1095-C / 1095-B FAQs

2023 1095 forms will be made available January 20, 2024 for those that opted to receive them electronically. All mailed forms will be postmarked by January 31, 2024.

If you received an email on January 20, 2024 IMPORTANT TAX INFORMATION: Your Health e(fx) Forms 1095-C Form is Available from no-reply@healthefxforms.us, this means you have signed up to receive your 1095-C form electronically.

If you did not receive this email, you have not opted to receive your form electronically. Your 1095 form will be mailed to your address on file with the District and postmarked January 31, 2024 or you can register a new user account by following the below instructions.

How do I view my 1095-C form on-line?

Employees  enrolled in the SDP continuation of coverage plans can access their forms on line.  See below, multi-step, trouble-shooting process to access your on-line 1095  form.

If you previously registered for electronic delivery, log in to healthefxforms.us/sdp. Use the ” Forgot your password?” if you don’t remember your password.

If you have not registered, follow the instructions below to access your 1095-C form online:

  • Click healthefxforms.us/sdp
  • Click the “Register as a new user” link underneath the log in button,
  • Fill out the required information on the “Create A New Account” page,
  • Click “Create A New Account”,
  • You will receive a confirmation email to activate your user account.
  • You should submit your registration and promptly wait for the confirmation. Both steps need to be completed within 24 hours and from the same computer.
  • Once you have created and confirmed a user account you will be given the option to receive this form via electronic delivery.

Additional Troubleshooting tips:

  • Google chrome is the preferred browser, https://www.google.com/chrome/
  • Reset your password by clicking the “Forgot your Password” link underneath the registration
  • You must use the same device and connection to register and verify your Healthefx account.  You will not be able to verify your account if you are using a separate device and/or connection than your original registration.
  • Email validation must be done within 24 hours of registering for an account.

1095-B form for Retirees were mailed to the address on file with your account with WEX, formerly Discovery Benefits


What is a 1095 Form?

This form reports whether your employer offered you health insurance coverage and information about what coverage was offered to you. This form is for your information only and is not included in your tax return.  Active employees will receive a Form 1095-C, Employer-Provided Health Insurance Offer and Coverage. Retirees and COBRA participants will receive Form 1095-B, Health Coverage.

When will I get my Form 1095 form?

Your current School District of Philadelphia employee form, and prior year forms, are available online at  https://www.healthefxforms.us/sdp. For employees who did not select electronic delivery, mailed copies will be postmarked by January 31, 2024.

If you need a duplicate, please access your form through PhilaSD Portal or directly at  https://www.healthefxforms.us/sdp  Requests for paper duplicates will not be accepted before March 14, 2024. Requests for corrections/adjustments must be submitted from your School District Email address to 1095-cforms@philasd.org. Please allow 14 days for the form to be audited, updated and re-issued.

What does the dollar amount in line 15 mean? 

Line 15 does not mean how much you paid for medical coverage, this line reports the lowest monthly cost to you for the lowest-cost available plan for single coverage whether or not  you have enrolled in District sponsored medical coverage. The amount reported on line 15 may not be the amount you paid for coverage if, for example, you chose to enroll in more expensive coverage such as family coverage. Line 15 will show an amount only if code 1B, 1C, 1D, 1E, 1J, or 1K is entered on line 14. If you were offered coverage but there is no cost to you for the coverage, this line will report a “0.00” for the amount.  For more information, including on how your eligibility for other healthcare arrangements might affect the amount reported on line 15, see IRS.gov.

Understanding the 1095 Form

It is not necessary for you to wait until you receive these forms to file your tax return.

What Is a Tax Form 1095-A and How Do I Use It?

  • Employee and Employer Information (Part I)
  • Employee Offer and Coverage (Part II) – information about healthcare insurance coverage offered to you and your dependents, the affordability of coverage offered, and any reasons you were or were not offered coverage by your employer
  • Covered Individuals (Part III) – employee and his/her dependents covered under an employer health plan

What do the codes in Part II, Line 14 mean? These codes describe the offer of coverage for each month, or for the full year, an employee is covered.   There may be some months that an employee was not covered pending being a new hire or termination date. See “Instructions for Recipient” on the back of Form 1095-C for a complete description of the codes.

What do the codes in Part II, Line 16 mean? These codes help the IRS determine if your employer was in compliance with the ACA’s Employer Mandate. For example, did your employer comply with the “Employer Shared-Responsibility Provisions” mandated by the IRS?

The dollar amount in Part II, Line 15 is not the same as the amount I pay for my medical insurance. Why not?  This amount is the monthly employee contribution for single coverage in the lowest-cost plan offered.  No cost is listed according to the IRS if the employee is qualified for a plan that is below <= 9.5% of the mainland Federal Poverty Level (FPL). Meaning, even if you enrolled in a plan that cost more than $96.08 a month, if you qualified for a single coverage plan that was less than $96.08 the cost will not be displayed on the form.

• The IRS uses this amount to determine if your employer offers an “affordable” plan that meets the requirements of the ACA law. You may have actually enrolled in a different plan and/or you may cover other family members under a different plan that may be more expensive

I don’t remember getting this form before…

Beginning in 2015, under the Affordable Care Act, if you are a full-time employee working an average of 30 or more hours per week and/or were enrolled in health insurance through your employer, you will receive a Form 1095-C from your employer.

What is Form 1095?

Form 1095-C contains information about your healthcare coverage provided to you and dependents by your employer. Information on this form supports the information you are required to include in your annual tax return.  It is not necessary for you to wait until you receive these forms to file your tax return

Why aren’t my Dependents listed on my form?

If your position is represented by District 1201/32 BJ,  benefits are administered by 32BJ 877-605-8300 or visit their website, http://www.32bjfunds.org/

Other employees who see a discrepancy on who is listed on their medical coverage in 2022 versus who is listed on the 1095 C form should email our office at benefits@philasd.org or 215-400-4630.

Why did I get more than one form?

If you were a full-time employee with more than one company or were on more than one employer’s health insurance plan in any manner, you may receive a Form 1095-C from each employer. You should keep all forms with your tax records.

Some student climate staff who receive medical coverage from the union may receive 1095 forms from their union, UNITE Here Local 634.

Who receives Form 1095-C?

Employees who work for Applicable Large Employers (ALEs) like the School District of Philadelphia with 50+ full-time-equivalent employees and employees already enrolled in an employer health insurance plan will receive Form 1095-C. Full-time employee means those who work/ed an average of 30+ hours per week during the year.

Why did some of my co-workers get a Form 1095-C, but not me?

Forms are provided to full-time employees working 30+ hours per week on a regular basis (whether or not you are enrolled in healthcare coverage), as well as any other employees who may be enrolled in an employer’s healthcare insurance plan. Employees not eligible for District medical coverage will not receive a 1095 form from the District.

You may also not receive a 1095-C if you were not the primary party insured. For example, you will not receive Form 1095-C if you were listed as a dependent or spouse under an eligible family member’s plan with his/her employer.  You will be listed as a dependent on the form issued to the insured.

Why do I have to report my healthcare coverage to the IRS?

The Affordable Care Act (ACA) includes both the individual (you) mandate and the employer mandate, which requires every eligible person in the USA to have healthcare coverage and provide proof of that insurance.  The employer mandate requires employers with 50 or more full-time-equivalent employees to offer healthcare coverage to their full-time employees or potentially face a fine.

If you, or a family member, were enrolled in healthcare coverage at any time in 2020, you will receive a Form 1095 from the entity that provided you the coverage. For example, if you were determined to be a full-time employee or were enrolled in coverage through the School District, you will receive a 1095-C from us.

Do I need to submit Form 1095-C to the IRS?

No.  You do not need to submit the 1095-C form with your 1040. Most people will only have to check a box on their IRS Form 1040 that states that they (and their dependents, if applicable) were insured for the year.  It is recommended that you keep a copy of the Forms with your tax records. The School District of Philadelphia must submit these forms to the IRS.

Will the IRS fine me if I did not receive a Form 1095-C from my employer?

If you think you should have received Form 1095-C, and you have not received one by March 02, 2024,  e-mail benefits@philasd.org or call (215) 400-4630, or visit the employee Benefits office in 440 N. Broad Street, located in Suite G-10 and our walk-in hours are Monday through Friday from 8:30 AM until 4:30 PM.

Will 1095-C information impact my taxes?

In most cases, it will not impact your taxes; individuals with health insurance should not be required to pay any additional taxes. BUT, if you did not (or do not) have healthcare coverage and do not qualify for an exemption, you may be subject to a fine/penalty when you file your taxes.