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Affordable Care Act

We want you to be aware of two forms you will be receiving on or before March 31 of every year as required under the Affordable Care Act (ACA). You should retain these forms for tax purposes. 

Form 1095-C

This form will be provided by Pleasant Valley School District to all ACA eligible employees.

Under the ACA, the Internal Revenue Service (IRS) requires employers with 50 or more full-time employees to offer health insurance to their employees working an average of 30 or more hours per week, or an average of 130 hours per month. Pleasant Valley School District is complying with this requirement. 

Beginning in tax year 2015, the IRS requires employers to file a Form 1095-C with the IRS for each employee working an average of 30 or more hours per week, or an average of 130 hours per month, and to provide a copy of Form 1095-C to each employee reported on to the IRS.  The Form 1095-C provides details about:

The coverage offered to you,
The lowest-cost premium available to you,
The months of the year when the coverage was available to you, and
The months of the year, if any, when you or any of your dependents enrolled in the medical plans.
All employees eligible for coverage under the ACA, regardless of whether you actually participate in a Pleasant Valley School District medical plan, will receive a Form 1095-C mailed to your home address on file.

Form 1095-B

This form will be provided by SISC to all employees enrolled in these plans.

Under the ACA, taxpayers who do not have health insurance coverage may be required to pay a penalty when they file their tax returns. Beginning in tax year 2015, health insurers are required to report to the IRS on Form 1095-B which employees and dependents are enrolled in an employer sponsored medical plan.  Health insurers are also required to provide a copy of Form 1095-B to each employee reported on to the IRS.  Form 1095-B provides information about:

The type of coverage you enrolled in for 2021,
Any dependents enrolled in your plan, and
The months of the year when you or any of your dependents were enrolled for 2021.
 

SISC will send these forms to your home address on file.

Please watch for these forms in your mail in January 2022. You should retain both forms for your records and provide them to your tax preparer upon request.  Should you have questions, we strongly encourage you to consult with your tax preparer. 

FAQs 1095 Form