Form 1095-C and Premium Tax Credit Eligibility

• Dan O'Donnell
• February 24, 2025
• 6 min read

Form 1095-C reports an employer’s health coverage offer and, in some cases, actual enrollment. It can help determine whether you or a family member qualify for a Marketplace premium tax credit. Receiving the form does not by itself establish or eliminate eligibility.

Who receives Form 1095-C?

Applicable large employers generally have at least 50 full-time employees, including full-time equivalents, in the preceding year. They report offers of coverage for full-time employees. Employers with self-insured plans also report covered individuals under the applicable rules.

For 2025 coverage, the general furnishing date was March 2, 2026. Employers may use an alternative notice-and-request method if they meet IRS conditions, so you may need to request your copy. Keep it with your records; do not attach it to your federal return. You generally do not have to wait for it to file if you have the information needed to prepare an accurate return.

Read the coverage offer correctly

• Part I: Employee and employer identifying information.
• Part II, line 14: Codes describing the coverage offer for each month.
• Line 15: The employee contribution for the applicable lowest-cost self-only coverage, when required. It may differ from the premium you actually chose to pay.
• Line 16: Codes used for employer shared responsibility reporting. Employer safe harbors do not replace the household-income test for your Marketplace credit.
• Part III: Covered individuals when the employer provides self-insured coverage.

Use the IRS Form 1095-C instructions to interpret your specific codes.

2025 and 2026 affordability thresholds

For plan years beginning in 2025, employer coverage is generally affordable if the required contribution does not exceed 9.02% of household income. For plan years beginning in 2026, the percentage is 9.96%. The offer must also provide minimum value to block a premium tax credit on that basis.

The employee test generally uses the employee’s cost for qualifying self-only coverage. Since 2023, affordability for family members uses the relevant family coverage cost. An affordable self-only offer does not automatically make family coverage affordable. Form 1095-C may not provide all family-premium information, so ask the employer for that amount.

What if you also have Marketplace insurance?

Check eligibility month by month. Enrollment in employer-sponsored minimum essential coverage generally prevents a Marketplace credit for the same person and month. Declining affordable coverage that provides minimum value can also prevent a credit.

If advance credits were paid, use Form 1095-A and Form 8962 to reconcile them. Excess advance credits can create tax owed. For tax years after 2025, the previous income-based repayment caps no longer apply. See the IRS premium tax credit questions and answers.

Correct errors before relying on the form

Contact the employer if coverage months, identifying information, or offer details are wrong. Keep supporting records. For the distinctions among coverage forms, see Form 1095-B reporting and our ACA tax and premium credit guide.