This version of the form is not currently in use and is provided for reference only. Download this version of
IRS Form 1095-C
for the current year.
IRS Form 1095-C Employer-Provided Health Insurance Offer and Coverage
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What Is IRS Form 1095-C?
This is a tax form that was released by the Internal Revenue Service (IRS) - a subdivision of the U.S. Department of the Treasury. Check the official IRS-issued instructions before completing and submitting the form.
Form Details:
- A 4-page form available for download in PDF;
- This form cannot be used to file taxes for the current year. Choose a more recent version to file for the current tax year;
- Additional instructions and information can be found on page 2 of the document;
- Editable, printable, and free;
- Fill out the form in our online filing application.
Download a fillable version of IRS Form 1095-C through the link below or browse more documents in our library of IRS Forms.
Download IRS Form 1095-C Employer-Provided Health Insurance Offer and Coverage