SUBJECT:

IRS 1095-B and 1095-C Forms

Beginning with tax year 2015, a new IRS Form 1095 was required by the Affordable Care Act (ACA).

There may be confusion regarding the difference between the 1095-B and 1095-C Forms, therefore, the below information is provided for clarification. You may receive one or more copies of these forms for your records; however, you are not required to include the forms with your tax return.

1095-B (Health Coverage): You will receive this form from your insurance plan regarding the minimum benefits that you or your dependents were eligible to receive.

1095-C: (Employer Provided Health Insurance Offer of Coverage): This form has relevant information regarding coverage offered to you for your dependents whether or not you took advantage of the offer.

Please contact your insurance plan directly if you have any questions regarding the 1095-B Form. Their telephone number is listed on the form. Any questions regarding the 1095-C Form should be directed to (858) 534-2816 for Campus employees and (619) 543-3200 for UCSD Health employees (Health System and Health Sciences). You may also contact the IRS for more information about the both forms at https://www.irs.gov

Pierre Ouillet Vice Chancellor and Chief Financial Officer Cheryl A. Ross Controller/Assistant Vice Chancellor Business & Financial Services Janet Kamerman Assistant Vice Chancellor - Health Human Resources