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Form 1095-C Available for Employees and Former Employees As required by the Affordable Care Act (ACA), Form 1095-C, which provides information about the health insurance coverage provided during your employment with U.S. Grounds Maintenance, is now available. If you were employed with us during the relevant year and need a copy of your Form 1095-C, please contact Tess McIntyre by filling in this form, or by calling (402) 345-6991 to request the form by phone, or ask any questions you may have.