Paperwork Reduction Act – Notice of Right to Request Form 1095-C

This notice is provided to inform current and former staff members of their right to request a Form 1095-C for the 2025 tax year, delivered via USPS mail.

The Paperwork Reduction Act amended the Affordable Care Act (ACA) to remove the requirement for employers and health insurance providers to automatically mail Form 1095-C to employees and covered individuals. Forms are now mailed upon request only.

What Is Form 1095-C?

Form 1095-C is an IRS tax form that reports information about health insurance coverage offered by an employer. It helps you and the IRS determine:

• Whether you were offered employer-sponsored health coverage

• Whether you may be eligible for a premium tax credit

• Whether your employer met ACA coverage requirements

You are not required to file Form 1095-C with your tax return. Keep it with your tax records. You may need it if you enrolled in Marketplace coverage, but it is generally not attached to your tax return.

How to Access or Request Your 2025 Form 1095-C

Form 1095-C is in Paycom under Payroll – Year-End Tax Forms and can be downloaded and printed directly from there without delay.

To request a copy of your Form 1095-C be mailed to you via USPS, or if you have questions regarding this notice, please contact: