In accordance with the Affordable Care Act (ACA) reporting requirements, employees and other covered individuals may receive a copy of their Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, upon request.

Paper copies of Form 1095-C are available upon request by email, telephone or in writing to the following:

Email: benefits@carrollcountymd.gov

Mailing Address:
Carroll County Government
225 N. Center Street, Room 113
Westminster, MD 21157
Telephone: 410-386-2129

Statements will be provided within 30 days of receipt of the request.