IRS · Official form

Form 1094-B, Transmittal of Health Coverage Information Returns

Form 1094-B is the cover sheet that transmits Forms 1095-B, the health coverage information returns, to the IRS. Fill in the official IRS PDF below and download it.

This is the genuine IRS PDF, unmodified. Source: IRS official page.

What is 1094-B?

Form 1094-B, Transmittal of Health Coverage Information Returns, accompanies Forms 1095-B when a coverage provider files them with the IRS. Form 1095-B reports who had minimum essential health coverage during the year; the 1094-B identifies the filer and states how many 1095-B forms are being submitted.

The pair is part of the Affordable Care Act information reporting system. Health insurers, small self-insured employers, and government coverage programs use these forms, while applicable large employers generally use Forms 1094-C and 1095-C instead.

Who files 1094-B?

  • Health insurance issuers and carriers reporting the coverage they provided
  • Small self-insured employers that are not applicable large employers
  • Government agencies administering coverage programs such as Medicaid or CHIP
  • Other providers of minimum essential coverage listed in the current instructions

How to fill out 1094-B

  1. Enter the filer’s name, EIN, and address in the identification section.
  2. Add the name and phone number of a contact person the IRS can reach with questions.
  3. Enter the total number of Forms 1095-B submitted with this transmittal.
  4. Sign and date the form.
  5. Download the PDF and submit it with the Forms 1095-B by the filing deadline in the current instructions. Filers at or above the e-file threshold must file electronically instead of on paper.
Worth knowing: Filers at or above the IRS electronic filing threshold must submit Forms 1094-B and 1095-B through the IRS AIR system, not on paper. If you qualify to file on paper, follow the print specifications in the current instructions.

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Frequently asked questions

What is the difference between Form 1094-B and Form 1094-C?

Form 1094-B transmits Forms 1095-B filed by insurers, small self-insured employers, and government programs. Form 1094-C transmits Forms 1095-C filed by applicable large employers, generally those with 50 or more full-time equivalent employees. The instructions explain which set applies to you.

Can Form 1094-B be filed on paper?

Only by filers below the electronic filing threshold in the current regulations, counted across most information return types combined. Filers at or above the threshold must e-file through the IRS AIR system. Check the current instructions for the threshold and deadlines.

Do individuals who had coverage file this form?

No. Coverage providers file the 1094-B and 1095-B. Individuals simply receive a copy of Form 1095-B for their records and generally do not attach it to their tax return.