Insurance

1095-C Distribution Notice

As an employer sponsoring a group health plan, we provide Form 1095-C for full-time
employees.

Form 1095-C is an information document used to help administer certain provisions of
the Affordable Care Act (ACA). You do not need the form to file your tax returns. For
more information, please visit the Internal Revenue Service’s Q&A External Site.
You will not automatically receive the Form 1095-C; you may request the form by
contacting us using any of the following methods of contact:

Telephone: 319-372-7252

Mailing Address: 1930 Ave M, Fort Madison Iowa 52627

Email: Cindy.Macomber@fmcsd.org