HR Partners

What You Need to Know About the Form 1095-C

News from January 13, 2017

This coming tax season, most Penn faculty and staff members will receive an IRS document called Form 1095-C. Required by the Affordable Care Act, Form 1095-C includes information about the health insurance coverage offered to you by Penn.

You will receive this form if you:

  • worked as a full-time benefits-eligible staff or faculty member in 2016, even if you have not enrolled in a Penn plan;
  • are a part-time benefits eligible staff or faculty member enrolled in a Penn benefit plan at any point in 2016,
  • or you worked at Penn an average of 30 or more hours per week in 2016 and were offered ACA benefits coverage.

The 1095-C form will be mailed to you on or before January 31, 2017. Your form will also be available online on or before January 31, 2017 in the My Pay section of the secure U@Penn portal at Select “My 1095-C form” to access yours.

If you have questions about your form, call Equifax at 1- 855-823-3728. Employer name or code is 10476.

If you receive a Form 1095-C from Penn, be sure to keep it for your records. You don't need the Form 1095-C to file your taxes.  Like last year, you'll need to indicate on your tax return if you had qualifying health coverage. 

If your family members–adult children under age 26, for example– are covered under a Penn healthcare plan, they may also need a copy of your Form 1095-C for their tax returns.

Your Form 1095-C will contain details about your eligibility for Penn health plans. The form will also provide information for each of your family members enrolled under your Penn benefit plan. The IRS will use the information from 1095-C to determine who will need to make a Shared Responsibility Payment for failing to have healthcare coverage as required by the Patient Protection and Affordable Care Act.

If you worked for other employers during 2016, or had other sources of coverage in 2016, you may receive similar forms from them as well.

For detailed information and updates about Form 1095-C, visit and the IRS Affordable Care Act Tax Provisions for Individuals and Families webpages.