Forms 1094-B and 1095-B

Purpose

• The report provides information on individuals enrolled in minimum essential coverage during the year (Section 6055 reporting). It will be used to enforce the individual mandate and to determine who is eligible for premium credits in the exchange marketplace.
• A form 1095-B must be filed with the IRS for each individual to whom minimum essential coverage is provided and can be aggregated along with the transmittal form 1094-B. 1095-B is also distributed to the “responsible individual”. This is typically the covered employee or former employee.

Information that Must Be Reported

• Generally, the report will list covered plan participants who received minimum essential coverage.
• The reference material includes a complete list of all information that must be included on the report.

Filing the Report with the IRS

• The insurer files the report for all fully insured health plans. Please note that employers with 50 or more employees may have obligations for filing 1094-C and 1095-C (see below).
• Self-insured small employers (with less than 50 employees) will furnish information to the IRS using Form 1095-B and the IRS transmittal Form 1094-B.
• Large employers report this information on Forms 1095-C and 1094-C (see below).
• Other reporting arrangements, such as those that cover employers in a controlled group, are allowed.

Filing Deadline

• Forms 1094-B and 1095-B must be filed with the IRS on or before February 28 of the year following the year the coverage is provided (March 31, if filed electronically). (Example: deadline for paper filing is February 28, 2017 for reporting information on the 2016 calendar year.)
  • An automatic 30-day extension of time to file is available if requested on or before the 1094/1095 due date. Filers may request an extension of time to file Forms 1094 & 1095 using Form 8809. Filers may request one additional extension, not to exceed 30 days, by submitting a second Form 8809 before the end of the first extension period. Note that this extension applies only to filing the 1094/1095 with the IRS. It does NOT extend the deadline for providing employee statements.
• Note: Employers filing 250 or more 1095 forms must file electronically.

Distributing Statements to Individuals

• Form 1095-B (or a similar statement) must be provided to a responsible individual for whom a Form 1095-B was submitted to the IRS. The responsible individual is the person who enrolls one or more individuals in minimum essential coverage and may be the primary insured, employee, former employee, uniformed services sponsor, parent, or other related person named on the coverage application. Typically, it will be the employee.
• The entity responsible for distributing the statements to individuals is the same entity responsible for filing the report with the IRS.
• If mailed, the statement must be sent to the responsible individual’s last known permanent address or, if no permanent address is known, to the individual’s temporary address. A reporting entity may furnish the statement electronically if specific requirements are satisfied.
• If posting a notice, a reporting entity would be required to post a notice on the entity’s website stating that individuals may receive a copy of their statement upon request.
  • The notice must include certain information and this alternative method of furnishing would apply only while the ACA individual shared responsibility payment penalty is zero.
  • A notice posted on a reporting entity’s website will satisfy the requirement under proposed regulations if written in plain, non-technical terms and with letters of a font size large enough (including any visual clues or graphical figures) to call to a viewer’s attention that the information pertains to tax statements reporting that individuals had health coverage.
  • The notice must remain on the reporting entity’s website until October 15 (or first business day following October 15 if October 15 falls on a weekend or holiday) of the year following the calendar year to which the applicable Form applies.

Distribution Deadline

• March 2Or the next business day, if the 30th day falls on a Saturday, Sunday, or legal holiday of the year following the year the coverage is provided, unless an extension has been provided.
  • The regulations provide for an extension of time to furnish statements (up to 30 days) for a showing of good cause upon written application to the IRS. Note: unlike the extension request for filing Forms 1094/1095 with the IRS, requesting an extension of time to provide employee statements is not automatic.