Employer-Provided Health Insurance Offer and Coverage: Pine River-Backus Schools is providing this notice in accordance with the Paperwork Burden
Reduction Act of 2024 and IRS Notice 2025-15.

Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, is not automatically furnished to employees. This form includes information about health insurance coverage that was offered to you during the calendar year and may be used when preparing your federal income tax return. The information reported on Form 1095-C is also provided to the Internal Revenue Service.

Current district employees may access their Form 1095-C electronically through SmartER. Current or past employees may also request a paper copy of their Form 1095-C at no cost by contacting:

Cindy Felthous, Human Resource Director
Pine River-Backus Schools
PO Box 610
Pine River, MN 56474

cfelthous@prbschools.org
218-587-8083

Upon request, Form 1095-C will be provided within 30 days of the request.