Notice of Availability of Form 1095-C

In compliance with the Affordable Care Act (ACA), Act-On Software is required to provide Form 1095-C, which outlines your health insurance coverage for the previous year.

Form 1095-C is available upon request.

If you would like to receive a copy of your Form 1095-C or have any questions about your form, please contact Payroll using one of the following methods:

• Email: [email protected]
• Phone: 503-536-1185
• Mail or in person:
  Act-On Software
  Attn: Payroll
  121 SW Morrison St, Ste 1600
  Portland, OR 97204

Requests can be made at any time, and the form will be provided to you by January 31 or within 30 days of your request, whichever is later.