Skip to main content
Why does/doesn't my form 1095-C have information in Part III - Covered Individuals?

Why does/doesn't my form 1095-C have information in Part III - Covered Individuals?

Part III will only be populated if you are enrolled in a self-insured health plan.  The current self-insured plans are the State’s Blue Cross Blue Shield (BCBS) plans, State Health Plan PPO and State HDHP with HSA. If you are enrolled in any other health plan, Part III will be blank and you may receive a 1095-B from the insurance company of your fully insured plan, if you enrolled, noting the months you and your dependents are covered. Employees enrolled in a fully insured health plan such as an HMO who do not receive a 1095-B but would like to request one, can contact the insurance company directly.