Municipal Employee Benefits

Annually, the City furnishes IRS Form 1095-C to employees and under 65 retirees. This form shows that you and your covered dependents, if applicable, were offered minimum essential coverage under the City’s Health Insurance plan and therefore have met the individual shared responsibility requirement for the months that you were covered under the plan. This IRS form is not required to be filed with individual taxes. 

As of January 1, 2025, the City is only required to provide 1095-C forms if requested by the employee. This notice is to inform staff that Form 1095-C will not automatically be issued for 2024. Employees that wish to receive a copy of Form 1095-C will need to request it from Human Resources. 

Employees can request the form by calling the Benefits Specialist at (603) 610-7270. 

Requests submitted to HR will be fulfilled within 30 days. Requested forms will be mailed to the employee's home address via USPS. Please note only one (1) copy will be provided to the employee. The employee is responsible for providing copies to any covered family member that may require the form. Electronic copies of the form are not available at this time. 

Form 1095-C will be automatically mailed to under 65 Retirees and former employees that terminated employment in 2024. Upon receipt, please review the form and if you find any discrepancies, contact HR for a corrected form. 

This notice will be posted through October 15, 2025.