This anatomy is for advisory purposes only. You may charge advice provided on this anatomy to abetment the IRS in free whether you are acceptable for a exceptional tax acclaim for purchasing alone bloom advantage through Covered California.
Under the ACA’s Employer Shared Responsibility accouterment (known as the employer mandate), the Accompaniment of California is appropriate to action affordable bloom advantage that provides minimum bulk to its full-time advisers and their abased accouchement to abstain a penalty. To authenticate compliance, the accompaniment charge book anniversary letters with the IRS and accouter a statement, IRS Anatomy 1095-C, by January 31 of anniversary year to full- time advisers with advice about the bloom advantage that was offered, if any, to the agent and their abased children.
The IRS will use advice appear on this anatomy to actuate if the accompaniment is acknowledging with the ACA’s employer authorization or accountable to a penalty.
You accustomed this anatomy because you were advised a full-time agent for ACA advertisement purposes for one or added months during the above-mentioned agenda year.
The ACA defines a full-time agent as any agent who averages 130 or added hours of account per month. The accompaniment is application a 6-month altitude aeon to boilerplate an employee’s hours of account to actuate their full-time cachet for ACA advertisement purposes.
If you were appointed to a position with a time abject of 3/4 or more, you should accept this form. Additionally, if you were appointed to an alternate time abject and averaged 130 or added hours of account per ages during one of the CSU’s 12-month altitude periods, you should accept this form, behindhand of whether you were acceptable for state-sponsored bloom coverage.
This anatomy was provided by your employer, the Accompaniment of California, because you were advised a full-time agent for ACA advertisement purposes for one or added months during the above-mentioned agenda year.
Information about the accompaniment employer’s action of bloom coverage, if any, to you, your apron and your abased accouchement is appear for anniversary ages during the above-mentioned agenda year in Part II of this form. This advice will advice the IRS actuate if the accompaniment is acknowledging with the ACA’s employer authorization and if you are acceptable for a exceptional tax acclaim if you acquirement alone bloom advantage through Covered California.
The codes on Line 14 reflect the blazon of bloom advantage offered, if any, to you, your spouse, and abased accouchement for anniversary ages during the above-mentioned agenda year. The accompaniment will address codes 1E or 1H on Line 14 of the form.
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The dollar amounts on Line 15 reflect your allotment of the everyman bulk account exceptional for self- alone advantage accouterment minimum bulk offered by the accompaniment (health exceptional bare your corresponding employer health/CoBen addition for self-only coverage). This bulk may not reflect the bulk you absolutely paid for bloom advantage if you chose to accept in added big-ticket coverage, such as a altered plan, two-party or ancestors coverage.
The dollar amounts on Line 15 may additionally reflect the abounding exceptional for self-only COBRA advantage (for the plan in which you were acceptable to enroll) for the month(s) you were offered/eligible for COBRA coverage, or the abounding exceptional for self-only advantage for the month(s) in which you were acceptable for or enrolled in bloom advantage but were not accepting the employer addition appear the bulk of coverage, for example, if you were on Direct Pay.
The IRS will use advice appear on Line 15 to actuate if the bloom advantage offered by the accompaniment meets the ACA’s affordability standards.
The codes on Line 16 accommodate advice to the IRS to actuate if the accompaniment is in acquiescence with the ACA’s employer authorization or accountable to a penalty.
Part III of the anatomy is bare because the accompaniment does not accommodate self-insured bloom coverage. Instead, you will accept a Anatomy 1095-B from your bloom advantage provider, if applicable, with advice about the individuals who were enrolled in minimum capital advantage for at atomic one day during the above-mentioned agenda year.
If you did not accept this form, you were not advised a full-time agent for ACA advertisement purposes for any ages during the above-mentioned agenda year.
You should acquaintance the Human Resources Office at (530) 898-5436 if any advice appear on the anatomy is incorrect.
You should acquaintance the Human Resources Office at (530) 898-5436 to abetment in requesting a alike anatomy 1095-C account from the Accompaniment Controller’s Office.
You should acquaintance Campus Allowances Office with questions or appointment www.irs.gov/affordable-care-act.
California Accompaniment University, ChicoBenefits [email protected](530) 898-5436
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