ACA 1095-C forms

ACA 1095-C forms will be available through the payroll department upon request. hamptonm@uplandhillshealth.org or stanekb@uplandhillshealth.org

This form is NOT required to file your individual tax return.

Affordable Care Act 1095-C is an Employer-Provided Health Insurance Offer and Coverage form used by employers to report the information required under sections 6055 and 6056 about offers of health coverage and enrollment in health coverage for their employees.

Why Choose Upland Hills Health?

Patient-First Care Every Patient. Every Time.

We are committed to providing the safest and best possible experience for every patient that enters our clinics, our hospital, our nursing and rehab center, our medical equipment store, or who invites us into their home through Home Care or Hospice services.

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