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ACA Tax Forms

Form 1095-C from West Virginia University
Beginning in 2016, West Virginia University will be sending out a new IRS form to anyone who met the definition of a full-time employee as defined by the Affordable Care Act during calendar year 2015. This form, called the 1095-C Form, is an annual statement that describes the insurance available to eligible employees.

View a sample 1095-C form

The deadline for employers to provide the 1095-C for tax year 2016 to eligible individuals has been extended to March 2, 2017. Individuals do not need to send this form to the IRS when filing their tax return, but should keep it with their tax records.

What is the purpose of this form?
The Affordable Care Act requires affected employers to provide certain employees with an annual summary of employer-sponsored health benefits offered.

View a short video explaining the 1095-C
  • Part I lists information about you and your employer.
  • Part II lists codes for each month to show if you were offered health benefits, if you enrolled in the offered coverage, and the lowest cost monthly premium for employee-only health coverage in your income tier. The back of the form lists what each code means.
  • Part III will be blank.
    Employees enrolled in PEIA will receive a second form from PEIA, called Form 1095-B, which will list the enrolled policyholder and any enrolled dependents.

What do I do with the form?
This form is for your information only and does not need to be filed with your tax return. You may wish to keep your 1095-C and your 1095-B (if applicable) with your income tax records.

Can I access my 1095-C electronically?
Yes, your Form 1095-C can be accessed electronically. Follow the instructions to opt into electronic access. Please note that your Social Security Number is required in order to access your form electronically. It is recommended that you provide a personal email address when creating your account, so that you will continue to have access to your documents should your WVU email address be deactivated.

What if I think my 1095-C is wrong?
If you think your 1095-C is incorrect, contact Benefits Administration’s Affordable Care Act line at 304.293.9016. For questions regarding your 1095-B, please contact PEIA at 888-680-7342.

The premium listed in Box 15 of my 1095-C is not the premium that I pay for my coverage. Is this an error?
Box 15 on your 1095-C lists the employee share of the lowest cost monthly premium for employee-only coverage offered to you as a WVU employee. For 2015, the lowest cost coverage that meets Affordable Care Act requirements is PEIA PPB Plan B. The monthly premium for employee-only PEIA PPB Plan B coverage for your salary tier, including a $25 per month tobacco-free discount, is listed in Box 15, regardless of whether you are enrolled in that plan. Your actual premium may vary from the amount listed in Box 15 depending on the plan you have chosen, any spouse or dependents you have enrolled, and any discounts that might apply to you.


Form 1095-B from West Virginia PEIA
Employees enrolled in PEIA will also receive a second new IRS form, Form 1095-B. Form 1095-B will list the enrolled policyholder, employer, and any dependents covered under the policy for the 2016 calendar year. Similar to Form 1095-C, Form 1095-B is informational and does not need to be submitted with your tax return, however, you should retain it with your tax records.

View a sample 1095-B

Can I access my 1095-B form electronically?
Form 1095-B is issued from West Virginia PEIA and is not available electronically. If you misplace your paper 1095-B, please contact PEIA directly at 888-680-7342 to request a replacement.

What if I think my 1095-B is wrong?
Please contact PEIA directly at 888-680-7342 if you believe the information listed on your 1095-B is incorrect. WVU does not issue Form 1095-B and is unable to correct any errors to this form.

Division of Human Resources
One Waterfront Place  *  PO Box 6640  *  Morgantown, WV 26506
Phone: 304.293.5700  *  Fax: 304.293.7532
Benefits@mail.wvu.edu   *  BenefitsBilling@mail.wvu.edu