Request 1095 C Form
IMPORTANT HEALTH COVERAGE DOCUMENTS
As an employee that was eligible for minimum essential health coverage provided by the Impact Business Group Benefit Plan you are entitled to a Form 1095-C for the 2025 tax year, which serves as proof of the coverage we offered you. This statement was previously mailed to individuals; however, due to new regulations designed to reduce paperwork and administrative burden, we are no longer required to send paper copies via mail.
You are not required to file this statement with your personal taxes. However, if you would like to request a free copy of your Form 1095-C for your records, you may do so by emailing ACA@impactbusinessgroup.com, calling 616-254-8586 or sending a request to:
iMPact Business Group
Attn: HR
1188 East Paris Avenue, SE Suite 120
Grand Rapids, MI 49546.
A paper copy will be mailed to the address on file within 30 days of receiving the request. If you prefer to receive an electronic copy of your Form 1095-C, please include your preferred email with the request.
