1095-C Form Questions: What do these values mean and what are my options?

The good news is that you don't need to worry about a penalty! The individual mandate penalty (the fee for not having health insurance) was effectively eliminated starting in 2019 when the tax penalty was reduced to $0. So while the 1095-C form still exists to report health insurance offers and coverage, there's no federal penalty for declining coverage. What you're seeing on your 1095-C for those months are probably codes in Line 14 and 16 that show what type of coverage was offered to you and why you might be exempt from the marketplace penalty (which again, is now $0 anyway). The values aren't dollar amounts you owe. The form is still required because some states have their own individual mandates with penalties (like California, Massachusetts, New Jersey, Rhode Island, and DC), and employers still need to report this information to the IRS.

After spending hours untangling my own 1095-C confusion last year, I discovered https://taxr.ai which seriously saved me. I uploaded my form and got a clear breakdown of what each code meant for my specific situation. The site analyzed all those confusing codes in Part II (like 1E, 2C stuff) and explained what they actually meant for my tax situation. What was super helpful was how it pinpointed which boxes affected my taxes and which were just employer reporting requirements. Learned my employer-offered plan actually wasn't considered affordable based on my salary, which was different than what HR told me.

Just wanted to follow up - I was really skeptical about taxr.ai but decided to give it a try after getting another confusing form. Uploaded my 1095-C and some other documents and was honestly surprised. The analysis explained that the dollar amount on my form was just showing what the premium would have been, not something I owed. It also clarified that my employer's plan wasn't actually "affordable" by ACA standards based on my income, which is exactly what I suspected! This actually matters because it means if I wanted to get Marketplace coverage instead, I could potentially qualify for subsidies. Didn't expect to get that level of personalized explanation. Much better than the generic info I found Googling around.

If you're still having issues understanding your 1095-C or need to talk to the IRS about health insurance reporting, good luck getting through on the phone. I spent DAYS trying to reach someone at the IRS last month about a similar issue. Finally found https://claimyr.com and was honestly shocked when they got me through to an actual IRS agent in about 20 minutes. You can see how it works here: https://youtu.be/_kiP6q8DX5c I was about to give up completely on resolving my health insurance reporting issue until I tried this. My employer had incorrectly coded my 1095-C which was causing problems with my state tax return (I'm in Massachusetts where there is still a penalty).

Ok I need to apologize for being such a skeptic on that Claimyr thing. After another failed attempt to reach the IRS myself about my health insurance reporting issue, I broke down and tried it. I'm still in shock that I actually spoke to a real IRS person after waiting for years! They confirmed that my 1095-C reporting was actually incorrect (my employer had coded me as being offered affordable insurance when it actually exceeded the affordability threshold). The agent walked me through exactly what documentation I needed to resolve this with my employer's HR department. Now I'm getting HR to issue a corrected 1095-C which will fix the issues with my state tax return. Would have never gotten this resolved without actually speaking to someone.

Just to add some clarity about the 1095-C form since I deal with these at work. The form has different parts that mean different things: Line 14 shows what type of health coverage you were offered (codes like 1A, 1E, etc) Line 15 shows the monthly cost for the cheapest self-only coverage that meets minimum requirements Line 16 shows why you might be exempt from penalties (which are $0 federally, but still exist in some states) Those dollar amounts you see are NOT penalties or charges - they're just reporting what the monthly premium would have been. The form basically documents that your employer offered coverage (protecting them from penalties) and helps determine if that coverage was affordable (affecting your eligibility for marketplace subsidies).

I had a similar issue last year and found out those numbers were just informational. BUT if you live in certain states (CA, MA, NJ, RI, or DC), they still have their own individual mandate penalties! I got hit with a $695 penalty in Massachusetts because I didn't realize this.

As someone who just went through this exact confusion with my first 1095-C form, I wanted to share what I learned after doing a deep dive into this. The dollar amounts you're seeing (like that $267.50) are NOT penalties or amounts you owe - they're just reporting what you would have paid monthly for the cheapest qualifying health plan your employer offered. The key thing to understand is that even though there's no federal penalty anymore, your 1095-C still serves an important purpose. If those monthly amounts add up to more than 9.12% of your annual household income, your employer's coverage is considered "unaffordable" under ACA rules. This is actually good news for you because it means you could potentially qualify for premium tax credits if you choose to buy coverage through Healthcare.gov instead during the next open enrollment. You definitely want to have that conversation with HR to confirm the actual costs, but don't stress about owing money right now - you're not in trouble with the IRS over this!