In alignment with the Paperwork Burden Reduction Act, with the exception of California employees, 1095-C Forms will no longer be mailed to employees and are available upon request. Requests for Form 1095-C can be made by using one of the following contact methods:

Email: [email protected]
Mail: Attention: Boldt Benefits Department; 2121 E. Capitol Drive, Appleton, WI, 54911
Phone: 920.225.6161

Please include your full legal name, phone number and mailing address or email address for the form to be securely sent.

Forms will be provided by the later of January 31 or 30 days following the date of the request.

What is Form 1095-C? Form 1095-C is a tax form sent to employees who were eligible for company-sponsored health insurance during the prior plan year. This form should be maintained with your tax records.