1095 – C Form

Customizable form for 1095 – C. Complete the form directly from your tablet or smartphone, and send it via email (or you can print it too!) when you’re done.

Form 1095-C, Employer-Provided Health Insurance Offer and Coverage Insurance, provides you with information about the health coverage offered by your employer. In some cases, it may also provide information about whether you enrolled in this coverage.

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