IRS Form 1095-B – Health Coverage

IRS Form 1095-B – Health Coverage – In today’s complex tax landscape, staying informed about health insurance reporting is essential for individuals, employers, and insurance providers. IRS Form 1095-B, also known as the Health Coverage form, plays a crucial role in documenting minimum essential coverage under the Affordable Care Act (ACA). Whether you’re a taxpayer verifying your coverage or a filer responsible for submission, this SEO-optimized guide covers everything you need to know about Form 1095-B, including its purpose, filing requirements, and updates for the 2025 tax year. We’ll draw from official IRS sources to ensure accuracy and reliability.

What is IRS Form 1095-B?

IRS Form 1095-B is an information return used to report health insurance coverage provided to individuals during the calendar year. It helps taxpayers confirm they had minimum essential coverage, which can impact eligibility for the premium tax credit on their federal tax return. This form is not filed with your personal tax return but should be kept for your records. It’s typically issued by health insurance providers, employers with self-insured plans, or government agencies sponsoring coverage programs.

The form includes details about the covered individuals, the type of coverage, and the months it was in effect. For the 2025 tax year, the form has been updated with minor adjustments, but its core structure remains consistent.

Purpose of Form 1095-B

The primary purpose of Form 1095-B is to provide proof of health coverage to the IRS and recipients. Under the ACA, minimum essential coverage includes:

  • Government-sponsored programs like Medicare Part A, Medicaid (with some exceptions), CHIP, and TRICARE.
  • Employer-sponsored plans, including self-insured group health plans.
  • Individual market plans purchased outside of the Health Insurance Marketplace.
  • Other designated coverage, such as certain health reimbursement arrangements (HRAs).

This reporting ensures compliance with health coverage requirements and assists in determining premium tax credit eligibility. Even though the individual shared responsibility payment (penalty for lacking coverage) was reduced to zero starting in 2019, Form 1095-B remains important for record-keeping and potential state-level mandates.

Who Must File Form 1095-B?

Filing responsibility falls on providers of minimum essential coverage. Key filers include:

  • Health Insurance Issuers and Carriers: For individual market coverage, insured employer-sponsored plans, and Small Business Health Options Program (SHOP) plans.
  • Employers with Self-Insured Plans: Small employers not subject to employer shared responsibility provisions use Form 1095-B; larger employers typically use Form 1095-C.
  • Government Agencies: For programs like Medicare, Medicaid, CHIP, and VA coverage.
  • Plan Sponsors: Including multiemployer plans, associations, and Multiple Employer Welfare Arrangements (MEWAs).

If multiple coverage types are provided by the same entity in a month, only one needs to be reported. Supplemental coverage (e.g., vision or dental only) is generally not reported unless it’s part of comprehensive health insurance.

Filers must submit Form 1095-B along with the transmittal Form 1094-B to the IRS. Recipients (responsible individuals, such as policyholders or employees) receive a copy for their records.

Key Information Reported on Form 1095-B

Form 1095-B is structured into four parts, each capturing specific details about the coverage:

  • Part I: Responsible Individual – Includes the name, SSN or TIN (truncated on recipient copies), date of birth (if TIN unavailable), address, and a code for the origin of coverage (e.g., A for SHOP, B for employer-sponsored, G for individual coverage HRA).
  • Part II: Information About Certain Employer-Sponsored Coverage – Completed only for insured plans; includes employer name, EIN (truncated), and address.
  • Part III: Issuer or Other Coverage Provider – Details the provider’s name, EIN, contact phone, and address.
  • Part IV: Covered Individuals – Lists up to six individuals (with continuation sheets for more), including names, SSNs or TINs (truncated), dates of birth, and checkboxes for full-year or monthly coverage.

The form emphasizes that coverage through the Health Insurance Marketplace is reported on Form 1095-A instead, and some employer coverage may appear on Form 1095-C.

How to Fill Out Form 1095-B?

Completing Form 1095-B requires accurate information from enrollment records. Here’s a step-by-step overview:

  1. Gather Data: Collect names, SSNs/TINs, dates of birth, addresses, and coverage periods for all covered individuals.
  2. Complete Part I: Enter the responsible individual’s details and select the appropriate origin code (Line 8). Line 9 is reserved and left blank for 2025.
  3. Fill Part II (if applicable): For employer-sponsored insured coverage, provide employer details.
  4. Enter Part III: List the coverage provider’s information, including a contact number for inquiries.
  5. Detail Part IV: For each covered person, input identifiers and mark coverage months (at least one day per month counts). Use the “Covered all 12 months” checkbox if applicable.
  6. Handle Corrections: If errors are found, file a corrected form by checking the “CORRECTED” box and submitting a complete new version with Form 1094-B.

For electronic filing, use the Affordable Care Act Information Returns (AIR) system. Paper filers must ensure forms are machine-readable and not folded. Always retain records for at least three years.

Filing Deadlines and Requirements for 2025

For coverage provided in 2025 (filed in 2026):

  • Furnishing to Individuals: Due by March 2, 2026 (automatic extension from February 2). Instead of mailing, filers can post a clear website notice by March 3, 2025, and provide copies upon request within 30 days.
  • Filing with IRS: Paper by March 2, 2026; electronic by March 31, 2026. Electronic filing is mandatory for 10 or more returns.

Extensions are available via Form 8809. Penalties for non-compliance can reach $340 per return for failures to file or furnish correctly, with higher amounts for intentional disregard. Small businesses may qualify for lower maximum penalties.

Recent Changes for the 2025 Tax Year

The IRS has introduced flexibility in furnishing statements: Automatic mailing is no longer required if a compliant website notice is posted, allowing recipients to request copies. Deadlines have been extended, and electronic filing thresholds remain at 10 returns. No major structural changes to the form itself, but filers should review IRS Notice 2025-15 for website notice guidelines. These updates aim to reduce administrative burdens while maintaining compliance.

How to Obtain Your Form 1095-B?

If you’re a recipient, contact your insurance provider, employer, or government agency. Many now provide access via online portals or upon request. For questions, use the contact number in Part III of the form. If you need to verify coverage for tax purposes, refer to IRS Publication 974 for premium tax credit details.

Common Questions About IRS Form 1095-B (FAQ)

  • Do I need to file Form 1095-B with my taxes? No, keep it for records only.
  • What if I didn’t receive my form? Request it from your provider; they must furnish it within 30 days.
  • How does this differ from Form 1095-A or 1095-C? Form 1095-A is for Marketplace coverage; 1095-C is for large employer-sponsored plans.
  • Are there penalties for individuals? No federal penalty for lacking coverage since 2019, but check state rules.
  • Can I e-file as an individual? This form is for providers; individuals don’t file it.

For more details, consult official IRS resources.

Download IRS Form 1095-B

You can download the latest PDF version of Form 1095-B directly from the IRS website: https://www.irs.gov/pub/irs-pdf/f1095b.pdf.

This guide is designed to help you navigate IRS Form 1095-B efficiently. Always consult a tax professional for personalized advice, and stay updated via IRS.gov for any further changes.