Form 1095-C to employees for tax year 2025
IMPORTANT INFORMATION
Regarding form 1095-C to employees for tax year 2025
Form 1095-C “Employer-Provided Health Insurance Offer and Coverage” is a document reporting your health coverage details for the tax year. This form is provided by the Agency each year and is separate from your W-2 form.
The Paperwork Burden Reduction Act and IRS Notice 2025-15 allows Employers to use an alternative method for furnishing forms 1095-C to individuals. We are no longer required to print and distribute these forms automatically to employees. Forms will only be distributed if a request is received from an employee.
Employees may use the contact information below to request a 1095-C form.
Mail request to:
Community Action of Southeast Iowa
2850 Mt. Pleasant Street, Suite 108
Burlington, IA 52601
Attn: Payroll. 1095-C request
Email request to:
Or
Call to request:
319-753-0193, ext. 1233, or ask for Laurey Gray. (leave a voicemail if Laurey doesn’t answer)
Form must be provided within 30 days of when we receive the request, or by January 31, 2026 (whichever is later).