Employee Benefits
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What Is the 1095-C Form?
- Form 1095-C provides information about your health insurance enrollment and when coverage was effective during a calendar year. The 1095-C form is informational only and is not required for filing your taxes.
Your 1095-C Form – What Changed?
- In December 2024, the Paperwork Burden Reduction Act (PBRA) removed the requirement for health insurance plan sponsors (employers) to provide Form 1095-C to employees. Previously, plan sponsors (employers like Fern Ridge) and health insurance providers (for example, PacificSource) for fully insured health plans were required to send Form 1095 to employees for their records. Effective December 23, 2024, PBRA removed this requirement.
- Again, the 1095-C form is informational only and is not required for filing your taxes.
Can I Get a 1095-C for 2025?
- Yes. If you prefer to receive your 2025 Form 1095-C, please choose from the options below and follow the directions to request a copy.
- If you do not take action, you will not receive a Form 1095-C for 2025.
Receive an Electronic Copy
- To receive an electronic copy of your 2025 Form 1095-C, you must have an Employee Access Center account. Your form will be available for download beginning March 2, 2026. If you need assistance accessing the Employee Access Center, please contact payroll@fernridge.k12.or.us.
Request a Paper 1095-C Form
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Email your request to payroll@fernridge.k12.or.us
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Mail your request to:
Fern Ridge School District
Attn: Payroll
88834 Territorial Road
Elmira, OR 97437; or
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Call 541-935-2253 ext. 1204, Monday–Friday from 8:00 a.m. to 4:00 p.m.
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- SBC – $2500 HDHP (HSA) 24-25
- SBC – $6,000 (VEBA) 25-26
- SBC – $8,000 (VEBA) 25-26
- SBC – $2,000 PPO 25-26
- COBRA Notice
- Medicare Creditable Coverage Notice
- Medicare Non-Creditable Coverage Notice for $2500 HDHP
- CHIPRA Notice
- Women’s Health and Cancer Rights Notice
- HIPAA Notification
- Market Exchange Notice
- 2025 403(b) Notice
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- Salary Reduction Agreement
- 403b Notice
- 403(b) Administrator:
- PenServ Plan Services:
- Ph. 1-803-791-4923 Fax 1-803-791-5925
- Email: service@penserv.com
- PO Box 3109
- West Columbia, SC 29171




