What is Health Coverage Form 1095-B?

Taxpayers who get minimal essential health insurance coverage under the Affordable Care Act (ACA) may receive Form 1095-B from the IRS.

A 1095-B form indicates health insurance coverage, effective dates, insured persons, and provider.

Understanding Health Coverage Form 1095-B

Form 1095-B: Health Coverage provides health care coverage information for taxpayers, their spouses, and their dependents registered through an insurance provider or self-insured business.

As part of the individual mandate for health insurance or a separate shared responsibility provision, the Affordable Care Act (ACA) requires the minimum necessary coverage.

Employer-provided health insurance is usually minimally essential. Some qualified plans are government-sponsored, such as Medicare and most Medicaid plans.

Cooperation Payment

The original ACA required taxpayers to have monthly minimum basic health insurance coverage (or an exception).

If you or your family didn’t have one or the other before the 2020 plan year (for which you filed taxes in 2021), you may have had to pay a shared responsibility payment (sometimes called the Individual Mandate penalty). The Tax Cuts and Jobs Act (TCJA) repealed the penalty for not having health insurance. This eliminates the need for an exception.6

For 2019, the IRS confirmed that the provider’s need to deliver Health Coverage 1095-B documents is not an enforcement priority. Providers will not be fined if they meet two IRS criteria.

The two criteria are that the provider’s website states that the Health Coverage Form is accessible to participants upon request, provides instructions on getting it, and that the provider must produce it within 30 days.

State Penalties

Some U.S. states penalize people without full-year health insurance. Massachusetts charges 50% of the lowest-cost plan available. Income-based penalty exemptions exist.

Check with state and municipal governments to see whether not having minimal essential health insurance throughout the year carries a penalty.

While a 1095-B form may help prepare a tax return, taxpayers do not need to submit it. Minimum necessary coverage requires marking a box on the tax return to indicate that they have health insurance for each month of the year.

Comparison of Forms 1095-B, A, and C

Health insurers deliver Form 1095-B to minimum essential coverage recipients. Who was insured, and when is it on Form 1095-B? You will get the Health Coverage Form: Health Insurance Marketplace Statement if you register for a qualifying health plan through the marketplace.

Your business with 50 or more workers may send you a 1095-C: Business-Provided Health Insurance Offer and Coverage form instead of a 1095-B document.

Health Coverage Form File

It would be best if, depending on your health insurance provider, you got Health Coverage Form 1095-B or 1095-C. Your federal tax return typically requires you to complete or acknowledge receiving one of these documents. You need not submit the form. Taxpayers check a box on their forms to indicate their coverage length.

The IRS website has all the Health Coverage Form pages.

Why is IRS Form 1095-B used?

Taxpayers who obtain the Affordable Care Act’s (ACA) minimum essential health insurance receive IRS Form 1095-B, which lists health insurance coverage, providers, coverage dates, and persons insured.

IRS Form 1095-B—What Should I Do?

Filers need not transmit the 1095-B to the IRS. Instead, you report 1095-B data on your tax return, such as how many months you had health insurance.

What is the difference between Forms 1095-B and 1095-C?

Health insurance carriers provide a Health Coverage Form to taxpayers, indicating the minimum necessary coverage. Those with health insurance from 50 or more workers may receive Form 1095-C instead of 1095-B.

Conclusion

• Health Coverage provides health care coverage information for taxpayers, spouses, and dependents registered via an insurance provider.
• Personal health insurance must have minimum coverage under the Affordable Care Act (ACA).
• Health Coverage Form recipients don’t have to deliver it to the IRS; they can tick a box on their tax forms to indicate their health insurance coverage months.