health coverage tax form 1095

view form 1095 online

View present and historical Form 1095s or request reprints online.
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 via email, 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.

Medicare-eligible participants: If Medicare was the primary coverage for you or any of your covered, Medicare-eligible dependents, you will not receive a Form 1095 from Chevron. Medicare is responsible for reporting your Medicare coverage to the IRS. Electronic delivery and the ability to view historical documents online as described below pertains only to the forms provided by Chevron.

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.

The first time you access the Form 1095 tool, you will need to register with an email and password of your choice, then choose your delivery preference for all future form deliveries. After the first login is complete, you will be automatically connected to the tool and your forms thereafter; a password is not required when accessing the forms from BenefitConnect.

Electronic delivery and the ability to view documents online applies only to the Form 1095 provided from Chevron; it doesn’t apply to a Form 1095 provided directly from an insurance carrier, another employer, or through Medicare. In addition, BenefitConnect will only display Form 1095 starting with the 2019 tax year. If you are searching for a historical form, please contact the HR Service Center for assistance.

Your Form 1095 will be automatically sent to you in January of each year - either by mail or online - according to the delivery preference in effect on December 31 of the previous year. If you want to change how your Form 1095 is delivered, you can update your preference at any time prior to December 31. Here's how to choose your delivery preference:

  • 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.
  • The first time you access the Form 1095 tool, you will need to register with an email and password of your choice. After the first login is complete, you will be automatically connected to the tool and your forms thereafter; a password is not required when accessing the forms from BenefitConnect.
  • From the Form 1095 home page, click on your email address in the upper right corner of the screen, then choose Settings.
  • There is an option to change your Form 1095 delivery settings from this screen.

Your Form 1095 will be automatically mailed to you by January 31 each year, unless you select electronic delivery on the BenefitConnect website. 

  • If you want to receive your Form 1095 electronically, you must select the electronic delivery preference prior to December 31.
  • If you signed up for electronic delivery of your Form 1095 by the previous December 31, you will be notified by email to view your form on the BenefitConnect website as soon as it's available each January.
  • If you have not selected electronic delivery prior to the previous December 31, your Form 1095 will be mailed to your mailing address (or alternate mailing address, if designated) prior to January 31.
  • If you select electronic delivery after December 31, this delivery preference will be applied to your next year's Form 1095 and all applicable forms thereafter, unless you change your delivery preference again.
If you have questions, or if you believe the information on your 1095 statement is inaccurate, contact the HR Service Center (choose the option for Benefits, then the option for Health Benefits).

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.
It's not a mistake. Chevron is only required to report the cost for You Only coverage in our lowest cost medical plan option – currently the High Deductible Health Plan Basic – regardless of the medical coverage option you've actually selected. So if you are enrolled in another Chevron medical plan option, or you're covering dependents, the cost displayed on your Form 1095 will be lower than what you actually pay.
Except for a few special situations, Chevron is required to provide a Form 1095 to anyone eligible for Chevron health coverage at any time during the year. This means you'll still receive a Form 1095 regarding Chevron health coverage if you were eligible for coverage but chose to waive it.
Except for a few special situations, Chevron is required to provide a Form 1095 to anyone eligible for health coverage at any time during the year. This means you'll still receive a Form 1095 regarding Chevron health coverage if you terminated employment with Chevron during the year.
If Medicare was the primary coverage for you or any of your covered, Medicare-eligible dependents, you will not receive a Form 1095 from Chevron. Medicare is responsible for reporting your Medicare coverage to the IRS. Electronic delivery and the ability to view historical documents online as described in this document pertains only to the forms provided by Chevron.

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 individual 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. Go to the U.S. HR website on the Chevron intranet, choose the My Personal Information (My HR) link on the right side of the page, then Pay Statement. 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. Go to the U.S. HR website on the Chevron intranet, choose the My Personal Information (My HR) link on the right side of the page, then W-2/W-2c Retrieval.
  • 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.

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