Important Information about the 1095-C Tax Form

Employees that were offered medical coverage in 2016 will receive a tax form called the 1095-C that will contain detailed information about your health care coverage. However, you do NOT need this form to file your taxes.

The IRS will use the information you report about your health care coverage to determine whether you will pay a penalty for failing to have health care coverage as required by the Patient Protection and Affordable Care Act. If you receive an Advance Premium Tax Credit, the information on the form will also help the IRS determine if you should repay any of the tax credit or receive an additional credit.

Texas Health will provide your 1095-C for the 2016 tax year to you in early 2017. You will receive the form by mail, unless you elect to receive the form electronically through MyTaxForm.com. To elect an electronic delivery of the form online:

• Go to www.mytaxform.com
• Enter the 5 digit Employer Code: 11138
• Enter your User ID (your Social Security Number)
• Enter your PIN:
  • If you have never logged into the system, you will need to enter your Default PIN which will be: MMDD of birth + last 4 of SSN.  You will then be prompted to enroll in the Authentication program. This step is designed to ensure secure access to your W-2 information.
  • If you have previously enrolled and logged into the system but have forgotten your PIN, please click on the “Forgot my PIN” link and follow instructions on how to obtain your current PIN.
• Consent for online delivery