1095-C REQUEST FORM

The Affordable Care Act (ACA) requires certain employers, such as the South Limestone Hospital District, to offer health insurance coverage to all full-time employees and their dependents. Form 1095-C includes information about the health insurance coverage offered to employees by the South Limestone Hospital District. Changes to Reporting Requirements Recently, the Paperwork Burden Reduction Act (HR 3797) modified requirements of the Affordable Care Act (ACA) to reduce the administrative burden of ACA reporting requirements on employers. As a result, employers are no longer required to mail the Form 1095-C to all employees. The 1095-C Tax Form is NOT required to complete your tax return! The Form 1095-C is not required to complete your tax return. Your tax preparer may request a copy of your Form 1095-C, but if you inform your tax preparer regarding the months you had coverage during the calendar year, they do not need to receive a copy of this form. How to Request a 1095-C Statement If you want to receive a copy of your most recent tax year Form 1095-C, you may request it by completing the 1095-C Request Form and submitting it via email to hrgroup@lmchospital.com Please allow 10 business days for processing plus delivery time.