The Patient Protection and Affordable Care Act (ACA) was enacted by Congress in 2010. Per the ACA Legislation, employers and insurance carriers must provide employees and insureds with Internal Revenue Service (IRS) Forms providing information on health insurance offers and coverage. These Forms indicate that health insurance was made available. Only one Form will be provided for all individuals covered by your plan. You may make additional copies if needed for a spouse or dependents.
ACA Compliance for State of Iowa Employees, Retirees, and COBRA-Covered Former Employees
Active State of Iowa Employees
- All State of Iowa health care plans meet the "minimum essential coverage requirement" under the ACA.
- All Centralized Payroll and DOT Employees subject to ACA-reporting requirements will receive Form 1095-C and/or 1095-B if offered and/or enrolled in a State-sponsored Wellmark (Blue Cross Blue Shield of Iowa) health insurance plan.
Retired/COBRA-Covered Former Employees
- All Centralized Payroll and DOT Retirees/COBRA-Covered Former Employees who are subject to ACA-reporting requirements will receive Form 1095-C and/or 1095-B if offered and/or enrolled in a State-sponsored Wellmark (Blue Cross Blue Shield of Iowa) health insurance plan.
Individual Mandate/Potential Penalties
- The Individual Mandate provision of the ACA requires most Americans to maintain health insurance that meets "minimum essential coverage" requirements.
Not sure which Form you should receive? See the State of Iowa's ACA Reporting Matrix.
All forms will be mailed on or before February 1, 2022. Please allow ample time for mail delivery as the Forms will be mailed from outside of Iowa.
Upon receipt, please review the Form for accuracy - including personal information such as your name, address, Social Security Number, date of birth (if included on the Form), and any dependents. If you identify an error on the Form, please submit corrections through the ACA Team button below by February 21, 2022.
Duplicates, Corrections, or Questions
To contact the ACA Team to request a duplicate Form 1095, make corrections to your Form 1095, or to ask questions related to ACA requirements, click the ACA Team button below and complete the information as requested.
Contact the State of Iowa ACA Team
Note: This form is only for individuals of the entities below who were covered by a State of Iowa insurance policy.
- Centralized Payroll Employees
- Department of Transportation (DOT) Employees
- COBRA-Covered Former Employees
This form is not intended for those who work for, or retired from, an entity listed below. You must contact them directly with any corrections or questions you may have.
- Regents Institutions
- Community Based Corrections (CBC)
- Iowa State Fair Board
- Iowa Counties, Cities or School Districts
- Medicare and/or Medicaid