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Form 1095-C online Washington: What You Should Know
How to use Form 1095-C with Social Security and Medicare — Internal Revenue Service; Health Care and Employment Services; and Office of Worker's Compensation Categories of Employer-Provided Health Insurance 1. Affordable Care Act Insurance Affordable Care Act Insurance (ACDI) is health insurance provided to you under a qualified comprehensive plan (see Qualified Comprehensive Plan for more information) that meets the Affordable Care Act's standards of affordability. ACDI is offered to employees of the United States or U.S. Territories, or their dependents. 2. Nonqualified Health Coverage A nonqualified health coverage is coverage you have for any services you receive from a health maintenance organization (HMO) or health insurance plan, unless the coverage is also provided for you under a qualified comprehensive plan (see Qualified Comprehensive Plan for more information). You cannot take advantage of this choice by purchasing health coverage under the WA Health Benefit Exchange (see Qualified Comprehensive Plan for more information). Your employer does not have to offer you coverage under WSU's plan. 3. Medicare Coverage Medicare (HMO's and insurers covered under Medicare) is not the primary coverage offered under the Oregon Health Plan (HP) or other Medicare plans. This includes coverage purchased by the State of Washington under the Medicare Advantage programs of the Centers for Medicare & Medicaid Services (CMS). Coverage purchased under the Medicare Advantage programs must meet the same health care quality standards as WSU's ACDI coverage in order for it to be considered ACDI. Your employer does not have to offer health coverage under WSU's plan. However, we highly recommend you contact us with questions regarding Medicare. Note: Medicare benefits are also not considered ACDI, but may be included as a benefit when the employer has to provide coverage from a qualified comprehensive plan under ACA Nonqualifiable Health Coverage You may be eligible for coverage under State of Washington WSU ACDI but do not qualify for coverage under a qualified comprehensive plan because your employer offers nonqualifiable health benefits coverage for any of the following reasons: WSU ACDI provides coverage for services not covered by your current health plan, a nonqualified health plan offered by your employer (such as COBRA coverage or a group health plan) or an alternative insurance policy. You work for a nonprofit organization (including a hospital, a library, a school or community group), for an executive branch agency of the U.S.
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