Form 1095-B: Health Coverage

What Is Form 1095-B: Health Coverage?

Form 1095-B is an Internal Revenue Service (IRS) form that may be sent to taxpayers who receive minimum essential health insurance coverage as defined by the Affordable Care Act (ACA).

A 1095-B form shows information such as the health insurance coverage, effective coverage dates, individuals covered, and the coverage provider.

Key Takeaways

  • Form 1095-B: Health Coverage contains health care coverage information for taxpayers, their spouses, and dependents if enrolled through an insurance provider.
  • Under the Affordable Care Act (ACA), minimum essential coverage is required as part of the individual mandate for health insurance.
  • Recipients of Form 1095-B don't have to send it to the IRS; instead, check off a box on their tax returns, indicating the months they had health insurance coverage during the tax year.

Understanding Form 1095-B: Health Coverage

Form 1095-B: Health Coverage contains health care coverage information for taxpayers, their spouse, and their dependents if they were enrolled through an insurance provider or a self-insured employer.

Under the Affordable Care Act (ACA), there is a requirement for minimum essential coverage as part of the individual mandate for health insurance, also called the individual shared responsibility provision.

Most health insurance plans provided by an employer will typically qualify as minimum essential coverage. Other qualifying plans include government-sponsored programs, like Medicare and most Medicaid plans.

Shared Responsibility Payment

Under the original rules of the ACA, taxpayers were required to have minimum essential health insurance coverage for each month of the year (or have a coverage exemption).

Prior to the 2020 plan year (for which you filed taxes in 2021), if you or your family members didn’t have one or the other, you may have had to pay a penalty called a shared responsibility payment (also sometimes referred to as the Individual Mandate penalty). However, as part of the Tax Cuts and Jobs Act (TCJA), the penalty for not having health insurance was eliminated. This also means that an exemption is no longer required.

In addition, beginning with the tax year 2019, the IRS acknowledged that the provider’s obligation to supply 1095-B forms is not an enforcement priority. If providers comply with two conditions the IRS has set forth, they will not be penalized.

These are the two conditions: first, the provider’s website contains a notice that Form 1095-B is available to participants upon request and includes specific information on how to request it, and second, the provider must then furnish Form 1095-B within 30 days of a request.

State Penalties

Some U.S. states have implemented their own penalties for those who do not have health insurance coverage for the entire tax year. For example, Massachusetts charges 50% of the cost of the lowest-cost plan that could have been purchased. There are income-based exemptions to the penalty.

Taxpayers should check with their state and local governments to determine if there is a penalty for not having minimum essential health insurance coverage throughout the tax year.

While the information on a 1095-B form may assist in preparing a tax return, taxpayers do not need to submit the form when filing their taxes. However, it must be indicated by checking off a box on the tax return stating that they had health insurance for each month of the tax year—called minimum essential coverage.

Form 1095-B vs. Form 1095-A vs. Form 1095-C

Health insurance providers send Form 1095-B to individuals for whom they provide minimum essential coverage. Form 1095-B provides information about who was covered and when. You will receive Form 1095-A: Health Insurance Marketplace Statement if you enrolled in a qualified health plan via the health insurance marketplace.

If you received or were offered healthcare from an employer who has 50 or more employees, you may receive 1095-C: Employer-Provided Health Insurance Offer and Coverage in addition to, or instead of, a 1095-B form.

How to File Form 1095-B: Health Coverage

Depending on who provided your health insurance coverage, as just noted, you should receive either Form 1095-A, Form 1095-B, or Form 1095-C. You usually have to provide information from these forms or acknowledge receiving one of them on your federal tax return. You do not have to submit the form itself. Taxpayers tick off a box on their returns, indicating how long they were covered throughout the tax year.

IRS Form 1095-B
IRS Form 1095-B.

Investopedia

All pages of Form 1095-B are available on the IRS website.

What Is IRS Form 1095-B Used For?

IRS Form 1095-B is sent to taxpayers who receive minimum essential health insurance coverage as defined by the Affordable Care Act (ACA), showing health insurance coverage, the insurance provider, coverage dates, and individuals covered.

What Do I Have to Do with IRS Form 1095-B?

Taxpayers do not need to send the 1095-B form to the IRS. Instead, you indicate on your tax return information provided from 1095-B, such as how many months you had health insurance coverage during the tax year.

What's the Difference Between Forms 1095-B and 1095-C?

Form 1095-B is sent to individuals from health insurance providers indicating whether the taxpayer had minimum essential coverage. Form 1095-C might be sent, with or instead of 1095-B, if you had health insurance coverage from an employer with 50 or more employees.

Article Sources
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  1. Internal Revenue Service. "About Form 1095-B, Health Coverage." Accessed Feb. 1, 2022.

  2. Internal Revenue Service. "Instructions for Forms 1094-B and 1095-B (2020), General Instructions for Forms 1094-B and 1095-B." Accessed Feb. 1, 2022.

  3. Internal Revenue Service. "Individual Shared Responsibility Provision." Accessed Feb. 1, 2022.

  4. Internal Revenue Service. "Instructions for Forms 1094-B and 1095-B (2020)." Accessed Feb. 1, 2022.

  5. U.S. Congress. "H.R.3590 - Patient Protection and Affordable Care Act." Accessed Feb. 1, 2022.

  6. U.S. Centers for Medicare & Medicaid Services. "Exemptions From the Requirement to Have Health Insurance." Accessed Feb. 1, 2022.

  7. Commonwealth of Massachusetts. "TIR 21-1: Individual Mandate Penalties for Tax Year 2021." Accessed Feb. 1, 2022.

  8. Internal Revenue Service. "About Form 1095-A, Health Insurance Marketplace Statement." Accessed Feb. 1, 2022.

  9. Internal Revenue Service. "About Form 1095-C, Employer-Provided Health Insurance Offer and Coverage." Accessed Feb. 1, 2022.

  10. Internal Revenue Service. "Form 1095-B: What You Need to Do With This Form." Accessed Feb. 1, 2022.

  11. Internal Revenue Service. "Prior Year Products." Accessed Feb. 1, 2022.

  12. Internal Revenue Service. "Form 1095-B: Health Coverage," Pages 1-3. Accessed Feb. 1, 2022.

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