Form 1095-B

What is Form 1095-B?

The IRS Form 1095-B conveys important information regarding health coverage for taxpayers who didn’t obtain their health insurance through an exchange or from a large employer. 

It primarily informs the taxpayer and the IRS whether an individual has Minimum Essential Coverage (MEC). 

Established by the Affordable Care Act (ACA), the shared responsibility clause required most taxpayers to possess health coverage or to pay a penalty. Although the penalty has been removed, the requirement for Form 1095-B remains. 

The form is issued annually for the previous year’s coverage, typically early in the year. It helps verify that an individual had health coverage that meets the required ACA standards. It also notes if your coverage disqualifies you from receiving a premium tax credit. 

Although only one copy is issued per policy, other covered individuals can request a copy if needed. 

Form 1095-B is issued by health insurers, government programs, or small employers (<50 full-time employees) offering health coverage, listing the following:

• All covered individuals in your tax household
• Type of coverage provided by the employer
• Months insured 

Who needs to file Form 1095-B?

Basically, anyone providing MEC must file a Form 1095-B for each covered individual and submit it with a transmittal Form 1094-B. You’ll receive Form 1095-B from your insurer or employer only if your health insurance meets legal requirements. 

Large employers with > 50 employees offering self-insured plans can generally report coverage in Part III of Form 1095-C. They can, however, use Form 1095-B for the non-employees. 

Health insurance providers must file Form 1095-B for most insured coverage, with the reporting typically handled by the program sponsors. This, however, does not include government programs like Medicare, the Children’s Health Insurance Program (CHIP), or Basic Health Program coverage. 

Coverage through Marketplaces is reported on Form 1095-A, except for SHOP coverage, as it requires Form 1095-B.

For 2024 coverage (filed in 2025), reporting on catastrophic plans through the Marketplace is optional.

What information is required in Form 1095-B?

Form 1095-B requires the following information:

1. Responsible Individual

This section is about the policyholder for the insurance or the name of the employee (in case of an employee-sponsored plan). 

You need to fill in these details here: Name, address, and Social Security Number (SSN) of the covered individual

2. Information About Certain Employer-Sponsored Coverage

This section is about the employer (if your insurance is employer-sponsored). 

You need to fill in these details here: Name, address, and Employer Identification Number (EIN) of the employer providing the coverage (if applicable)

3. Issuer or Other Coverage Provider

This section requires information about your coverage provider. 

You need to fill in these details here: Name, address, and EIN of the insurance provider or entity offering the coverage

4. Covered Individuals

Lastly, this section enlists the covered individuals under the policyholder’s policy 

You need to fill in these details here: Names, SSNs or TINs, DOBs, and months of coverage

While you don’t need to attach this form to your tax return, you can keep it for your records.

How do you fill out Form 1095-B?

Form 1095-B contains four sections. You must fill in the relevant details accordingly. Let’s go through each part, step-by-step.

1. Part I is about responsible individuals. Here, you must fill out the information below:

• Full name (first, middle, last)
• Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN)
• Date of birth (only if SSN/ITIN is not available)
• Mailing address (street, city, state, ZIP code)

Line 8 is about identifying the origin of health coverage through a code. Here, you must enter one of the letters below to identify the required information.

• A for government-sponsored program (e.g., Medicare, Medicaid)
• B for employer-sponsored coverage
• C for individual market insurance
• D for multi-employer plan
• E for other minimum essential coverage
• F for individual coverage HRA

Line 9 is reserved for future use. You may leave it blank.

2. Part II is about employer-sponsored coverage. Only complete this section if applicable (i.e., if coverage was provided by an employer not subject to Form 1095-C). Here, you must fill out the information below:

• Employer name and EIN (Employer Identification Number)
• Employer address

Leave it blank if the coverage is not employer-based or if it was reported on Form 1095-C

3. Part III is about the issuer or coverage provider. You must provide the details below about the insurance provider or plan sponsor:

• Provider/insurer name and EIN
• Mailing address and contact number
• Use this contact if you have questions about your coverage
• Full details are also sent to the IRS, even if they appear redacted on your copy

4. Part IV is about the covered individuals. It lists each person covered under the policy, including the responsible individual. Fill out the details below for each covered individual:

• Full name
• SSN or Date of Birth
• Coverage months (check the box for each month they were covered or the “Covered All 12 Months” box if applicable)

Please note that if someone changes coverage during the year (switches jobs or insurers), they may appear on more than one 1095-B form. Additionally, no calculations are required on this form. If you’re applying for the Premium Tax Credit, consult IRS Form 8962 and Publication 974 to check your eligibility. 

Ideally, you should receive Form 1095-B by January 31 of the year following the coverage year.

How to submit Form 1095-B?

Here’s how you can seamlessly submit Form 1095-B: 

1. Complete the form by filling out the required details.
2. If you’re submitting via mail, you need to attach Form 1094-B, which acts as the transmittal form. 
3. You can either e-file Form 1095-B through the IRS Affordable Care Act Information Returns (AIR) system or mail it to the IRS. 

You must take care of the following necessities before submitting the form: 

• When filing on paper, send forms in a flat mailing. Do not fold, staple or use a paperclip. 
• Use conveniently sized packages for bulk submissions, and add your name and number on the packages consecutively. 
• Keep Form 1094-B in package one and a copy in each additional package.
• Use first-class mail as per postal regulations. The official mailing address for Form 1095-B depends on your location. Please check the specific address on the IRS website before mailing.
• Print all returns in landscape format.

You must file electronically if you’re filing 10 or more information returns in aggregate. You can exclude this if you receive a hardship waiver. To request a waiver, file Form 8508 at least 45 days before the due date, but no later than the due date. Basically, these waivers cover corrections for the same return type. They are processed starting January 1 of the filing year and are valid for only one tax year.  

What is the deadline for filing Form 1095-B?

Form 1095-B is generally due by March 31 of the year after the coverage year. If needed, you can get an automatic 30-day extension by filing Form 8809.

What are the most common mistakes to avoid for Form 1095-B?

Following are some common mistakes you must avoid while filing Form 1095-B:

1. Ensure that you do not fail to furnish Form 1095-B to the covered individuals. This can create processing delays or penalties for the individual. Send the form to the affected individuals as soon as possible. If you identify an error after furnishing incorrect information, issue a corrected form and mark it appropriately.
2. Failing to file Form 1095-B with the IRS by the due date can result in substantial penalties. Strictly adhere to the designated deadlines—Feb 28 for paper and Mar 31 for electronic submissions. In case of delay due to reasonable cause(s), consider submitting a written explanation, followed by a penalty relief request. 
3. Don’t submit forms with incorrect details. This also includes typos, misspelled names, incorrect SSNs, wrong coverage dates, etc. Such errors can lead to rejections and even IRS penalties. After filling out the details, thoroughly check the form. Identify errors and file a corrected form with the IRS. Also issue corrected forms to recipients. 
4. Do not use an improper form layout or format. Your submission can go rejected if it does not comply with the IRS-required layout or design such as incorrect formatting or unofficial templates. Always use the IRS-issued version of Form 1095-B. Ensure your substitute form strictly follows the specifications outline in IRS Publication 5223. 
5. Not ensuring compliance with the necessary IRS AIR system protocols when filing electronically, including the approved XML schema, can result in rejection or being flagged unfiled. 
6. If you’re unable to file electronically due to a hardship and do not request a waiver, you may be penalized for not meeting filing requirements. Submit Form 8508, “Request for Waiver from Filing Information Returns Electronically,” at least 45 days before the filing deadline. Keep the IRS response on file.
7. Do not delay correcting known errors. Doing so can increase the risk of ongoing non-compliance and penalties. Once you’ve identified an error, file a corrected return and issue updated copies to concerned recipients to avoid further issues. 
8. Do not use truncated SSNs or EINs on the IRS copy of the form. Use it only on the recipient’s copy. In case you’ve done otherwise, refile the form with full TINs or EINs as required on IRS submissions. Also indicate that the submission is a correction. 

How to amend Form 1095-B?

Do not panic if you have made mistakes while filing Form 1095-B. Follow the steps below to correct errors:

1. Get a completely new form with accurate information. 
2. Submit the corrected form to the IRS. If the original form was filed electronically, submit the corrected version via the IRS AIR system. In case of paper filing, send the corrected form to the same address used for initial submission. 
3. File corrected returns promptly, as soon as you discover any error. This ensures compliance and helps prevent potential penalties. 

There is no formal correction process for correcting errors on Form 1095-B. Simply prepare a new form as soon as you identify any errors and submit it with corrected information to the IRS, with the “CORRECTED” checkbox marked. 

What should I do if I have lost my 1095-B form? 

For those filing taxes in an individual mandate state without possessing Form 1095-B, you can download it from your member website. You can also request a copy by calling the number on your ID card or other plan materials.

How to get a replacement 1095-B form?

This is how you can get a replacement Form 1095-B: 

1. Directly contact your insurer or employer who provided your health coverage. Several providers offer online portals where you can access and download Form 1095-B. 
2. If your provider has a member services department, contact them to request a replacement form. 
3. If you received coverage through a state program like Medi-Cal in California, contact your local county human services agency. They can assist you in requesting a reprint of your Form 1095-B. 
4. Some insurance providers, such as UnitedHealthcare, allow members to access their 1095-B forms through their online accounts. Log into your account and navigate to the tax documents section to download the form. 
5. If you’re unable to obtain the form from your provider, you can contact the IRS for assistance. Visit their official website or call their helpline at 1-800-829-1040 for guidance.
6. Ensure that your mailing address and contact information are up to date with your health coverage provider. This will help avoid delays in receiving your Form 1095-B.

What is the difference between Form 1095-B and Form 1095-C?

Both Form 1095-B and Form 1095-C are important for verifying coverage when filing taxes. However, they cater to different requirements. 

Form 1095-B is used by insurance providers and government programs like Medicaid to report an individual’s health coverage for the year. It helps determine if the individuals meet the ACA’s coverage requirements. 

Form 1095-C, on the other hand, is issued by large employers with 50 or more full-time employees. It details the health insurance coverage offered to employees, including whether it meets ACA standards.