February 22, 2016 FAC/STAFF

---

Affordable Care Act Notice

Affordable Care Act Notice: Form 1095-C “Employer-Provided Health Insurance Offer and Coverage”

Last month, full-time benefit-eligible employees were notified that they would be receiving the new form 1095-C “Employer-Provided Health Insurance Offer and Coverage.” Within the next few days, this form will be sent to eligible employees via US Mail. The information on this form verifies that you, your spouse and any dependents had coverage for each month of 2015. If you and your family members had minimum essential coverage for every month of the year, you will check a box on your 2015 tax return to report that coverage. If there are months when you or your family members did not have coverage, you will determine if you qualify for an exemption or must make an individual shared responsibility payment.

Please contact your accountant or financial advisor for assistance in filing your tax return, but if you believe information contained on the forms is incorrect or incomplete, please contact Ryan Armsworthy in the Human Resources Department at 216.397.1576.

For a further explanation of this tax form, please refer to the HR website: http://sites.jcu.edu/hr/2015/12/01/important-new-tax-reporting-requirement-under-the-affordable-care-act-aca/.

Or to the IRS website: https://www.irs.gov/Affordable-Care-Act/Questions-and-Answers-about-Health-Care-Information-Forms-for-Individuals