1095-B Form (Health Coverage)

Purpose of Filing Form 1095-B

Form 1095-B is used to report certain information to the IRS and to taxpayers about individuals who are covered by minimum essential coverage and therefore aren't liable for the individual shared responsibility payment.

Minimum essential coverage includes government-sponsored programs, eligible employer-sponsored plans, individual market plans, and other coverage the Department of Health and Human Services designates as minimum essential coverage. Minimum essential coverage is described in more detail under Who Must File, later.

Minimum essential coverage doesn't include coverage consisting solely of excepted benefits. Excepted benefits include vision and dental coverage not part of a comprehensive health insurance plan, workers� compensation coverage, and coverage limited to a specified disease or illness

Who must file 1095-B?

Every person that provides minimum essential coverage to an individual during a calendar year must file an information return reporting the coverage. Filers will use Form 1094-B (transmittal) to submit Forms 1095-B (returns).

Employers (including government employers) subject to the employer shared responsibility provisions sponsoring self-insured group health plans generally will report information about the coverage in Part III of Form 1095-C instead of on Form 1095-B. However, employers that offer employer-sponsored self-insured health coverage to non-employees who enroll in the coverage may use Form 1095-B, rather than Form 1095-C, Part III, to report coverage for those individuals and other family members. In general, employers with 50 or more full-time employees (including full-time equivalent employees) during the prior calendar year are subject to the employer shared responsibility provisions. See the Instructions for Forms 1094-C and 1095-C for more information about who must file Forms 1094-C and 1095-C and for more information about reporting coverage for non-employees. Small employers that aren't subject to the employer shared responsibility provisions sponsoring self-insured group health plans will use Forms 1094-B and 1095-B to report information about covered individuals.

Insured Coverage

Health insurance issuers and carriers must file Form 1095-B for most health insurance coverage, including individual market coverage and insured coverage sponsored by employers. However, health insurance issuers and carriers don't report coverage under the Children�s Health Insurance Program (CHIP), Medicaid, Medicare (including Medicare Advantage), or the Basic Health Program provided through health insurance companies. These types of coverage are reported by the government sponsors of those programs.

In addition, health insurance issuers and carriers aren't required to file Form 1095-B to report coverage in individual market qualified health plans that individuals enroll in through Health Insurance Marketplaces. This coverage generally is reported by Marketplaces on Form 1095-A. However, health insurance issuers are required to file Form 1095-B to report on coverage for employees obtained through the Small Business Health Options Program (SHOP). For coverage in 2016 (filing in 2017), health insurance issuers and carriers are encouraged (but not required) to report coverage in catastrophic health plans enrolled in through the Marketplace.

When to File?

The return and transmittal form must be filed with the IRS on or before February 28 if filing on paper (March 31 if filing electronically) of the year following the calendar year of coverage.

You will meet the requirement to file if the form is properly addressed and mailed on or before the due date. If the regular due date falls on a Saturday, Sunday, or legal holiday, file by the next business day. A business day is any day that isn't a Saturday, Sunday, or legal holiday.

For forms filed in 2017 reporting coverage provided in calendar year 2016, Forms 1094-B and 1095-B are required to be filed by February 28, 2017, or March 31, 2017, if filing electronically.

Extension of Time To File

You can get an automatic 30-day extension of time to file by completing Form 8809 and filing it with the IRS on or before the due date for the Form 1094-B and 1095-B. Form 8809 may be submitted on paper or through the FIRE System either as a fill-in form or an electronic file. No signature or explanation is required for the extension.
However, you must file Form 8809 by the due date of the returns in order to get the 30-day extension. Under certain hardship conditions, you may apply for an additional 30-day extension. See Form 8809 and the instructions for more information about extensions of time to file.

eFiling Requirement

If you're required to file 250 or more information returns, you must file electronically. The 250-or-more requirement applies separately to each type of form filed and separately for original and corrected returns. For example, if you must file 500 Forms 1095-B and 100 Forms 1095-C, you must file Forms 1095-B electronically, but you aren't required to file Forms 1095-C electronically. As another example, if you have 150 Forms 1095-B to correct, you may file the corrected returns on paper because they fall under the 250 threshold even if you originally filed 250 or more Forms 1095-B and properly filed those forms electronically. If you have 300 Forms 1095-B to correct, they must be filed electronically. The electronic filing requirement doesn't apply if you apply for and receive a hardship waiver. The IRS encourages you to file electronically even if you're filing fewer than 250 returns.

Waiver

To receive a waiver from the required filing of information returns electronically, submit Form 8508. You are encouraged to file Form 8508 at least 45 days before the due date of the return but no later than the due date of the return. The IRS doesn�t process waiver requests until January 1st of the calendar year the returns are due. You can't apply for a waiver for more than one tax year at a time. If you need a waiver for more than one tax year, you must reapply at the appropriate time each year. An approved waiver for original returns will cover corrections only for the same type of return. If you receive an approved waiver, don't send a copy of it to the service center where you file your paper returns. Keep the waiver for your records only.
If you are required to file electronically but fail to do so, and you don't have an approved waiver, you may be subject to a penalty of up to $260 per return unless you establish reasonable cause. However, you can file up to 250 returns on paper; those returns will not be subject to a penalty for failure to file electronically. The penalty applies separately to original returns and corrected returns.