Notice of Availability of IRS Form 1095-B and Form 1095-C
In accordance with applicable Internal Revenue Service (IRS) regulations, The City of Cottonwood is providing this notice to inform current and former employees, as well as other individuals who may be covered under the Company’s level-funded or self-funded health plan, that IRS Form 1095-B and/or IRS Form 1095-C are available upon request.
For the 2025 reporting year, the City of Cottonwood is not automatically distributing Forms 1095-B or 1095-C. Individuals may request a copy of their Form 1095-B and/or Form 1095-C using one of the contact methods listed below.
To request a copy:
Email: klennon@cottonwoodaz.gov
Call: 928-340-2712
Mail Request: Atten: Kirsten Lennon, 821 N Main Street, Cottonwood, AZ 86326
Upon receipt of a request, the City of Cottonwood will provide the requested Form 1095 within 30 days, as required by IRS regulations. Forms will be provided by mail or hand delivery unless the individual has provided specific consent to receive the form electronically.