The Affordable Care Act (ACA) requires that Penn send the 1095-C tax form to certain benefits-eligible faculty and staff members. This form includes information about the health insurance coverage offered to you by Penn as well as information for each of your family members enrolled under your Penn benefits plan.

You should receive this form if, for any month in 2019, you were enrolled in or offered health care coverage from Penn; and you were:

• Considered a regular full-time or part-time benefits-eligible staff or faculty member, or
• Worked an average of 30 or more hours per week

The 1095-C form will be mailed and available online on or before the third week in February. To access your form online, go to the My Pay section of the secure U@Penn portal at www.upenn.edu/u@penn then select “My 1095-C form.”

If you have questions about your form, call Equifax at (855) 823-3728. When prompted for your employee ID number, enter your social security number to speak to a customer service representative. You can also contact the Penn Employee Solution Center at (215) 898-7372 or hcmsolutioncenter@upenn.edu for assistance.

While you do not need to attach your 1095-C to your tax return when filing, keep it for your records as it provides proof of qualifying health coverage.

For general information about Form 1095-C, visit the IRS webpage Q&A about Form 1095-C or consult your tax advisor.

—Division of Human Resources