health coverage tax form 1095
view form 1095 online
Your 2019 Form 1095 is now available from a new tool located on the BenefitConnect website. The first time you access the tool, you’ll need to register with an email and password of your choosing, then you'll select a delivery preference for all future Form 1095s.
The Patient Protection and Affordable Care Act (ACA) requires that almost everyone in the U.S. have health coverage that qualifies as minimum essential coverage. U.S. taxpayers must be able to provide proof of such coverage for themselves and their dependents. Form 1095 is required to report information about offers of health coverage and enrollment in health coverage for federal tax purposes. Depending on the source of your health care coverage during the tax year, you may receive a Form 1095-B, a Form 1095-C, or even both.
If you're eligible for Chevron health coverage, your Form 1095 will be automatically mailed to you – or sent electronically, depending on your delivery preference; you don’t have to do anything. These forms are typically distributed by January 31 of each year, just like a Form W-2. You generally will not need to file it with your Federal income tax return but you should keep your Form 1095 with your other income tax documents.
Effective January 1, 2020, Form 1095 tax forms will be available from the BenefitConnect website for the first time. Please note that your previous delivery preference - whether by mail or electronic - is no longer valid and all eligible participants will receive their 2019 Form 1095 in the mail. You'll need to reset your future delivery preferences through the Form 1095 tool on the BenefitConnect website. In addition, the new web tool on the BenefitConnect website provides electronic access to forms starting with the 2019 tax year and on. If you need access to a historical Form 1095, please call the HR Service Center for assistance.
access your form 1095
Your Form 1095 is always available online.
- Login to the BenefitConnect website.
- Click the I need to tab in the top navigation.
- Choose View Health Tax Form 1095 under the My Personal Information column.
- Starting in 2021, if you signed up for electronic delivery of your Form 1095, you will be notified by email to view your form on the BenefitConnect website as soon as it's available.
- If you signed up for a paper mailing delivery preference, your Form 1095 will be mailed to your mailing address (or alternate mailing address, if designated) prior to January 31 of each year.
what you need to know about form 1095
Form 1095 will show whether you and any dependents received health care coverage during the tax year, and how it was provided to you - whether through Chevron or another source, like another employer or Medicare.
There are two types of Form 1095s: a Form 1095-B and a Form 1095-C. The form you receive depends on whether or not you were an employee, a retiree, or a dependent, what type of health coverage you were offered and enrolled in, and whether you worked inside or outside the U.S. during the tax year.
There are certain situations in which you could receive more than one Form 1095. You'll need them all; it's not a mistake. Save them with your other income tax documents. Here are some of the most common reasons why you might receive more than one Form 1095:
- You're enrolled in any of Chevron's Medical HMO options.
- You were working in the U.S. for part of the year, and then started an expatriate assignment.
- You were on an expatriate assignment for part of the year, and then repatriated to the U.S.
- You retired from Chevron during the year.
- Your employment with Chevron terminated during the year and you are now participating in COBRA coverage.
- You had a job change in which you moved between certain Chevron opcos that had different Employer Identification Numbers (EINs).
- You changed employers.
You will receive a 1095-C from Chevron if:
- You were an employee eligible to enroll in Chevron medical coverage on any day in the prior tax year, whether or not you chose to enroll.
- Even if you are currently on COBRA or are a retiree, if you were an employee eligible to enroll in Chevron medical coverage on any day in the prior tax year, you will still receive a Form 1095-C.
You will receive a 1095-B from Chevron if:
- If you were on COBRA or a retiree (or eligible dependent) for the entire tax year and enrolled in one of Chevron’s self-insured medical plans (Medical PPO, High Deductible Health Plan, High Deductible Health Plan Basic).
You will receive a 1095-B directly from your insurance carrier if:
- You were enrolled in one of Chevron’s fully-insured plans (Medical HMO, Global Choice Plan, International Healthcare Assistance Plan) for even one day of the prior tax year.
If you are enrolled in Medicare, the appropriate reporting will be done by Medicare.
You might see references to fully insured or self-insured plans. These terms reference how your medical plan is financed by an employer. Chevron offers both fully insured and self-insured plans. The IRS requires different Form 1095s depending on what kind of plan you are in.
For your information, these are currently Chevron's self-insured plans:
- Medical PPO Plan
- High Deductible Health Plan (HDHP)
- High Deductible Health Plan Basic
These are Chevron's fully insured plans:
- All Medical HMO Plans
- Global Choice Plan (U.S.-Payroll Expatriates)
- Global Choice Plan (Expatriates in the U.S.)
- International Healthcare Assistance Plan (IHAP)
The IRS has issued guidance that you do not have to wait for either Form 1095-B or 1095-C to file your inpidual income tax return. You can use other forms of documentation, in lieu of the Form 1095 information, to prepare your tax return. Other forms of documentation that would provide proof of your medical coverage include:
- Your medical ID card.
- Explanation of Benefits (EOB) from your medical plan.
- Chevron pay statements reflecting medical plan deductions. You can view and print your pay statements online. Your pay statement shows the monthly deduction taken for Chevron medical coverage as well as the year-to-date total for medical coverage. Note that medical contributions are taken in advance, so to see your tax year medical year-to-date total, go to the pay statement from the next-to-last pay period in the tax year (not the last pay period).
- Your form W-2 shows the value of your Chevron medical coverage. You can also access your W-2 online from the U.S. HR website on the Chevron intranet.
- Other statements indicating that you, or a member of your family, had health care coverage.
You do not need to send the IRS proof of your medical coverage. However, you should keep any documentation with your other tax records. This includes records of your family’s Chevron (or other employer-provided) coverage, premiums paid, and type of coverage. You are encouraged to consult a tax professional if you have questions about your U.S. tax return.
If you were enrolled for the entire tax year in any of Chevron’s active employee medical plans or medical plans for retirees not eligible for Medicare, then you had what the IRS considers minimum essential coverage for each month of the year. You can simply check the appropriate box indicating your medical coverage situation when you file your federal income tax return. No further action is required of you. However, consider consulting a tax professional or review other tax resources for further instructions if any of the following situations applied to you in during the tax year:
- If you waived or did not have Chevron medical coverage for all or part of the year.
- If you chose to enroll in medical coverage through another employer.
- If you enrolled in medical coverage through the Health Insurance Marketplace.
- If you believe you are exempt from the shared responsibility payment.