Health Care Reform

Affordable Care Act Tax Forms 1095 Are Here!

The Affordable Care Act, ACA, includes both an individual mandate and an employer mandate. The individual mandate requires that most Americans have qualifying healthcare coverage or potentially face a fine. The employer mandate requires employers with 50 or more full-time equivalent employees to offer healthcare coverage to their full-time employees or potentially face a fine. In order to verify individuals have the required health coverage, several new tax reporting forms have been created. 

Much like the Form W-2 is used to determine whether or not you owe taxes, the IRS will use the information reported from your Form 1095-C to determine whether you (or TSRI, your employer) may have to pay a fine for failing to comply with the Affordable Care Act. Think of the form as your “proof of insurance” for the IRS. Form 1095-C is used by employers to report information regarding the coverage offered to employees and whether or not a person chose to participate in the coverage.  All TSRI benefit eligible participants will receive a 1095-C form which will reflect an offer of coverage was made and meets the health care reform requirements regarding affordability.  In addition, the form will indicate whether or not the coverage was elected.

Form 1095-B is used by health insurance providers of fully insured coverage to report the type of health coverage, the dependents covered and the period of coverage on the plan.  If you are enrolled in the Aetna HMO plan in California, you will receive a 1095-B form from Aetna.  This will be in addition to the 1095-C form you will receive from TSRI.

Together, these forms will provide details to any health coverage you had in 2015 through TSRI.  You will need this information to file your 2015 income tax return. It is our understanding individuals do not need the actual form in hand in order to complete tax filings.  If you are enrolled in TSRI coverage, you can indicate your months of coverage by self-reporting on your tax forms.  In addition, all of TSRI’s medical plans offer minimum essential coverage and meet affordability requirements under the Affordable Care Act rules.  Generally, you will not need to attach the form to your return, but it should be kept with your records. 

TSRI works with American Technology Solutions, Corp. (ATS), a third party vendor to create the 1095-C forms.  Usually, the 1095 forms must be sent to employees by February 1st.  As this is the first year employers are required to provide the forms to employees, an extension was granted to March 31st.  However, we anticipate the 1095-Cs will be sent by mail the middle of March. We will send further notification once we have a confirmed mailing date.  Aetna has indicated they sent out the 1095-B forms by February 1st.   

ATS also has a website employees may access to print the 1095-C as often as necessary and before the forms may arrive by U.S. Mail.  You may also consent to have your 1095-C sent electronically in future years once you login into ATS’s website.  The Forms are available to download electronically effective March 10, 2016.

Helpful FAQs and a link to obtain your form through ATS’s website can be found to the right of this page under "Information".  If you have any questions regarding the Form 1095s, please contact Human Resources, Benefits Administration at 858-784-8487 or benefits@scripps.edu.


2022 Summary of Benefits and Coverage

 Glossary of Health Coverage and Medical Terms 

Comprehensive (PPO) Medical Plan 

High Deductible PPO Medical Plan with HSA 

High Deductible PPO Medical Plan with HRA 

California HMO Medical Plan- English Version 

Florida EPO Medical Plan 

TSRI Graduate Student Medical