Request for Form 1095-C  


Notice Regarding Availability of Form 1095-C

Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, is available upon request. Individuals who were full-time employees of Educational Service Unit 10 during the 2025 calendar year may request a copy of their Form 1095-C. To request a copy of Form 1095-C, please contact: Jodi Andersen, Personnel Coordinator

Email: jandersen@esu10.org
Phone: 308-237-5927
Mail: P.O. Box 850 Kearney, NE 68848

A copy of Form 1095-C will be provided within 30 days of the request or by January 31, 2026, whichever is later.