Form 1095-C is a document WVU Medicine employees will need to submit with their tax return. It will be generated for tax year 2015 because WVU Medicine is an applicable large employer subject to the employer shared responsibility provision in the Affordable Care Act.

Form 1095-C includes information about the health insurance coverage offered to employees and their dependents by the employer. If you purchased health insurance coverage through the Health Insurance Marketplace and wish to claim the premium tax credit, this information will assist you in determining whether you are eligible.

Below are the instructions to receive Form 1095-C electronically. No waiting for the 1095-C to be mailed. Also, by opting out of paper you can access your 1095-C anytime, anywhere. You no longer have to keep track of a slip of paper. Of course, it’s also better for the environment.

Form 1095-C is separate from Form W-2. If you previously selected electronic for your W-2 form, you must still complete the consent for Form 1095-C. To consent to the electronic Form 1095-C, follow these steps:

  1. In the UltiPro portal go to Myself > Benefits > 1095-C.
  2. Select Change 1095-C Consent Form.
  3. Make your selection. The Payroll Office recommends, I want an electronic copy only.
  4. Select Save.

In January 2015, the Payroll Department will notify WVU Medicine employees when electronic Form 1095-C information for tax year 2015 is available view. You can print as many copies as you need to attach to your personal tax return. If you lose it, no worries. Just print another copy; no need to wait for one to be mailed. For more information regarding the Affordable Care Act, visit