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    IRS Form 1095-B

    Form 1095-B: Health Coverage

    Report minimum essential health coverage to the IRS and taxpayers to ensure Affordable Care Act compliance.

    Filing Deadline

    February 28 (paper) or March 31 (electronic)

    Recipient Copy

    Due by January 31

    Electronic Threshold

    250 or more returns

    Overview

    Form 1095-B is used to report information to the IRS and taxpayers about individuals who are covered by minimum essential coverage. This form helps verify that individuals maintained health coverage and are not liable for the individual shared responsibility payment under the Affordable Care Act.

    Minimum essential coverage includes government-sponsored programs (Medicare, Medicaid, CHIP), eligible employer-sponsored plans, and individual market health insurance plans.

    Who Must File

    Required Filers

    • •Health insurance issuers and carriers providing coverage
    • •Sponsors of self-insured health plans (small employers not subject to employer shared responsibility)
    • •Government agencies sponsoring programs like Medicare Part A, Medicaid, CHIP, TRICARE, and VA coverage
    • •Employers reporting SHOP coverage

    Exceptions

    • ✕Large employers (50+ employees) use Form 1095-C instead
    • ✕Marketplace qualified health plans (reported on Form 1095-A)
    • ✕Coverage consisting solely of excepted benefits (vision, dental only)
    • ✕Medicaid/CHIP in U.S. territories

    Form Structure & Instructions

    Form 1095-B is divided into four parts. Here's what information goes in each section:

    Part I: Responsible Individual

    Information about the primary individual covered under the policy

    1
    Name
    Full legal name of the primary covered individual
    2
    SSN
    SSN or other TIN of the responsible individual
    3
    Date of birth (DOB)
    Birth date in MM/DD/YYYY format
    4-7
    Address
    Street address, city, state, and ZIP code
    8
    Origin of Policy
    Enter code A (small employer), B (individual market), or C (government program)
    9
    Policy Number
    Optional - health insurance policy or plan number if applicable

    Part II: Information About Certain Employer-Sponsored Coverage

    Complete this section only for self-insured employer-sponsored coverage

    10-15
    Employer Information
    Employer name, EIN, contact information, and address (only for self-insured plans)

    Part III: Issuer or Other Coverage Provider

    Information about the entity providing the health coverage

    16
    Provider Name
    Name of the health insurance issuer or coverage provider
    17
    Employer Identification Number (EIN)
    EIN of the provider
    18-22
    Contact Information
    Phone number and complete address of the issuer or provider

    Part IV: Covered Individuals

    List all individuals covered under this policy during the year

    Column (a)
    Name
    Full name of each covered individual
    Column (b)
    SSN or TIN
    Social Security Number or taxpayer identification number
    Column (c)
    Date of Birth
    DOB in MM/DD/YYYY format
    Column (d)
    Covered All 12 Months
    Check if covered for entire year
    Column (e)
    Months of Coverage
    If not full year, enter each month's coverage using Jan, Feb, Mar format

    Important Filing Notes

    Electronic Filing Required

    If you're filing 250 or more Forms 1095-B, you must file electronically through the IRS Affordable Care Act Information Return (AIR) system.

    Transmittal Form 1094-B

    Use Form 1094-B as a transmittal form when submitting paper Forms 1095-B to the IRS. Include summary information and total count.

    Corrected Returns

    To correct a previously filed Form 1095-B, check the 'CORRECTED' box at the top and complete the form with corrected information.

    Recipient Copy Requirements

    You must furnish a copy of Form 1095-B to the responsible individual by January 31. Electronic delivery requires recipient consent.

    Additional Resources

    IRS Form 1095-B (PDF)
    Download the current year form
    Instructions for Forms 1094-B and 1095-B
    Complete IRS instructions
    Affordable Care Act Information
    General ACA compliance guidance
    Form 1094-B (Transmittal)
    Transmittal form information

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