2025 IRS Form 1095-C Request
Current or former employees who were eligible for employer-provided health coverage may request a copy of their IRS Form 1095-C by contacting:
Requests should include
- Employee’s full legal name,
- Last four digits of the Social Security number (or employee ID)
- Approximate dates of employment
- Current mailing address and phone number
By submitting a request by email, the individual consents to receive the IRS Form 1095-C electronically unless a paper copy is requested.
Please allow up to 30 days for fulfillment.