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: 4100 Venture Place, Groveport, OH 43125
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 1095-C will be posted to your Acloché employee portal in the Documents section within 30 days of receiving your written request.
If you did not opt in for an electronic-only version, your 1095-C will also be mailed within 30 days of receiving your written request. If no address is provided, your 1095-C will be mailed to the address on file. Under no circumstances will 1095-Cs be sent via email.
Please contact Acloché at 614-824-3700 with questions.