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.

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.

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.

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