full-time employee and, for self-insured plans, who was covered.

Who needs to file Form 1095-C?

Employers with 50 or more full-time employees, counting full-time equivalents, file one for each person who was a full-time employee in any month. Employers with self-insured plans also complete Part III for everyone enrolled.

How to fill out Form 1095-C?

1. Open the 1095-C in the Profi PDF editor.

2. Part I: enter the employee's name, SSN and address, and your name, EIN, address and contact phone number. Add the plan start month.

3. Line 14: enter the offer of coverage code, for all 12 months or month by month.

4. Line 15: enter the employee required contribution for the lowest-cost self-only plan, where the line 14 code calls for it.

5. Line 16: enter any safe harbor or relief codes.

6. Line 17: enter the ZIP code used for an individual coverage HRA, if you offered one.

7. Part III (self-insured plans only): list each covered person and the months they were covered.

8. Download the form, give the employee their copy, and file it with the IRS along with Form 1094-C.

Complete your Form 1095-C now!

Report the coverage you offered each employee, month by month

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When is Form 1095-C due?

Employees must get their copy by early March of the following year (March 2 in recent years). The IRS filing is due February 28 on paper or March 31 if you file electronically.

Where do I file Form 1095-C?

With the IRS, together with the transmittal Form 1094-C. You must file electronically through the IRS AIR system if you file 10 or more information returns in total; otherwise you can mail it to the address in the instructions. Profi PDF helps you fill out the form; it doesn't file it for you.

Do I need to sign Form 1095-C?

No. The 1095-C has no signature line; the employer signs the transmittal Form 1094-C.

When is Form 1095-C not required?

Employers with fewer than 50 full-time employees don't file it (unless they have a self-insured plan, which reports on Form 1095-B). Large employers don't file one for an employee who was never full-time in the year and wasn't enrolled in a self-insured plan.

How to get a blank Form 1095-C?

The editor opens with the 2024 Form 1095-C loaded. Make sure you use the form for the year you are reporting.