Form 1095-C — Availability Notice

Pursuant to federal law, Form 1095-C (Employer-Provided Health Insurance Offer and Coverage) is available to you upon request.

This form provides information about the health coverage offered to you during the applicable tax year. You may not need the form to file your federal income tax return; however, you may request a copy for your records. 

To request a copy of your Form 1095-C, contact:
Email: [email protected]
Mail: Human Resources Manager, 4230 S. 94th St., Omaha, NE 68127
Phone: (402) 558-3677

A copy of the form will be provided within 30 days of your request. 

This notice will remain available on this website through October 15 of the applicable reporting year. 

Last updated: March 12, 2026