FORM 1095-C – AVAILABLE BY REQUEST ONLY
Form 1095-C is an annual statement of information about the health care coverage offered by Acloché.
All full-time employees are eligible to receive this informational form regardless of whether they participate in the company health plan.
Form 1095-C can assist you in determining eligibility for a premium tax credit, but it is not necessary to have Form 1095-C to file your tax return.
As of 2024, form 1095-C will only be provided to eligible employees upon written request.
You must submit your request for your 1095-C to Acloché in writing using one of the following methods:
- Email: HR@acloche.com
- US Mail: 1800 Watermark Drive, Ste 430, Columbus, OH 43215
Please include the following information in your request:
- Your full name (first and last)
- Last four digits of your SSN
- Confirmation of your mailing address
Your 2024 1095C will be mailed within 30 days of receiving your written request.
If no address is provided, your 1095-C will be mailed to the address Acloché currently has on file. Under no circumstances will 1095-Cs be sent via email or other methods.
Please contact Acloché at 614-824-3700 with questions.