Affordable Care Act | 1095-C

The Patient Protection and Affordable Care Act, known as the "Affordable Care Act" (ACA), has three stated objectives: to increase healthcare accessibility, affordability, and quality.

The Affordable Care Act implemented and enforces the individual responsibility (also known as "Individual Mandate") and the employer shared responsibility (also known as "Play-or-Pay") provisions to support these objectives.

Essentially, the State of Arizona is subject to a penalty under the ACA Employee Shared Responsibility if it:

  • Fails to offer any full-time employee (and their dependents) the opportunity to enroll in minimum essential coverage (MEC); or
  • Fails to offer a full-time employee (and their dependents) coverage that is either affordable or does not provide minimum value; or
  • Fails to report information on 1094/1095 statements properly.
     

This page is intended to be an ACA resource for State Agencies and employees to assist in ensuring the State remains compliant.

AFFORDABLE CARE ACT GENERAL NOTICE

  • The Affordable Care Act (ACA) requires most Americans to have health insurance or face a penalty. It also mandates that employers, including the State of Arizona, offer full-time employees and their dependents health insurance.

    The State of Arizona will send a 1095-C statement to eligible employees to document the insurance coverage offered. The IRS uses this form to verify your health care coverage.

    1095-C statements will be mailed to employees' home addresses by January 31 each year. If you haven't received yours by March 1, contact Benefits Services at [email protected].

    To ensure timely receipt, keep your address updated in hrsystems.az.gov > Y.E.S. Portal.

    For questions about your 1095-C, contact the Benefits Services Division at [email protected]. For tax-related inquiries, consult your tax adviser.

  • Legal Notice
  • IRS Website - ACA Tax Provisions for Individuals and Families

AFFORDABLE CARE ACT FREQUENTLY ASKED QUESTIONS | FAQ

What is Form 1095-C?
Form 1095-C provides details about your health care coverage under the Affordable Care Act. It serves as proof of insurance for the IRS and includes coverage information and dependents.

How to Request Additional Copies
Submit a reprint request form after March 1.

Who Receives Form 1095-C?
Full-time employees (30+ hours per week) or those enrolled in ADOA health benefits will receive this form, including retirees and COBRA participants.

Why Did I Receive Form 1095-C?
You will receive this form if you were full-time or enrolled in ADOA health insurance during the tax year.

Why Did I Receive More Than One Form?
If you worked for multiple employers, you may receive a separate form from each, such as if you worked at Arizona State University and another State agency.

Why Didn’t I Receive Form 1095-C?
If you worked less than 30 hours per week or weren’t enrolled in ADOA health coverage, you won’t receive a form.

When Will I Receive My 1095-C?
Forms will be mailed by January 31 to the home address on file. If you haven’t received it, contact Benefits Services or submit a reprint request form after March 1.

Where Will It Be Mailed?
The form will be mailed to the address on file in HRIS/YES as of January 15. Update your address by logging into hrsystems.azdoa.gov > Y.E.S. Portal > Bookmarks > Personal Information > Contact Information.

What Should I Do with the Form?
Keep the form for your records. You may need to provide it to the IRS as proof of insurance.

What Information Is on Form 1095-C?

  • Part I: Your information and the State of Arizona.
  • Part II: Coverage details, affordability, and eligibility.
  • Part III: Covered individuals, including dependents.

Will My Dependents Receive a 1095-C?
No. Only the primary insured will receive the form. Provide dependents with a copy for their tax records if needed.

How Will This Affect My Taxes?
If you didn’t have coverage and don’t qualify for an exemption, you may face a fine. Any discrepancies between your report and your employer’s could delay your tax filing.

How Do I Know if I Qualify for a Premium Tax Credit?
Consult a tax adviser for eligibility.

What If There’s an Error on My Form?

  • Address Errors: Update your address in HRIS/YES. The form remains valid for tax filing, and you won’t receive a new one for address corrections.
  • Incorrect Dependent Information: Provide supporting documentation (e.g., birth certificate, social security card) for any name, social security number, or birth date changes.
  • Other Errors: Contact ADOA Benefits Services at [email protected].

Additional Questions?
Contact the Benefits Services Division at [email protected]. For tax-related questions, consult your tax adviser.

PLEASE NOTE: These questions and answers are not intended to be tax advice. If you have any tax questions, you should contact your tax adviser.

  • The 1095-C statements are mailed annually in February.  
  • Please do not request a new form until March 1 to allow time for the postal service to deliver the form.

  • If you have general questions regarding ACA, please contact the Benefit Services Division at [email protected]