Create your 1095c Order Form from scratch

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Here's how it works

01. Start with a blank 1095c Order Form
Open the blank document in the editor, set the document view, and add extra pages if applicable.
02. Add and configure fillable fields
Use the top toolbar to insert fields like text and signature boxes, radio buttons, checkboxes, and more. Assign users to fields.
03. Distribute your form
Share your 1095c Order Form in seconds via email or a link. You can also download it, export it, or print it out.

Create your 1095c Order Form in a matter of minutes

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Step 1: Access DocHub to build your 1095c Order Form.

Start signining into your DocHub account. Utilize the pro DocHub functionality at no cost for 30 days.

Step 2: Go to the dashboard.

Once signed in, head to the DocHub dashboard. This is where you'll build your forms and manage your document workflow.

Step 3: Design the 1095c Order Form.

Click on New Document and select Create Blank Document to be redirected to the form builder.

Step 4: Design the form layout.

Use the DocHub features to add and arrange form fields like text areas, signature boxes, images, and others to your form.

Step 5: Insert text and titles.

Add necessary text, such as questions or instructions, using the text field to assist the users in your document.

Step 6: Customize field settings.

Modify the properties of each field, such as making them required or arranging them according to the data you plan to collect. Designate recipients if applicable.

Step 7: Review and save.

After you’ve managed to design the 1095c Order Form, make a final review of your form. Then, save the form within DocHub, send it to your chosen location, or share it via a link or email.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
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This requirement ensures that statements are furnished electronically only to individuals who are able to access them. The consent must relate specifically to receiving the Form 1095-C electronically. An individual may consent on paper or electronically, such as by email.
If the employee was issued a 1095-C, request a duplicate from ACA Online Support at (916) 322-3770 or by email at acasupport@sco.ca.gov. Include the employees full name and the last four digits of their Social Security Number in the request.
Some taxpayers may not receive a Form 1095-B or Form 1095-C by the time they are ready to file their tax return and it is not necessary to wait for Forms 1095-B or 1095-C in order to file. While the information on these forms may assist in preparing a return, they are not required.
This Form 1095-C includes information about the health insurance coverage offered to you by your employer. Form 1095-C, Part II, includes information about the coverage, if any, your employer offered to you and your spouse and dependent(s).
You may receive these forms by U.S. Mail, or hand delivery (for example, from your employer); or, if you consented to receive the forms electronically, you may receive the form via e-mail.
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Related Q&A to 1095c Order Form

No later than 30 days after January 31, the State of California, via the State Controllers Office, will issue a Form 1095-C to its full-time employees with information about the health coverage offered, if any, to the employee, their spouse and dependents.
If you have not received your 1095-C form by mid-March, please contact the HR Service Center to request a reprint. Note: You may not need to wait until Form 1095-C arrives to complete your taxes.

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