The Office of the Comptroller will mail paper Forms 1095-C (Affordable Care Act) by the end of February.
Forms 1095-B and 1095-C should be kept with tax records. Do not submit them to the IRS or Massachusetts Department of Revenue.
State employees can suppress their paper Form W-2 and Form 1095-C through HR/CMS Self-Service Time and Attendance.
Going paperless helps employees get their forms faster, and is more secure. In addition, this saves the Commonwealth money and is environmentally friendly. View instructions on Mass.gov.
Part I – Employee: Employees assessed ACA full-time, including from Commonwealth of Massachusetts, University of Massachusetts, MBTA, or MSBA are listed under the Applicable Large Employer.
Part I – Employer: Employer information including Tax ID for Commonwealth of Massachusetts, MBTA or MSBA
Part II Employee Offer of Coverage:
Employee’s Age on January 1: Not applicable. The Commonwealth of Massachusetts does not offer plans with Health Reimbursement Arrangement (HRA)
All 12 Months: If the reporting value for you was unchanged throughout the year, then you will have a single value for the year.
Line 14 -Employer’s Offer of Coverage: codes reporting.
Line 15 – Employee Required Contribution: The lowest cost of Commonwealth Heath Plan available to you, not the cost of coverage you chose, if any.
Line 16 – Section 4980H Safe Harbor and Other Relief: The determination of a “Safe Harbor” of affordability, based on your rate of pay, not your annual pay.
Line 17 – Zip Code: Not applicable. The Commonwealth of Massachusetts does not offer plans with Health Reimbursement Arrangement (HRA).
Part III – Covered Individuals: This part will be blank. This data will be included on the Form 1095-B, available upon request.
If you were determined to be a full-time employee of the Commonwealth of Massachusetts, the Massachusetts Bay Transit Authority (MBTA), or Massachusetts School Building Authority (MSBA) under the Affordable Care Act (ACA) rules, you will receive a Form 1095-C.
The Affordable Care Act requires Applicable Large Employers having more than 50 full-time employees working an average of 30 or more hours per week to be provided this form.
There are other IRS tax forms that are similar to Form 1095-C that you may request:
Please Note: All above forms should be kept with tax records. Do not submit them to the IRS.
If you worked at more than one agency, municipality, or company, you may receive a Form 1095-C from each employer. For example, if you changed jobs during the year and were enrolled in coverage with both employers, you should receive a 1095-C from each employer.
Please note: If you work for more than one job at the Commonwealth of Massachusetts (including working for one or more agency or institution of higher education), you will receive one Form 1095-C that will be inclusive of all your jobs with the Commonwealth. If you worked for the MBTA, MSBA, and the Commonwealth, each considered a separate employer, you may receive three forms.
Keep this form with the materials you give to your tax preparer. If you prepare your own taxes, you will need to refer to this information as you prepare your federal return. Do not include it with your filing to the IRS.
There are three parts to the form:
If you have questions about your Form 1095-C (the offer of health insurance coverage) issued by the Commonwealth of Massachusetts (including institutions of higher education), the MBTA, or MSBA, call your human resources department.
If you have any questions about the Form 1095-B (offer of health insurance coverage) from the GIC, please see the Form 1095-B FAQs at mass.gov. You can also visit the IRS website.
The Form 1095-B (Offer of Health Insurance Coverage) will no longer be automatically mailed by the Group Insurance Commission (GIC). For more information please visit see the GIC's page.
VISIT MASS.GOV
