Form 1095-B, Health Coverage
Form 1095-B shows that a person had minimum essential health coverage during the year. Fill in the official IRS PDF below and download it.
This is the genuine IRS PDF, unmodified. Source: IRS official page.
What is 1095-B?
Form 1095-B, Health Coverage, is an information return that reports which individuals had minimum essential coverage and for which months. Insurance companies, government programs, and some self-insuring employers send it to the covered person and file it with the IRS.
It documents coverage under the Affordable Care Act. Most people do not need to attach it to a tax return, but it is useful proof of coverage, and some states with their own coverage mandates ask for the information on it.
Who files 1095-B?
- Health insurance carriers reporting the people covered under their policies
- Small self-insured employers that are not Applicable Large Employers
- Government programs and other sponsors of minimum essential coverage
- Plan administrators furnishing proof of coverage to enrollees
How to fill out 1095-B
- Complete Part I with the responsible individual’s name, SSN or date of birth, and address, and pick the origin-of-coverage letter.
- Fill in Part II with employer-sponsored coverage details if the coverage came through a job.
- Enter the coverage provider’s name, EIN, and contact information in Part III.
- List every covered individual in Part IV and check the months each one had coverage, or the all-12-months box.
- Download the finished PDF. Furnish a copy to the responsible individual and file the IRS copy with transmittal Form 1094-B.
Quick fill 1095-B on this page
Prefer to see the form itself while you type? Open 1095-B in the editor to fill it on the actual pages, add a signature, and download.
Frequently asked questions
Do I need Form 1095-B to file my taxes?
Generally no. The federal penalty for going without coverage is currently zero, so most filers just keep the form as proof of coverage. Some states with their own mandates may want the information, so check your state’s rules.
Who sends Form 1095-B, my employer or my insurer?
For fully insured plans, the insurance company sends it. A small self-insured employer sends it for its own plan. Large employers report coverage on Form 1095-C instead.
What transmittal goes with Form 1095-B?
Paper or electronic filings of 1095-B go to the IRS under Form 1094-B, Transmittal of Health Coverage Information Returns.