Tax Information

In accordance with the Affordable Care Act (ACA) reporting requirements, Memento Mori Hospitality is providing notice that the default delivery setting for IRS Form 1095-C will be updated to paperless starting with the 2025 reporting year. This form includes information about the health insurance coverage offered to you and, if applicable, your family. This means employees will no longer automatically receive printed copies of their 1095-C forms. Instead, they will receive a paperless copy available in platform. Employees can now request a paper copy of their 1095-C via self-service through the Paperless Options page on their Employee profile. Employees may also receive a copy of their Form 1095-C upon request.

You are not required to wait for Form 1095-C to file your individual income tax return. You should retain any Form 1095-C you receive with your other important tax records.

To request a copy of your Form 1095-C, or if you have any questions, please complete the Form 1095-C Request Form and send the completed request form using one of the methods below:

Email: info@dolphinhm.com

Mailing Address: 3501 Jamboree Road, Suite 550, Newport Beach, CA 92660

Current Employees

The 1095-C form is also accessible to you in Paycom under Payroll > Year-End Tax Forms > 1095 Forms.

Dolphin Hotel Management will provide your requested Form 1095-C no later than 30 days after receiving your request. The notice will remain posted through October 15 of the year following the calendar year to which it relates.