About This Notice

Primary Companies has elected to use the Internal Revenue Service’s alternative method of furnishing Form 1095-C to employees, as permitted under applicable ACA regulations. Rather than mailing a paper copy of Form 1095-C, eligible employees may request a copy of their form at no cost.

Form 1095-C provides information about the health coverage offered to you during the applicable calendar year and may be needed when preparing your personal tax return.

How to Request Your Form 1095-C

Employees may request a copy of their Form 1095-C by contacting Human Resources using the information below or complete the form below. Requested forms will be provided within 30 days of the request.

Questions or Requests

Please contact Samantha at 920-756-2577 ext. 533 or hr@primarycompanies.com to request your Form 1095-C or if you have any questions.