Instructions for IRS Form 1094-B, 1095-B

This document contains official instructions for IRS Form 1094-B, and IRS Form 1095-B. Both forms are released and collected by the Internal Revenue Service (IRS), a subdivision of the U.S. Department of the Treasury. An up-to-date fillable IRS Form 1094-B is available for download through this link. The latest available IRS Form 1095-B can be downloaded through this link.

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2020
Department of the Treasury
Internal Revenue Service
Instructions for Forms
1094-B and 1095-B
Section references are to the Internal Revenue Code unless
Affordable-Care-Act/Employers/Information-Reporting-by-
otherwise noted.
Providers-of-Minimum-Essential-Coverage.
Future Developments
For information relating to filing Forms 1094-B and 1095-B
electronically, visit
IRS.gov/For-Tax-Pros/Software-
For the latest information about developments relating to
Developers/Information-Returns/Affordable-Care-Act-
Forms 1094-B, Transmittal of Health Coverage Information
Information-Return-Air-Program.
Returns, and 1095-B, Health Coverage, and the instructions,
such as legislation enacted after they were published, go to
General Instructions for Forms
IRS.gov/Form1094B
and IRS.gov/Form1095B.
1094-B and 1095-B
What’s New
Individual coverage health reimbursement arrangement
Purpose of Form
(HRA). For plan years beginning on or after January 1,
Form 1095-B is used to report certain information to the IRS
2020, employers may offer HRAs integrated with individual
and to taxpayers about individuals who are covered by
health insurance coverage or Medicare, subject to certain
minimum essential coverage. Eligibility for certain types of
conditions (individual coverage HRAs). Generally, an HRA,
minimum essential coverage can affect a taxpayer's eligibility
including an individual coverage HRA, is a self-insured group
for the premium tax credit.
health plan and, therefore, is an eligible employer-sponsored
plan.
Minimum essential coverage includes
government-sponsored programs, eligible
New type of coverage code. A new code G must be
employer-sponsored plans, individual market plans, and
entered on Form 1095-B, line 8 to identify an individual
other coverage the Department of Health and Human
coverage HRA.
Services designates as minimum essential coverage.
Extension of due date for furnishing statements. The
Minimum essential coverage is described in more detail
due date for furnishing Form 1095-B to individuals is
under
Who Must
File, later.
extended from January 31, 2021, to March 2, 2021. See
Minimum essential coverage doesn't include
Notice 2020-76
and
Extension of Time To Furnish Statement
coverage consisting solely of excepted benefits.
to
Recipients, later.
TIP
Excepted benefits include vision and dental
Relief for failure to furnish statements. The IRS will not
coverage not part of a comprehensive health insurance plan,
impose a penalty for failure to furnish Form 1095-B to
workers’ compensation coverage, and coverage limited to a
individuals if certain conditions are met. See
Notice 2020-76
specified disease or illness.
and
Information Reporting
Penalties, later.
Extension of good faith relief for reporting and furnish-
Who Must File
ing. The IRS will not impose a penalty for reporting incorrect
Every person that provides minimum essential coverage to
or incomplete information on the Forms 1095-B if you make a
an individual during a calendar year must file an information
good faith effort to comply with the information reporting
return reporting the coverage. Filers will use Form 1094-B
requirements. See
Notice 2020-76
and
Information Reporting
(transmittal) to submit Forms 1095-B (returns).
Penalties, later.
Employers (including government employers) subject to
Additional Information
the employer shared responsibility provisions sponsoring
For information relating to the Affordable Care Act, visit
self-insured group health plans, including individual coverage
IRS.gov/ACA.
HRAs, generally will report information about the coverage in
Part III of Form 1095-C instead of on Form 1095-B. However,
For the final regulations relating to Form 1095-B reporting,
employers that offer employer-sponsored self-insured health
see T.D. 9660, 2014-13 I.R.B. at
IRS.gov/IRB/2014-13_IRB/
coverage to non-employees who enroll in the coverage may
AR08.html.
use Form 1095-B, rather than Form 1095-C, Part III, to report
For additional guidance and proposed regulatory changes
coverage for those individuals and other family members. In
relating to Form 1095-B reporting, including clarifications
general, employers with 50 or more full-time employees
regarding the reporting requirements for providers of
(including full-time equivalent employees) during the prior
minimum essential coverage and the requirement to solicit
calendar year are subject to the employer shared
the TIN of each covered individual for purposes of the
responsibility provisions. See the Instructions for Forms
reporting of health coverage information, see Proposed
1094-C and 1095-C for more information about who must file
Regulations section 1.6055-1(h) and Regulations section
Forms 1094-C and 1095-C and for more information about
301.6724-1.
reporting coverage for non-employees. Small employers that
For additional information relating to reporting by
aren't subject to the employer shared responsibility
Providers of Minimum Essential Coverage, go to
IRS.gov/
provisions sponsoring self-insured group health plans will
Oct 08, 2020
Cat. No. 63017B
2020
Department of the Treasury
Internal Revenue Service
Instructions for Forms
1094-B and 1095-B
Section references are to the Internal Revenue Code unless
Affordable-Care-Act/Employers/Information-Reporting-by-
otherwise noted.
Providers-of-Minimum-Essential-Coverage.
Future Developments
For information relating to filing Forms 1094-B and 1095-B
electronically, visit
IRS.gov/For-Tax-Pros/Software-
For the latest information about developments relating to
Developers/Information-Returns/Affordable-Care-Act-
Forms 1094-B, Transmittal of Health Coverage Information
Information-Return-Air-Program.
Returns, and 1095-B, Health Coverage, and the instructions,
such as legislation enacted after they were published, go to
General Instructions for Forms
IRS.gov/Form1094B
and IRS.gov/Form1095B.
1094-B and 1095-B
What’s New
Individual coverage health reimbursement arrangement
Purpose of Form
(HRA). For plan years beginning on or after January 1,
Form 1095-B is used to report certain information to the IRS
2020, employers may offer HRAs integrated with individual
and to taxpayers about individuals who are covered by
health insurance coverage or Medicare, subject to certain
minimum essential coverage. Eligibility for certain types of
conditions (individual coverage HRAs). Generally, an HRA,
minimum essential coverage can affect a taxpayer's eligibility
including an individual coverage HRA, is a self-insured group
for the premium tax credit.
health plan and, therefore, is an eligible employer-sponsored
plan.
Minimum essential coverage includes
government-sponsored programs, eligible
New type of coverage code. A new code G must be
employer-sponsored plans, individual market plans, and
entered on Form 1095-B, line 8 to identify an individual
other coverage the Department of Health and Human
coverage HRA.
Services designates as minimum essential coverage.
Extension of due date for furnishing statements. The
Minimum essential coverage is described in more detail
due date for furnishing Form 1095-B to individuals is
under
Who Must
File, later.
extended from January 31, 2021, to March 2, 2021. See
Minimum essential coverage doesn't include
Notice 2020-76
and
Extension of Time To Furnish Statement
coverage consisting solely of excepted benefits.
to
Recipients, later.
TIP
Excepted benefits include vision and dental
Relief for failure to furnish statements. The IRS will not
coverage not part of a comprehensive health insurance plan,
impose a penalty for failure to furnish Form 1095-B to
workers’ compensation coverage, and coverage limited to a
individuals if certain conditions are met. See
Notice 2020-76
specified disease or illness.
and
Information Reporting
Penalties, later.
Extension of good faith relief for reporting and furnish-
Who Must File
ing. The IRS will not impose a penalty for reporting incorrect
Every person that provides minimum essential coverage to
or incomplete information on the Forms 1095-B if you make a
an individual during a calendar year must file an information
good faith effort to comply with the information reporting
return reporting the coverage. Filers will use Form 1094-B
requirements. See
Notice 2020-76
and
Information Reporting
(transmittal) to submit Forms 1095-B (returns).
Penalties, later.
Employers (including government employers) subject to
Additional Information
the employer shared responsibility provisions sponsoring
For information relating to the Affordable Care Act, visit
self-insured group health plans, including individual coverage
IRS.gov/ACA.
HRAs, generally will report information about the coverage in
Part III of Form 1095-C instead of on Form 1095-B. However,
For the final regulations relating to Form 1095-B reporting,
employers that offer employer-sponsored self-insured health
see T.D. 9660, 2014-13 I.R.B. at
IRS.gov/IRB/2014-13_IRB/
coverage to non-employees who enroll in the coverage may
AR08.html.
use Form 1095-B, rather than Form 1095-C, Part III, to report
For additional guidance and proposed regulatory changes
coverage for those individuals and other family members. In
relating to Form 1095-B reporting, including clarifications
general, employers with 50 or more full-time employees
regarding the reporting requirements for providers of
(including full-time equivalent employees) during the prior
minimum essential coverage and the requirement to solicit
calendar year are subject to the employer shared
the TIN of each covered individual for purposes of the
responsibility provisions. See the Instructions for Forms
reporting of health coverage information, see Proposed
1094-C and 1095-C for more information about who must file
Regulations section 1.6055-1(h) and Regulations section
Forms 1094-C and 1095-C and for more information about
301.6724-1.
reporting coverage for non-employees. Small employers that
For additional information relating to reporting by
aren't subject to the employer shared responsibility
Providers of Minimum Essential Coverage, go to
IRS.gov/
provisions sponsoring self-insured group health plans will
Oct 08, 2020
Cat. No. 63017B
use Forms 1094-B and 1095-B to report information about
Each participating employer (for its own employees) for a
covered individuals.
plan or arrangement maintained by a Multiple Employer
Welfare Arrangement.
Insured coverage. Health insurance issuers and carriers
must file Form 1095-B for most health insurance coverage,
A government employer may designate another
including individual market coverage and insured coverage
government entity to report coverage of its employees.
sponsored by employers. However, health insurance issuers
Generally, a designated government entity will file Form
and carriers don't report coverage under the Children’s
1095-B on behalf of a government employer that sponsors or
Health Insurance Program (CHIP), Medicaid, Medicare
maintains a self-insured group health plan for its employees
(including Medicare Advantage), or the Basic Health
only if that government employer isn't subject to the employer
Program provided through health insurance companies.
shared responsibility provisions, which would require
These types of coverage are reported by the government
reporting on Form 1095-C. The Instructions for Forms
sponsors of those programs.
1094-C and 1095-C contain further information on reporting
options for government entities.
In addition, health insurance issuers and carriers aren't
required to file Form 1095-B to report coverage in individual
Government-Sponsored Programs
market qualified health plans that individuals enroll in through
Health Insurance Marketplaces. This coverage generally is
The following government-sponsored programs are minimum
reported by Marketplaces on Form 1095-A. However, health
essential coverage.
insurance issuers are required to file Form 1095-B to report
1. Medicare Part A.
on coverage for employees obtained through the Small
Business Health Options Program (SHOP). For coverage in
2. Medicaid, except for the following programs:
2020 (filing in 2021), health insurance issuers and carriers
a. Optional coverage of family planning services.
are encouraged (but not required) to report coverage in
catastrophic health plans enrolled in through the
b. Optional coverage of tuberculosis-related services.
Marketplace.
c. Coverage of pregnancy-related services.
Eligible Employer-Sponsored Plans
d. Coverage of medical emergency services.
Eligible employer-sponsored plans are minimum essential
e. Coverage of medically needy individuals.
coverage and include:
f. Coverage of COVID-19 testing and diagnostic
1. Group health insurance coverage for employees under:
services.
a. A governmental plan, such as the Federal
3. The Children’s Health Insurance Program (CHIP).
Employees Health Benefits program.
4. The TRICARE program, except for the following options:
b. An insured plan or coverage offered in the small or
large group market within a state.
a. Coverage on a space-available basis in a military
c. A grandfathered health plan offered in a group
treatment facility for individuals who aren't eligible for
market.
TRICARE coverage for private sector care.
2. A self-insured group health plan for employees.
b. Coverage for a line-of-duty-related injury, illness, or
Generally, an HRA, including an individual coverage
disease for individuals who have left active duty.
HRA, is a self-insured group health plan.
5. Coverage administered by the Department of Veterans
Affairs that is:
As noted earlier, minimum essential coverage doesn't
include coverage consisting solely of excepted benefits.
a. Coverage consisting of the medical benefits package
Excepted benefits include vision and dental coverage not
for eligible veterans.
part of a comprehensive health insurance plan, workers’
compensation coverage, and coverage limited to a specified
b. CHAMPVA.
disease or illness.
c. Comprehensive health care for children suffering
Health insurance issuers or carriers will file Form 1095-B
from spina bifida who are the children of Vietnam
for all insured employer coverage. Plan sponsors are
veterans and veterans of covered service in Korea.
responsible for reporting self-insured employer coverage.
6. Coverage for Peace Corps volunteers.
Plan sponsors that are employers subject to the employer
shared responsibility provisions generally must report the
7. The Nonappropriated Fund Health Benefits Program of
coverage on Form 1095-C and other plan sponsors (such as
the Department of Defense.
employers not subject to the employer shared responsibility
In general, the government agency sponsoring the
provisions and sponsors of multiemployer plans) report the
program will file Form 1095-B. The state agency that
coverage on Form 1095-B.
administers a Medicaid or CHIP program will file Form
Plan sponsors of self-insured employer coverage include:
1095-B for coverage under those programs. However,
Each participating employer (for its own covered
Medicaid and CHIP agencies in U.S. possessions or
individuals) in a plan or arrangement established or
territories (American Samoa, the Commonwealth of the
maintained by more than one employer;
Northern Mariana Islands, Guam, Puerto Rico, and the U.S.
The association, committee, joint board of trustees, or
Virgin Islands) aren’t required to report Medicaid or CHIP
similar group of representatives who establish or
coverage on Form 1095-B.
maintain a multiemployer plan;
The employee organization for a plan or arrangement
When coverage under the Nonappropriated Fund Health
maintained solely by an employee organization; and
Benefits Program of the Department of Defense or TRICARE
-2-
Instructions for Forms 1094-B and 1095-B (2020)
is reported on Form 1095-B, Part I, line 8, filers should use
This second rule applies to eligible employer-sponsored
code C (government-sponsored program).
coverage only if both types of coverage (the supplemental
coverage and the eligible employer-sponsored coverage for
Coverage designated as minimum essential coverage.
which section 6055 reporting is required) are offered by the
The Department of Health and Human Services has
same employer. For example, if an employer offers both an
designated the following health benefit plans or
insured group health plan and an HRA that an employee is
arrangements as minimum essential coverage.
eligible for if the employee enrolls in the insured group health
1. Medicare Part C (Medicare Advantage).
plan, and an employee enrolls in both, the employer is not
required to report the employee’s coverage under the HRA
2. Refugee Medical Assistance.
for the months in which the employee is enrolled in both
plans. If, however, an individual is covered by an HRA
3. Coverage provided to a business owner under a plan
sponsored by one employer, including an individual coverage
that is eligible employer-sponsored coverage with
HRA, and a non-HRA group health plan sponsored by
respect to at least one employee.
another employer (such as spousal coverage) or an
4. Coverage under a group health plan provided through
individual is covered by an individual coverage HRA, each
insurance regulated by a foreign government if:
employer (or the health insurance issuer or carrier, if the plan
is insured) must report the coverage the employer (or issuer
a. A covered individual is physically absent from the
or carrier) provides.
United States for at least 1 day during the month; or
For more information on the reporting of supplemental
b. A covered individual is physically present in the
coverage, including the rule on when different entities are
United States for a full month and the coverage
treated as a single employer for purposes of the second rule,
provides health benefits within the United States
see Proposed Regulations section 1.6055-1(d)(2) and (3).
while the individual is outside the United States.
5. The Basic Health Program.
When To File
6. Coverage of pregnancy-related services that consists of
Generally, the return and transmittal form must be filed with
full Medicaid benefits.
the IRS on or before February 28 if filing on paper (March 31
if filing electronically) of the year following the calendar year
7. Coverage under a section 1115 demonstration waiver
of coverage.
program.
You will meet the requirement to file if the form is properly
8. Specific programs listed at
CMS.gov/CCIIO/Programs-
addressed and mailed on or before the due date. If the
and-Initiatives/Health-Insurance-Market-Reforms/
regular due date falls on a Saturday, Sunday, or legal
Minimum-Essential-Coverage.html
(click on the link for
holiday, file by the next business day. A business day is any
“approved plans.”)
day that isn't a Saturday, Sunday, or legal holiday.
Providers of these and later designated programs will file
For forms filed in 2021 reporting coverage provided in
Form 1095-B. The sponsor for the Basic Health Program is
calendar year 2020, Forms 1094-B and 1095-B are required
the state government agency administering the program.
to be filed by March 1, 2021, or March 31, 2021, if filing
electronically.
Coverage in More Than One Minimum Essential
Coverage Plan or Program
See
Statements Furnished to Individuals
for information
on when Form 1095-B must be furnished.
If, for any month, an individual is covered by more than one
minimum essential coverage plan or program that is provided
Extension of Time To File
by the same provider, the provider is required to report only
You can get an automatic 30-day extension of time to file by
one of the plans or programs for that month. For example, if
completing Form 8809 and filing it with the IRS on or before
an individual is covered by a self-insured major medical plan
the due date for the Form 1094-B and 1095-B. Form 8809
and a health reimbursement arrangement (HRA) provided by
may be submitted on paper or through the FIRE System
the same employer for a month, the employer is the provider
either as a fill-in form or an electronic file. No signature or
of both types of coverage and therefore is required to report
explanation is required for the extension. However, you must
the coverage of the individual under only one of the
file Form 8809 by the due date of the returns in order to get
arrangements for that month.
the 30-day extension. Under certain hardship conditions, you
Generally, reporting also is not required for an individual’s
may apply for an additional 30-day extension. See Form
minimum essential coverage for a month if that minimum
8809 and the instructions for more information about
extensions of time to file.
essential coverage is offered only to individuals who are also
covered by other minimum essential coverage for which
How to apply. File Form 8809 as soon as you know that a
reporting is required. For example, an insurance company
30-day extension of time to file is needed. Follow the
offering a Medicare or TRICARE supplement for which only
instructions on Form 8809, which provide information on
individuals enrolled in Medicare or TRICARE are eligible is
where to fax or mail your Form 8809. You can also submit the
not required to report coverage under the Medicare or
extension request online through the FIRE System. You are
TRICARE supplement.
encouraged to submit requests using the online fill-in form.
See Pub. 1220 for more information on filing online or
Under this rule, a state Medicaid agency is not required to
electronically. See the Instructions for Form 8809 for more
report Medicaid coverage for which only individuals enrolled
information.
in other minimum essential coverage, such as
employer-sponsored coverage or a qualified health plan, are
eligible.
-3-
Instructions for Forms 1094-B and 1095-B (2020)
Where To File
1095-B and properly filed those forms electronically. If you
have 300 Forms 1095-B to correct, they must be filed
Send all information returns filed on paper to the following.
electronically. The electronic filing requirement doesn't apply
if you apply for and receive a hardship waiver. The IRS
If your principal business,
encourages you to file electronically even if you're filing fewer
office or agency, or legal
than 250 returns.
Use the following address:
residence in the case of an
individual, is located in:
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
Alabama, Arizona, Arkansas,
date of the return but no later than the due date of the return.
Connecticut, Delaware, Florida,
The IRS doesn’t process waiver requests until January 1 of
Georgia, Kentucky, Louisiana,
the calendar year the returns are due. You can't apply for a
Maine, Massachusetts,
Department of the Treasury
waiver for more than 1 tax year at a time. If you need a waiver
Mississippi, New Hampshire,
Internal Revenue Service
for more than 1 tax year, you must reapply at the appropriate
New Jersey, New Mexico, New
Center
time each year. An approved waiver for original returns will
York, North Carolina, Ohio,
Austin, TX 73301
cover corrections only for the same type of return. If you
Pennsylvania, Rhode Island,
receive an approved waiver, don't send a copy of it to the
Texas, Vermont, Virginia,
service center where you file your paper returns. Keep the
West Virginia
waiver for your records only.
Alaska, California, Colorado,
If you are required to file electronically but fail to do so,
District of Columbia, Hawaii,
and you don't have an approved waiver, you may be subject
Idaho, Illinois, Indiana, Iowa,
to a penalty of up to $280 per return unless you establish
Department of the Treasury
Kansas, Maryland, Michigan,
reasonable cause. However, you can file up to 250 returns on
Internal Revenue Service
Minnesota, Missouri, Montana,
paper; those returns will not be subject to a penalty for failure
Center
Nebraska, Nevada, North
to file electronically. The penalty applies separately to
P.O. Box 219256
Dakota, Oklahoma, Oregon,
original returns and corrected returns.
Kansas City, MO 64121-9256
South Carolina, South Dakota,
Pub. 5165, Guide for Electronically Filing Affordable Care
Tennessee, Utah, Washington,
Act (ACA) Information Returns for Software Developers and
Wisconsin, Wyoming
Transmitters, specifies the communication procedures,
transmission formats, business rules, and validation
procedures, and explains when a return will be accepted,
If your legal residence or principal place of business or
accepted with errors, or rejected for returns filed
principal office or agency is outside the United States, file
electronically for calendar year 2020 through the ACA
with the Department of the Treasury, Internal Revenue
Information Return (AIR) system. To develop software for use
Service Center, Austin, TX 73301.
with the AIR system, software developers, transmitters, and
issuers, including employers filing their own Forms 1094-B
How To File
and 1095-B, should use the guidelines provided in Pub.
5165, along with the Extensible Markup Language (XML)
Filing Paper Returns With the IRS
Schemas published on IRS.gov.
Shipping and mailing. If you're filing on paper, send the
Reminder. The formatting directions in these instructions
forms to the IRS in a flat mailing (not folded) and don’t staple
are for the preparation of paper returns. When filing forms
or paperclip the forms together. If you're sending many
electronically, the formatting set forth in the XML Schemas
forms, you may send them in conveniently sized packages.
and Business Rules published on IRS.gov must be followed
On each package, write your name, and number the
rather than the formatting directions in these instructions. For
packages consecutively. Place Form 1094-B in package
more information regarding electronic filing, see Pubs. 5164
number one and a copy of Form 1094-B in each additional
and 5165.
package. Postal regulations require forms and packages to
Substitute Returns Filed With the IRS
be sent by first-class mail. Returns filed with the IRS must be
printed in landscape format.
See Pub. 5223, General Rules and Specifications for
Affordable Care Act Substitute Forms 1095-A, 1094-B,
Keeping copies. Generally, keep copies of information
1095-B, 1094-C, and 1095-C, for specifications for private
returns you filed with the IRS or maintain the ability to
printing of substitute information returns. You may not
reconstruct the data for at least 3 years, from the due date of
request special consideration. Only forms that conform to the
the returns.
official form and the specifications in Pub. 5223 are
If you're required to file 250 or more
acceptable for filing with the IRS. Substitute returns filed with
information returns, you must file
the IRS must be printed in landscape format.
electronically. The 250-or-more
requirement applies separately to each type of form filed and
Void Box
separately for original and corrected returns. For example, if
Don't use this box on Form 1095-B.
you must file 500 Forms 1095-B and 100 Forms 1095-C, you
must file Forms 1095-B electronically, but you aren't required
Corrected Form 1095-B
to file Forms 1095-C electronically. As another example, if
For information about filing corrections for electronically filed
you have 150 Forms 1095-B to correct, you may file the
forms, see section 7.1 of Pub. 5165. A corrected return
corrected returns on paper because they fall under the 250
threshold even if you originally filed 250 or more Forms
-4-
Instructions for Forms 1094-B and 1095-B (2020)
should be filed as soon as possible after an error is
Sharon is approved for Medicaid coverage beginning on
discovered. File corrected returns as follows.
November 1, 2020. The Medicaid agency must file a
Form 1095-B: Fully complete Form 1095-B and enter an
corrected Form 1095-B with the IRS and furnish Sharon a
“X” in the CORRECTED checkbox. File a Form 1094-B
corrected statement reporting coverage for January through
Transmittal with the corrected Forms 1095-B. (Do not file
September and November through December 2020.
a corrected Form 1094-B.)
Statements Furnished to Individuals
Recipient's statement: A copy of the corrected Form
1095-B must be furnished to the individual who received
Filers of Form 1095-B must furnish a copy by March 2, 2021,
the original Form 1095-B.
to the person identified as the “responsible individual” on the
form for coverage in 2020. However, the IRS will not impose
Note. Enter an “X” in the CORRECTED checkbox only when
a penalty for failure to furnish a copy of Form 1095-B if
correcting a Form 1095-B previously filed with the IRS. If you
certain conditions are met. See
Notice 2020-76
and
are correcting a Form 1095-B that was previously furnished
Information Reporting
Penalties, later, for more information
to a recipient, but not filed with the IRS, write, print, or type
about this penalty relief.
CORRECTED on the new Form 1095-B furnished to the
The “responsible individual” is the person who, based on a
recipient.
relationship to the covered individuals, the primary name on
See the next chart for examples of errors and
the coverage, or some other circumstances, should receive
step-by-step instructions for filing corrected returns.
TIP
the statement. Generally, the statement recipient should be
the taxpayer (tax filer) who would be liable for the individual
shared responsibility payment for the covered individuals, if
Original Form 1095-B Filed With the IRS and Furnished to the
that person is known. A statement recipient may be a parent
Recipient
if only minor children are covered individuals, a primary
IF any of the following are
THEN ...
subscriber for insured coverage, an employee or former
incorrect ...
employee in the case of employer-sponsored coverage, a
uniformed services sponsor for TRICARE, or another
Name of responsible individual
1. Fully complete a new Form
individual who should receive the statement. Filers may, but
(Part I)
1095-B and enter an “X” in the
CORRECTED checkbox.
aren't required to, furnish a statement to more than one
recipient.
2. File a Form 1094-B Transmittal
with the corrected Form 1095-B.
Copies of Form 1095-B furnished to recipients may
Origin of the Health Coverage
3. Furnish a copy of the corrected
include a truncated SSN or other TIN, if applicable, of the
(Part I)
Form 1095-B to the person
statement recipient and covered individuals by showing only
identified as the responsible
the last four digits of the SSN or other TIN and replacing the
individual.
first five digits with asterisks (*) or Xs. Copies of Form 1095-B
furnished to recipients also may truncate the EIN of an
Social security number (SSN) or
taxpayer identification number
employer reported in Part II, if any. The filer’s EIN may not be
(TIN) (Part I)
truncated on the statement furnished to recipients.
Truncation of TINs, including EINs, is not allowed on returns
Information About Certain
filed with the IRS.
Employer-Sponsored Coverage
(Part II)
In general, statements must be furnished on paper by mail
(or hand delivered), unless the recipient affirmatively
Issuer or Other Coverage
consents to receive the statement in an electronic format. If
Provider (Part III)
mailed, the statement must be sent to the recipient’s last
known permanent address, or, if no permanent address is
Covered Individuals (Part IV)
known, to the recipient’s temporary address.
Consent to furnish statement electronically. Except as
provided below, a filer is required to obtain affirmative
You must file a corrected return to report retroactive
changes in coverage.
consent to furnish a statement electronically. The
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requirement to obtain affirmative consent to furnish a
CAUTION
statement electronically ensures that statements are sent
Example 1. Tim enrolls in health insurance with Ace
electronically only to individuals who are able to access
Insurance Company in January 2020. Tim fails to pay his
them. The consent must relate specifically to receiving Form
premiums for November and December 2020 and January
1095-B electronically. A recipient may consent on paper or
2021. Ace sends Tim a Form 1095-B on January 31, 2021,
electronically, such as by email. If consent is on paper, the
reporting coverage for every month in 2020. On February 1,
recipient must confirm the consent electronically. A
2021, Ace cancels Tim’s coverage effective November 1,
statement may be furnished electronically by email or by
2020. Ace must send Tim a corrected Form 1095-B reporting
informing the recipient how to access the statement on the
that Tim was covered only for January through October 2020.
filer’s website. Statements reporting coverage under an
If Ace filed the Form 1095-B with the IRS, it must file a
expatriate health plan, however, may be furnished
corrected Form 1095-B with the IRS reporting coverage only
electronically unless the recipient has explicitly refused to
for January through October 2020.
consent to receive the statement in an electronic format.
Example 2. Sharon is enrolled in Medicaid for January
through September 2020. The Medicaid agency files a Form
1095-B and furnishes a statement to Sharon reporting
coverage for January through September 2020. In April 2021,
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Instructions for Forms 1094-B and 1095-B (2020)
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