1095-B Reporting
E-file 1095B Reporting
What is 1095-B Reporting?
The Form 1095‑B is the IRS document that verifies an individual maintained minimum essential coverage (MEC) health insurance. Typically prepared by insurers and certain self‑insured employers, it lists the type of coverage provided, the months it was active, and everyone covered under the plan. Although you generally don’t file Form 1095‑B with your tax return, you should keep it on hand as proof of coverage and to confirm the accuracy of any health‑coverage information you report to the IRS.
Overview of Forms 1094‑B and 1095‑B
Under the Affordable Care Act (ACA), Forms 1094‑B and 1095‑B are used to report health‑coverage information to the IRS.
Form 1095‑B shows which individuals were enrolled in minimum essential coverage (MEC) during the year. It is usually issued by insurance carriers or smaller self‑insured employers. Taxpayers should keep this form with their records, but they generally do not attach it to their tax return.
Form 1094‑B is the transmittal sent to the IRS along with the accompanying 1095‑B statements. It serves as a cover sheet, summarizing the filer’s information and the total number of 1095‑B forms submitted.
What information is included in Form 1095-B Reporting?
Form 1095-B provides detailed information about an individual's health coverage to ensure compliance with the ACA. Line by line, the form requires the following:
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Part I – Responsible Individual (Lines 1 – 9)
Captures the recipient’s identifying details—name, SSN or TIN, address—and, on Line 8, a single‑letter code indicating the type of coverage. -
Part II – Employer‑Sponsored Coverage (Lines 10 – 15)
Completed only when coverage is offered through an employer; it lists the employer’s name, EIN, and contact information. -
Part III – Issuer or Other Coverage Provider (Lines 16 – 22)
Identifies the insurance company or government program that issued the policy, along with its EIN and phone number for questions. -
Part IV – Covered Individuals (Lines 23 – 28)
Lists each person covered, their SSN/TIN (or date of birth), and their coverage months.
Columns (d) and (e) show whether the individual was insured for all 12 months or specify the exact months of coverage.
Import
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Who needs to submit a Form 1095-B reporting?
Form 1095‑B must be completed by the entities that actually provide minimum essential coverage under the Affordable Care Act. This group includes private insurers, small employers with self‑insured health plans, and government programs such as Medicaid and CHIP. Each of these providers is required to prepare and transmit a 1095‑B to report the coverage they offered during the year.
Individuals who were enrolled in one of these plans will receive the ACA statement for their own records. Taxpayers do not attach Form 1095‑B to their returns, but they should keep it on file as proof of qualifying health coverage.
What is the deadline for Form 1095-B?
Form 1095-B deadlines are twofold, catering to recipients and the Internal Revenue Service (IRS). Insurance providers and certain other entities are required to furnish Form 1095-B to the covered individuals by Monday, March 3rd, 2025 of the year following the coverage year.
Additionally, the issuers of the coverage must file these forms, along with the transmittal Form 1094-B, with the IRS by Friday, February 28th, 2025 if paper filing* and by Monday, March 31st, 2025 if electronically filing. It's essential for entities to adhere to these deadlines to avoid potential penalties.
*Please note that entities that are required to file more than 10 Forms 1095-B must submit an electronic filing.
What are the filing methods for Form 1095-B reporting?
Form 1095-B can be filed using two primary methods: electronic filing and paper filing. Entities issuing Form 1095-B are encouraged to file electronically, especially if they have to file 10 or more of these forms. Electronic filing is conducted through the IRS's ACA Information Returns (AIR) system.
If entities are filing fewer than 10 forms and choose not to use the electronic method, they can submit paper copies of Form 1095-B to the IRS.
Alongside the individual 1095-B forms, issuers must also send the transmittal Form 1094-B, which serves as a cover sheet summarizing the accompanying 1095-B forms. Regardless of the method chosen, it's vital to adhere to the respective deadlines to ensure compliance and avoid penalties.
E-filing Form 1095-B
Form 1095-B e-filing refers to the electronic submission of Form 1095-B to the IRS using approved digital methods. The IRS AIR system facilitates the e-filing process for these forms.
E-filing is particularly advantageous for entities that have to file a large number of forms, as it streamlines the submission process, reduces the potential for errors, and offers faster confirmation of receipt.
It's worth noting that entities submitting 10 or more Form 1095-Bs are required to e-file, emphasizing the IRS's preference for this efficient and secure method.
Paper Filing Form 1095-B
1095-B paper filing pertains to the traditional method of submitting Form 1095-B to the IRS using physical, printed forms which must be sent to the appropriate address. The ACA mailing address is dependent upon where the filer's business address is located.
While e-filing is encouraged for efficiency and accuracy, entities that issue fewer than 10 Form 1095-Bs in a year have the option to paper file. When using this method, the issuer must also include the transmittal Form 1094-B, which acts as a cover sheet summarizing the accompanying 1095-B forms.
Paper filing requires careful attention to detail to avoid errors, and entities should be mindful of the distinct submission deadlines compared to e-filing to ensure timely compliance.
Penalties
Entities that fail to furnish Form 1095-B or fail to file it with the IRS can receive hefty penalties. For 2025, the penalty is $330 for each form not provided to the recipient or not filed with the IRS. However, penalties could be higher for intentional disregard of the requirement to furnish forms.
Conclusion
In conclusion, Form 1095-B reporting plays a pivotal role in the landscape of the U.S. healthcare system, ensuring compliance with the ACA. With potentially hefty penalties in play for missteps, it's imperative to stay informed about the form's intricacies and adhere strictly to the stipulated guidelines.
Whether opting for electronic or paper filing methods, timely and accurate submission is a non-negotiable aspect of responsible financial and healthcare management.
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