IMPORTANT HEALTH COVERAGE TAX DOCUMENTS
Notice of Availability – Form 1095-C

Under the Paperwork Burden Reduction Act, Puget Sound Regional Services is not required to automatically furnish Form 1095-C to employees unless a copy is requested. Form 1095-C provides information about health coverage offers made to full-time employees.

Employees may request a copy of their Form 1095-C at any time. Upon request, the form will be provided within 30 days of the request or by the applicable IRS furnishing deadline (including any approved extensions), whichever is later.

To request a copy of your Form 1095-C or for additional information, please contact:

Email: HR@gopsrs.org

Phone: 206-772-5700 x624

Mail:

Puget Sound Regional Services
Attn: Human Resources
PO Box 2577
Renton, WA 98056

Please include your full name and the mailing address where you would like your Form 1095-C sent.