1095-B

Health Coverage

Agency
IRS
Revision
2025
Fillable fields
355
Pages
3
Official source
IRS form page
Checked
October 21, 2026
Fill 1095-B online
Page 1 of form 1095-B

Form 1095-B: Health Coverage

Form 1095-B, Health Coverage, is an information return. The instructions say it "is used to report certain information to the IRS and to taxpayers about individuals who are covered by minimum essential coverage." Minimum essential coverage includes government-sponsored programs, eligible employer-sponsored plans, individual market plans and other coverage that the Department of Health and Human Services designates.

The form is completed by the provider of the coverage, such as a health insurance issuer or carrier, a government agency that sponsors a program like Medicaid, or the sponsor of certain self-insured plans. The provider files it with the IRS under the Form 1094-B transmittal and gives a copy to the "responsible individual" named in Part I. The recipient copy says "Do not attach to your tax return. Keep for your records."

This page covers the 2025 form. You can fill it out free in your browser on this page and download the result without an account.

What's on Form 1095-B

Part I: Responsible Individual, lines 1 to 9

Name, SSN or other TIN, date of birth only when no TIN is given, mailing address, and line 8 for the letter that identifies the origin of the health coverage. Line 9 is reserved.

Line 8 coverage codes

One letter from A to G: SHOP, employer-sponsored coverage, government-sponsored program, individual market insurance, multiemployer plan, other designated coverage, or individual coverage HRA.

Part II: Employer-sponsored coverage, lines 10 to 15

The employer's name, EIN and address. The instructions say this part is completed only by issuers or carriers of insured group health plans, including coverage purchased through SHOP.

Part III: Issuer or other coverage provider, lines 16 to 22

The provider's name, EIN, contact telephone number on line 18 and mailing address.

Part IV: Covered Individuals, lines 23 to 28

One row per covered person with name, SSN or other TIN, date of birth, a box for all 12 months and a box for each month of coverage. Page 3 is a continuation sheet with rows 29 to 40.

How Form 1095-B is filled out

  1. 1

    Lines 1 to 7

    Enter the responsible individual's name, nine-digit SSN or other TIN and complete mailing address. The instructions say to enter a date of birth on line 3 only if line 2 is blank.

  2. 2

    Line 8 and line 9

    Enter the one letter that identifies the origin of the health coverage. For 2025, the instructions say to leave line 9 blank.

  3. 3

    Part II

    The instructions say insurance companies entering code A or B on line 8 complete Part II. Employers reporting self-insured coverage enter code B but skip Part II and go to Part III.

  4. 4

    Part III

    Enter the provider's name, EIN and mailing address. Line 18 is the telephone number an individual seeking more information may call to speak to a person.

  5. 5

    Part IV

    List each covered individual. Check column (d) for coverage of at least 1 day in all 12 months, or check the months in column (e). Use the continuation sheet if there are more than six people.

  6. 6

    Transmit and furnish

    File the forms with the IRS under Form 1094-B and give a copy to the responsible individual. To correct a form filed with the IRS, the instructions say to enter an X in the CORRECTED box.

The instructions for Forms 1094-B and 1095-B describe each line for the filer.

Why fill Form 1095-B on indox

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Deadlines, where to file and penalties

Filing deadline for 2025 coverage

The instructions say Forms 1094-B and 1095-B are required to be filed by March 2, 2026, or March 31, 2026, if filing electronically. Form 8809 requests an automatic 30-day extension.

Copy to the responsible individual

Filers furnish a copy by March 2, 2026, for 2025 coverage. A provider can instead post a website notice and furnish the form on request, no later than the later of January 31, 2026, or 30 days after the request.

Where to mail paper returns

By the filer's location, either Internal Revenue Service Center, Austin, TX 73301, or Internal Revenue Service Center, P.O. Box 219256, Kansas City, MO 64121-9256. Filers outside the United States use Austin, TX 73301.

Electronic filing

The instructions say filers of 10 or more information returns in the aggregate file electronically through the ACA Information Return (AIR) system. Form 8508 requests a waiver.

Penalties

For 2025 returns the instructions list $340 for each incorrect or missing return and $340 for each payee statement, with a calendar year maximum of $4,098,500 each.

Truncated numbers

Recipient copies may show only the last four digits of an SSN or other TIN. The instructions say truncation is not allowed on returns filed with the IRS.

Related forms

Who fills out Form 1095-B?

  • Health insurance issuers and carriers

    The instructions say issuers and carriers file Form 1095-B for most health insurance coverage, including individual market coverage and insured coverage sponsored by employers, and for coverage obtained through SHOP.

  • Government program sponsors

    In general the government agency sponsoring the program files. The instructions say the state agency that administers a Medicaid or CHIP program files Form 1095-B for coverage under those programs.

  • Sponsors of certain self-insured plans

    Small employers not subject to the employer shared responsibility provisions, and sponsors of multiemployer plans, use Forms 1094-B and 1095-B to report self-insured coverage, the instructions say.

  • Employers that use Form 1095-C instead

    Employers subject to the employer shared responsibility provisions that sponsor self-insured group health plans generally report that coverage in Part III of Form 1095-C, not on Form 1095-B.

  • The responsible individual receives it

    The recipient is the person named in Part I, generally the primary taxpayer. The instructions list a parent of covered minor children, a primary subscriber or an employee as examples.

The instructions say every person who provides minimum essential coverage to an individual during a calendar year files an information return reporting it. The covered person receives a copy and does not fill it out.

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Questions about Form 1095-B

Do I attach Form 1095-B to my tax return?

No. The recipient copy says "Do not attach to your tax return. Keep for your records." The coverage provider files the form with the IRS.

Who sends Form 1095-B?

The provider of minimum essential coverage, such as a health insurance issuer or carrier, a government agency running a program like Medicaid or CHIP, or the sponsor of certain self-insured plans.

What does the letter on line 8 mean?

It identifies the origin of the coverage: A for SHOP, B for employer-sponsored coverage, C for a government-sponsored program, D for individual market insurance, E for a multiemployer plan, F for other designated coverage and G for an individual coverage HRA.

Part II of my form is blank. Is that a problem?

The recipient instructions say Part II may be left blank even if you had employer-sponsored coverage, and that you do not need to fill it in or return it to your employer or other coverage provider.

Why does my Form 1095-B show only part of my SSN?

The form says that for your protection it may show only the last four digits. The coverage provider reports the complete SSN or other TIN to the IRS.

How is Form 1095-B different from Forms 1095-A and 1095-C?

The form says Marketplace coverage is generally reported on Form 1095-A, and employer-sponsored coverage may be reported on Form 1095-C (Part III) rather than on Form 1095-B.

Who can I call about the information on the form?

Line 18 shows a telephone number for the coverage provider. For questions on the Affordable Care Act tax provisions, the form lists the IRS Healthcare Hotline at 800-919-0452.