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Human Resources

Notices

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Notice of Availability of Form 1095-C Upon Request

In compliance with IRS regulations and the Affordable Care Act (ACA), we are required to provide Form 1095-C to employees who were eligible for health insurance coverage during the tax year. This form contains important information about the health insurance coverage offered to you and may be required for your federal tax return.

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How to Request Your Form 1095-C

If you would like to request a copy of your Form 1095-C, please contact Human Resources using the information below:

    • Phone: (657) 278-3415
    • Email: Contact Maddie Nunez
    • Mailing Address: 1121 N. State College Blvd. Fullerton, CA 92831

Upon receiving your request, we will provide your Form 1095-C within 30 business days either electronically or via mail, based on your preference.

Important Notes

    • Form 1095-C provides details about the health insurance coverage offered to you during the tax year [Year].
    • You are not required to submit Form 1095-C when filing your tax return, but it may be helpful for your records.
    • If you have already received your Form 1095-C electronically or by mail, there is no need to request another copy unless you require a replacement.

For more information about Form 1095-C or the ACA’s reporting requirements, please visit the IRS website: Instructions for Forms 1094-C and 1095-C (2025)

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