Annual Statements and Tax Forms
This page covers two annual documents: your Total Compensation Statement, which shows the full value of your pay and benefits, and the Affordable Care Act (ACA) Form 1095 tax forms.
Dartmouth Benefits Office
Phone: (603) 646-3588
Human.Resources.Benefits@dartmouth.edu
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Total Compensation Statement ACA Reporting (Form 1095) Who Receives a Form Reading Form 1095-C Questions and W-2 Forms
Total Compensation Statement
Also called a Total Rewards Statement, this annual statement shows the benefits Dartmouth offers in addition to your compensation. It is a comprehensive review of all your benefits, not just a record of payments like your pay slip.
About the Statement
- Many benefit amounts on the statement can also be found in the year-to-date totals on your last pay slip of the prior calendar year.
- For hourly employees, amounts are based on actual paid time off hours paid during the year.
- Your W-2 Box 1 total is reflected in the statement's Compensation Summary section.
- The statement reflects benefits in effect as of December 31, and does not reflect any pending elections at that time.
- Many benefits shown depend on your employee category.
- Amounts shown are contributions made by you and/or Dartmouth during that calendar year. Only current contributions to the Defined Benefit Plan are reflected.
- Your Wellness Benefit election for the year is noted on the statement.
A few things that may not be reflected: a spouse's Pulse wellness rewards, or a reimbursement submitted late in the year due to processing timing.
ACA Reporting (Form 1095)
As part of the Affordable Care Act (ACA), large employers like Dartmouth are required to report information to the government about your health insurance coverage and also provide 1095 tax forms to certain individuals.
About Reporting
The reporting tells the IRS whether an offer of Minimum Essential Coverage (MEC) was made to full-time employees, whether that coverage meets Minimum Value (MV), and whether it is affordable in the eyes of the ACA. The reporting also provides proof of coverage for individuals for the Individual Mandate.
Do I Need a Form 1095 to File My Tax Return?
As communicated by the IRS, 1095 forms are not required to file your individual tax return, but the information on them may be helpful to you. You do not need to submit a copy of your Form 1095-C with your federal tax return, but we recommend that you keep it with your tax documents. Depending on the state you live in, you may need the form for state tax filing purposes.
What Is a Form 1095-C?
Form 1095-C contains detailed information about the health insurance coverage offered to you and your dependents by Dartmouth.
When and How Will I Receive My Form?
Dartmouth uses bswift, its benefits administration vendor, to produce and mail the forms to individuals. Forms are mailed to your legal mailing address in the winter, ahead of the federal deadline, and are also posted in the Employee File section of the FlexOnline Portal. The return address is Dartmouth.
Residents of states with earlier individual reporting deadlines (for example, California and Rhode Island) receive their forms earlier. The bswift system monitors all state reporting deadlines, and those forms are also posted in the Employee File in FlexOnline.
Who Receives a Form
The ACA defines full-time employees as those who work an average of 30 hours or more per week.
Form 1095-C
- All individuals who were a full-time employee for at least 1 month in the calendar year. This includes full-time employees who enrolled in coverage, full-time employees who waived coverage, and full-time employees who may not have been made an offer of coverage (for example, temporary employees who worked 30 or more hours per week).
- All part-time employees (those working less than 30 hours per week) who were enrolled in Dartmouth's plan during the year. If you worked less than an average of 30 hours per week for the entire calendar year and waived coverage, you will not receive a 1095-C.
- COBRA participants.
- Individuals who were active employees for part of the year and non-employees for part of the year.
Form 1095-B
Individuals who were non-employees for the full 12 months and enrolled in a Dartmouth medical plan receive a 1095-B. This includes retirees under 65 years old.
Medicare
- If you were enrolled in the DCMS plan as an individual (no covered dependents) for the full year, you will not get a form from Dartmouth.
- If you have Part A, you can ask Medicare to send you an IRS Form 1095-B. In general, you don't need this form to file your federal taxes. For more information, visit the Medicare qualifying health coverage notice page.
Reading Form 1095-C
What Information Is on the Form?
There are three parts to the form:
| Part | Lines | What it shows |
|---|---|---|
| Part I | 1 to 13 | Information about you and your employer. |
| Part II | 14 to 16 | The coverage Dartmouth offered you, whether it was affordable, and the reason you were or were not offered coverage. |
| Part III | 17 to 22 | The individuals covered under your plan. Completed only for individuals who enrolled in coverage, and it may differ among covered dependents (for example, if a spouse was added mid-year). |
What Do the Part II Codes Mean?
| Line | What it shows | Common codes |
|---|---|---|
| Line 14 | Whether an offer of coverage was made to the employee and the plan offered. All Dartmouth plans exceed the Minimum Value. | 1E or 1G: an offer of coverage was made that month. 1H: no offer of coverage was made that month. |
| Line 15 | The monthly employee-only contribution to the lowest cost plan (the Cigna High Deductible Health Plan in most cases). This amount does not necessarily reflect the plan or tier you were actually enrolled in. It may be blank, for example for months with a 1H on line 14. | A dollar amount, adjusted for your salary and FTE. |
| Line 16 | Your enrollment or the reason you were not enrolled. | 2C: you were enrolled in coverage that month. 2A: you were not an employee. 2B: you were not a full-time employee. 2H: you waived coverage, but the coverage offered was affordable. This line may be blank for some individuals who waived coverage. |
Changes from Earlier Years
If you compare your form with forms from before tax year 2022, you may notice differences in how Part II is filled in:
- Line 14: in past years you may have had a 1A. bswift does not generate the 1A code and uses a 1E instead. Both mean Dartmouth offered Minimum Essential Coverage meeting Minimum Value to you, and at least Minimum Essential Coverage to your dependents and spouse.
- Line 15: with a 1A on line 14, line 15 was left blank. With a 1E, bswift must enter the monthly employee-only contribution to the lowest cost plan.
- Line 16: if you waived coverage, you may have seen a 2G in the past. You will likely see a 2H now. Both mean the coverage offered was affordable.
- "All 12 months" box: this box was not previously used, and a value was entered for each month instead. bswift uses it. For example, a full-time employee who was offered and enrolled in coverage all year will see 1E on line 14, a dollar amount (the employee-only contribution to the HDHP, adjusted for salary and FTE) on line 15, and 2C on line 16 in the "All 12 months" boxes, with the January to December boxes blank.
- Part III: bswift also uses the "Covered all 12 months" box, where each individual month was checked off before, even for full-year coverage.
Questions and W-2 Forms
Questions About Your 1095 Form or Need a Reprint?
Contact the Dartmouth Human Resources Benefits Office at (603) 646-3588. Review your form as soon as you receive it, and contact the Benefits Office right away if you think you need a correction.
Where Can I Get My W-2?
Current employees can access, download, and print their W-2 using Payroll's online Employee Self Service (ESS) portal. The portal also allows you to update your federal W-4, enroll in direct deposit and paperless paystubs, and view all of your current and previous W-2 forms and paystubs. W-2 forms are available online as of January 31. Former employees, please see Payroll's Paychecks and W2 Forms page for how to get your W-2.
Questions about your W-2? Contact the Dartmouth Payroll Office at (603) 646-2697 or Dartmouth.Payroll@dartmouth.edu.
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