The Netchex Definitive Guide to Form 1095-B for Employers (2026)

Form 1095-B, Health Coverage, is an information return used to report certain types of minimum essential health coverage provided to individuals. The form identifies individuals who were covered by qualifying health insurance during the year. Insurance companies, government programs, and certain employers who sponsor self-insured health plans use Form 1095-B to report coverage information to both the IRS and covered individuals.

References

Source: IRS About Form 1095-B

Source: IRS Instructions for Forms 1094-B and 1095-B

Form 1095-B is generally filed by health insurance providers, including insurance carriers and government programs that provide coverage such as Medicaid or Medicare. Certain small employers that sponsor self-insured health plans may also be required to file Form 1095-B to report coverage for employees and their dependents.

References

Source: IRS ACA Information Reporting for Providers

Source: IRS Instructions for Forms 1094-B and 1095-B

The purpose of Form 1095-B is to report minimum essential health coverage provided to individuals during the calendar year. The form verifies whether individuals had qualifying health insurance coverage. This was originally used to enforce the individual mandate requirement under the Affordable Care Act.

References

Source: IRS ACA Individual Coverage Information

Form 1095-B reports health coverage provided to individuals, while Form 1095-C reports health coverage offered by applicable large employers to employees. Form 1095-C focuses on employer mandate compliance, while Form 1095-B focuses on documenting individuals who were covered by minimum essential coverage.

References

Source: IRS ACA Forms Overview

Individuals who were covered under a health insurance plan that qualifies as minimum essential coverage will receive Form 1095-B from the provider of that coverage. The form documents the months during which each individual was covered by the plan.

References 

Source: IRS About Form 1095-B

Form 1095-B reports coverage that qualifies as minimum essential coverage under the Affordable Care Act. Examples include private health insurance, employer-sponsored self-insured plans for small employers, government programs such as Medicare or Medicaid, and certain other qualifying plans.

References

Source: IRS ACA Minimum Essential Coverage

Form 1095-B includes identifying information about the coverage provider, the responsible individual (policyholder), and individuals covered under the plan. The form also reports the months during which each individual had health coverage.

References 

Source: IRS Instructions for Forms 1094-B and 1095-B

Form 1095-B contains four sections. Part I includes information about the responsible individual who enrolled in coverage. Part II identifies the employer sponsoring the plan if applicable. Part III identifies the insurance provider, and Part IV lists covered individuals and months of coverage.

References 

Source: IRS Instructions for Forms 1094-B and 1095-B

Part I includes identifying information about the responsible individual, such as their name, address, and Social Security number. The responsible individual is typically the policyholder or primary enrollee for the health coverage.

References 

Source: IRS Instructions for Forms 1094-B and 1095-B

Part II identifies the employer that sponsors the health plan when coverage is provided through an employer. This section includes the employer’s name and Employer Identification Number (EIN).

References

Source: IRS Instructions for Forms 1094-B and 1095-B

Part III includes information about the insurance provider responsible for the coverage. This section identifies the entity providing the health insurance. The provider’s name, address, and employer identification number are reported here.

References 

Source: IRS Instructions for Forms 1094-B and 1095-B

Part IV lists each individual covered under the health plan and the months during which they were covered. Covered individuals may include employees, spouses, and dependents enrolled in the health plan.

References

Source: IRS Instructions for Forms 1094-B and 1095-B

Minimum essential coverage refers to health insurance coverage that meets the requirements of the Affordable Care Act. Coverage that meets these requirements satisfies the ACA individual mandate provisions.

References 

Source: IRS ACA Individual Coverage Information

Form 1095-B must generally be furnished to individuals by January 31 of the year following the coverage year. However, the IRS sometimes grants automatic extensions for furnishing these forms to recipients.

References

Source: IRS ACA Reporting Deadlines 

Forms 1095-B must generally be filed with the IRS by late February if filed on paper or by March 31 if filed electronically. The forms must be submitted along with Form 1094-B, which acts as a transmittal document.

References

Source: IRS ACA Reporting Instructions

Form 1094-B is the transmittal form used to submit Forms 1095-B to the IRS. It summarizes information about the filer and the number of forms submitted.

References

Source: IRS About Form 1094-B 

Employers filing large numbers of information returns must file electronically with the IRS. Electronic filing improves processing efficiency and reduces errors.

References 

Source: IRS ACA Electronic Filing (AIR System)

The AIR (Affordable Care Act Information Returns) system is the IRS electronic platform used to submit ACA information returns such as Forms 1095-B and 1095-C. Employers and insurance providers use the system to transmit coverage data electronically.

References 

Source: IRS AIR Filing System

A responsible individual is the primary person who enrolled in the health coverage plan. This individual receives Form 1095-B and is responsible for the policy.

References 

Source: IRS Instructions for Forms 1094-B and 1095-B

Covered individuals include anyone enrolled in the health insurance plan, such as employees, spouses, children, and other dependents. Each covered person is listed on the form along with their coverage months.

References 

Source: IRS Instructions for Forms 1094-B and 1095-B

If an individual’s health coverage begins partway through the year, Form 1095-B should reflect coverage only for the months the individual was enrolled in the plan. Each month of coverage must be reported separately or marked as all 12 months if the person was covered the entire year. Accurate reporting ensures the IRS can confirm when minimum essential coverage was in place for each covered individual.

References

Source: IRS Instructions for Forms 1094-B and 1095-B

If coverage ends during the year, the coverage provider must report only the months during which the individual was actually enrolled in the health plan. For example, if coverage ended in September, the form would show coverage from January through September and leave the remaining months blank.

References 

Source: IRS Instructions for Forms 1094-B and 1095-B

If an employee leaves the company and was covered under a self-insured plan, the employer must still report the months the employee had coverage before termination. If the employee elects COBRA continuation coverage, those months of coverage may also be reported depending on the coverage arrangement.

References 

Source: IRS ACA Employer Reporting Guidance

When dependents are added to a health insurance plan, the employer or insurance provider must include those individuals in Part IV of Form 1095-B. The form should indicate the months each dependent was covered under the plan.

References 

Source: IRS Instructions for Forms 1094-B and 1095-B

If a dependent is removed from coverage during the year, the coverage months reported on Form 1095-B should reflect only the months the dependent was actually enrolled. This ensures the IRS has an accurate record of coverage for each individual.

References 

Source: IRS ACA Reporting Instructions

If an individual changes coverage plans during the year, the form still reports whether minimum essential coverage was provided for each month. The specific plan selected typically does not affect Form 1095-B reporting as long as the coverage qualifies as minimum essential coverage.

References 

Source: IRS ACA Minimum Essential Coverage Guidance

If a covered individual dies during the year, the coverage provider must report coverage only through the month of death. Accurate reporting ensures the IRS has correct records for the individual’s coverage history.

References 

Source: IRS Instructions for Forms 1094-B and 1095-B

If a Social Security number is not available for a covered individual, the coverage provider must make reasonable attempts to obtain the number. If the number cannot be obtained, the individual’s date of birth may be used instead.

References

Source: IRS TIN Solicitation Rules

If incorrect information is reported, the filer must issue a corrected Form 1095-B to both the IRS and the individual receiving the form. Correcting errors promptly helps prevent potential penalties and ensures accurate reporting.

References 

Source: IRS Information Return Corrections

To correct a Form 1095-B, the filer must submit a corrected form with updated information and clearly mark it as corrected. The corrected form must also be sent to the individual whose coverage was reported.

References

Source: IRS Instructions for Correcting ACA Returns 

TIN solicitation refers to the process of requesting a taxpayer identification number such as a Social Security number from individuals covered by a health plan. Filing entities must make reasonable efforts to obtain correct TINs for all covered individuals.

References 

Source: IRS TIN Matching and Solicitation Guidance

If a filer fails to submit required Forms 1095-B, the IRS may assess penalties for failing to file correct information returns. Penalties may increase depending on how late the forms are filed.

References 

Source: IRS Information Return Penalties 

Providing incorrect or incomplete information on Form 1095-B may also result in IRS penalties. These penalties apply per form and may accumulate if multiple forms contain errors.

References 

Source: IRS Information Return Penalties

ACA reporting penalties are generally assessed per incorrect or late form submitted to the IRS or furnished to individuals. The amount may vary depending on how quickly errors are corrected after the filing deadline.

References 

Source: IRS Penalty Guidelines for Information Returns 

Employers should maintain records showing which individuals were covered by their health plans, the dates of coverage, and identifying information such as Social Security numbers. These records support the accuracy of Forms 1095-B submitted to the IRS.

References

Source: IRS ACA Employer Reporting Guidance

Employers and coverage providers should generally retain ACA reporting records for at least three to four years. Keeping accurate records ensures that information can be verified if the IRS reviews the filings.

References

Source: IRS Recordkeeping Guidance 

If an individual receives coverage from multiple providers during the year, each provider may issue its own Form 1095-B reporting the months of coverage they provided. This ensures that all coverage periods are accurately documented.

References

Source: IRS ACA Coverage Reporting Guidance

If coverage overlaps between providers, each provider reports the months during which their coverage applied. Overlapping coverage does not affect reporting requirements.

References 

Source: IRS Instructions for Forms 1094-B and 1095-B 

Medicare coverage is reported by the government agency responsible for administering the program. Individuals enrolled in Medicare may receive Form 1095-B documenting their coverage.

References 

Source: IRS ACA Individual Coverage Reporting

State agencies responsible for Medicaid programs issue Form 1095-B to report coverage under the program. These forms document the months individuals were enrolled in Medicaid coverage.

References 

Source: IRS ACA Individual Coverage Reporting 

COBRA coverage may be reported by the health coverage provider depending on the structure of the health plan. COBRA allows individuals to continue employer-sponsored coverage after leaving employment.

References 

Source: U.S. Department of Labor COBRA Information

Retiree health coverage provided through an employer or insurance carrier may be reported using Form 1095-B. The coverage provider reports the months during which the retiree had coverage.

References 

Source: IRS ACA Coverage Reporting Instructions

During an IRS review, the agency may verify that ACA reporting forms accurately reflect coverage provided during the year. Filers may be asked to provide documentation supporting the reported coverage.

References 

Source: IRS ACA Compliance Guidance

Common errors include missing Social Security numbers, incorrect coverage months, and inaccurate identifying information. Reviewing coverage data before filing can help prevent these issues.

References 

Source: IRS Instructions for Forms 1094-B and 1095-B 

If the IRS issues a notice regarding ACA reporting, the filer should review the notice carefully and respond by the deadline provided. Supporting documentation may be required to resolve discrepancies.

References

Source: IRS ACA Employer Compliance Information

Insurance carriers are typically responsible for issuing Form 1095-B when coverage is provided through a fully insured plan. They report coverage details directly to the IRS and covered individuals.

References

Source: IRS ACA Reporting Guidance

Small employers that sponsor self-insured health plans may be responsible for filing Form 1095-B to report coverage for employees and dependents. Employers offering fully insured plans generally rely on the insurance carrier to handle reporting.

References 

Source: IRS ACA Employer Guidance

Coverage providers should gather information including the responsible individual’s identifying information, covered individuals, Social Security numbers, and months of coverage. Accurate data helps ensure correct reporting.

References 

Source: IRS Instructions for Forms 1094-B and 1095-B

Payroll and benefits systems often track employee eligibility and enrollment coverage. These systems help generate reports used to prepare ACA information returns.

References

Source: IRS ACA Employer Reporting Guidance

Many employers and insurance providers use third-party vendors to manage ACA reporting requirements. These vendors help prepare, validate, and file ACA forms with the IRS.

References 

Source: IRS ACA Electronic Filing Guidance 

When companies merge or restructure, the reporting responsibility may shift depending on which entity provides the health coverage. Coverage providers must ensure reporting accurately reflects coverage provided during the year.

References 

Source: IRS ACA Employer Reporting Guidance

If a company closes during the year but provides health coverage earlier in the year, the coverage provider must still report coverage for those months. Forms must still be filed with the IRS for the applicable coverage period.

References 

Source: IRS ACA Reporting Instructions

If coverage providers change during the year, each provider reports the coverage they provided during their coverage period. Individuals may receive multiple Forms 1095-B reflecting different coverage providers.

References 

Source: IRS ACA Reporting Guidance

Yes. Coverage providers may furnish Forms 1095-B electronically if the recipient consents to electronic delivery. Electronic distribution must meet IRS consent and disclosure requirements.

References 

Source: IRS Electronic Furnishing Rules 

Form 1095-B can be downloaded directly from the IRS website. The site also provides detailed instructions for completing the form.

References

Source: IRS Form 1095-B 

Form 1094-B serves as the transmittal form for submitting Forms 1095-B to the IRS. It is available on the IRS website.

References

Source: IRS Form 1094-B

Employers can find detailed reporting instructions for ACA forms on the IRS website. The instructions explain how to complete Forms 1094-B and 1095-B.

References 

Source: IRS Instructions for Forms 1094-B and 1095-B

Accurate coverage reporting helps verify compliance with ACA health coverage requirements and ensures individuals have documentation of their coverage. Incorrect reporting can lead to penalties or IRS inquiries.

References 

Source: IRS ACA Reporting Guidance 

Best practices include maintaining accurate coverage records, verifying Social Security numbers, reviewing coverage months carefully, and validating forms before submission. Employers often use ACA reporting software or vendors to reduce errors.

References 

Source: IRS ACA Employer Compliance Guidance

Form 1095-B provides documentation of minimum essential health coverage provided to individuals during the year. Accurate reporting helps ensure compliance with ACA reporting requirements and provides individuals with proof of coverage.

References 

Source: IRS About Form 1095-B