Notice: 2020 1095-C forms were mailed on Feb. 19, 2021
Affordable Care Act Information for LaGov HCM Paid State Employees and Retirees
Beginning in 2016, the federal ACA requires that applicable large employers must report certain health insurance information via Form 1095-C. Large employers are required to provide this form to ACA full time employees, retirees and certain other covered individuals (COBRA, surviving spouse/dependent) and to file this informational form with the IRS. The form identifies ACA full-time employees and other individuals who were offered health insurance and/or were covered by an OGB-sponsored health plan during the previous calendar year.
If you meet the criteria of having been an ACA full time employee and/or had OGB sponsored health insurance during 2020, you will receive this form by March 2, 2021. Employees, retirees and other covered individuals (COBRA, surviving spouse/dependent) who are members of a self-insured plan (Blue Cross/Blue Shield or LSU Health) will receive Form 1095-C from the Office of State Uniform Payroll; employees who are members of a fully-insured plan (Vantage) will receive two forms, Form 1095-C from OSUP reporting the offer of health insurance and Form 1095-B directly from the insurance carrier reporting insurance coverage information.
If you are retired from an agency paid through the State Payroll System (UPS, ISIS HR, LaGov HCM) and had Blue Cross/Blue Shield or LSU Health coverage in 2020, then you will receive Form 1095-C from OSUP.
Under the individual shared responsibility provision of ACA, individuals must have qualifying health insurance for themselves and their dependents or be subject to penalties. The information on Forms 1095-B (if applicable) and 1095-C will assist you and the IRS in establishing that you have satisfied this obligation; therefore you will not be subject to a penalty. Refer to the IRS website for more information about the individual shared responsibility provision.
Once you receive the form(s), be sure to review the instructions. You should use the form when preparing your 2020 tax return. This form is for your records and should be kept with other important tax documents. Do not return the form to OSUP.
Requesting a Duplicate Form 1095-C
As required by the ACA, OSUP provides IRS Form 1095-C to ACA full-time employees, retirees and certain other covered individuals (COBRA, surviving spouse/dependent) who are members of a self-insured plan (Blue Cross/Blue Shield or LSU Health). These forms are not available in LEO. Form OSUP/F037 should be used to request a duplicate copy of Form 1095-C issued by OSUP. Requests will be accepted beginning about two weeks after mailing (see mailing date at the top of this page).
Active Employees and Non-Retirees
Duplicate Forms 1095-C for prior calendar years are available for active employees and non-retirees by contacting their HR/EA offices and completing Form OSUP/F037. Duplicate forms will be printed and mailed directly to the employee's mailing address that is in LaGov HCM (payroll system). This form cannot be emailed.
Retirees and Other Covered Individuals (Surviving Spouse/Dependent)
OSUP will accept requests directly from retirees and other covered individuals. Complete Form OSUP/F037 and fax it to 225.342.1650.
Note: Retired employees should contact the Office of Group Benefits at 800.272.8451 and select Option 6 for address changes.