Form 1095-B Filing Requirements: Complete Compliance Guide for Health Coverage Providers

ACA reporting is an essential part of compliance for health insurance coverage providers. In this blog, we tell you everything about 1095-B filing requirements to help you comply with ACA reporting.

What is Form 1095-B?

It’s an information return that reports an individual’s minimum essential health coverage (MEC) as defined by the Affordable Care Act (ACA). It’s basically a receipt that documents who was covered, by whom, and for which months during the tax year.

The form provides detailed information such as the health insurance coverage, the individuals covered under the plan, the insurance provider and coverage dates.

Although the federal penalty for not having health insurance is currently $0, this form is still required. The IRS uses Form 1095-B to validate tax returns and make sure people have been provided minimum essential insurance under ACA requirements. It ensures ACA reporting compliance for both the payer/filer and covered individuals. If no reporting was done or the form is missing or has errors, the IRS might assume coverage was not provided.

Who Must File 1095-B?

Since there is no reporting threshold, the entity providing the minimum health coverage is responsible for filing Form 1095-B. That could be:

• Health insurance issuers and carriers (fully insured plans)
• Small self-insured employers that sponsor self-insured health plans and are not Applicable Large Employers (Employers with less than 50 full-time equivalents (FTEs))
• Government programs such as Medicare, Medicaid, CHIP, and certain VA health coverage
• Sponsors of multiemployer plans including union-sponsored coverage

Note: A large employer or an employer with 50+ full-time employees (FTE) do NOT file Form 1095-B, they file Form 1095-C.

Information to Collect Before Filing

Before you start filing, make sure you’ve got all this information ready.

• Responsible individual details (main policyholder): Full name, address, SSN (or DOB if SSN not available).
• Coverage details: List the months when minimum coverage started and ended plus specific months that were covered.
• Dependent information: Names, SSNs/DOBs, and which months they had coverage.
• Coverage details: EIN, business name, address, and contact details.
• Supporting records: Signed enrolment forms, documentation, or W-9s for verification.

How to Fill Form 1095-B?

Let’s walk you through the different sections of 1095-B. You need a separate form for each covered policyholder (their dependents get listed under them). For individuals enrolled mid-year, only report the months they actually had coverage.

Part I – Responsible Individual

Enter the individual’s name, Social Security Number (or DOB if SSN is missing), address and other contact details.

Part II – Employer Information (only when coverage is provided through an employer-sponsored plan)

Include the employer’s name, address, and Employer Identification Number (EIN).

Part III – Issuer or Other Coverage Provider

Add the payer’s or coverage provider’s business name, EIN, contact information, and address.

Part IV – Covered Individuals

List everyone covered under the plan. For each person, provide their name, SSN or DOB, and mark the months they had coverage. If they were covered all year, check “All 12 months” box.

Form 1095-B Deadlines You Must Keep In Mind

You must meet ACA 1095-B deadlines. Missing any of them can result in penalties.

• Recipient Copies: March 2, 2026
• Paper Filing with IRS: March 2, 2026
• E-Filing with IRS: March 31, 2026

Penalties For Not Filing 1095-B On Time

• $60 per return if you correct within 30 days
• $130 per return if you correct by August 1
• $340 per return if you correct after August 1
• $680 per return for intentional disregard

Note: The penalties apply separately for IRS filings and the copies you send to individuals. So, it doubles the exposure.

1095-B State Reporting Requirements

Some states require separate state-level ACA reporting on top of federal filing. This makes staying compliant with different requirements way more complicated. For example, states like California, New Jersey, Rhode Island, and DC require ACA MEC reporting using Forms 1095.

A few states have their own reporting requirements. For example, Massachusetts require Form MA 1099-HC rather than federal Forms 1095-B or 1095-C.

States requiring ACA reporting have their own format requirements, sometimes using specific XML schemas. The deadlines and penalties may also differ. Always check the specific state filing requirements before filing or you can e-file with Tax1099 to get support where state reporting applies. Including e-filing to participating states directly or via the IRS CF/SF program for eligible forms.

How Tax1099 Simplifies 1095-B Filing

Filing 1095-B forms manually can be draining and prone to errors due to its complex reporting requirements. Here’s how Tax1099 simplifies ACA Form 1095-B filing.

• Bulk import: Eliminate manual data entry by uploading data directly from Excel, CSV, QuickBooks, or HR platforms.
• IRS TIN-Matching: This feature validates Name/TIN against IRS records before you file forms, reducing the chances of filing errors and rejections.
• Recipient delivery: Deliver copies to recipient along with tracking, plus print-and-mail service.
• Multi-EIN dashboard: Manage filing for multiple entities with just one login credential.
• State filing support: We offer support for state filing alongside your IRS filing.
• Secure storage: Archive records for 4+ years for audit purposes.

Common 1095-B Mistakes To Avoid

Payers often trip up on specific details that can lead to IRS rejections and audits. Some of these mistakes are:

1. Filing 1095-B when you should file 1095-C
Large employers (50+ FTEs) must file 1095-C. Filing 1095-B fails to satisfy the employer mandate reporting. Always double-check company size before filing.

2. Forgetting to include dependents
The IRS record will show incomplete coverage if you omit dependents. Ensure that you verify all family coverage details.

3. Incorrect SSNs or Names
The IRS validates the name against the SSN database. If it’s incorrect, IRS rejects your form. So, use the TIN-matching to validate the data before filing.

4. Reporting full-year coverage for partial-year employees
This creates a mismatch with enrolment records. You must report only the months where minimum essential coverage was provided.

5. Not sending recipient copies
The IRS imposes penalties for failure to furnish copies to the recipient. To avoid this, send Form 1095-B to recipients by March 2.

Real-Life Examples

FAQs

1. What’s the difference between 1095-B and 1095-C?

Form 1095-B is used by small employers and insurers that provide minimum essential coverage, while Form 1095-C is used by large employers with 50 or more full-time equivalent employees provide minimum essential coverage.

2. What is the minimum dollar threshold for 1095-B?

There is no minimum dollar threshold for Form 1095-B. You must report all covered individuals regardless of the amount.

3. Do dependents get separate forms?

No, they are individually listed on the policyholder’s form 1095-B.

4. Can I file 1095-B electronically?

Yes. In fact, the IRS mandates e-filing if you have 10 or more returns in total across all types, unless a waiver applies.

5. What happens if I miss the deadline?

You’ll have to pay penalties. It ranges from $60 per return to $680 for intentional disregard.

6. Are state filings required?

Certain states such as California, New Jersey, Rhode Island, and DC require ACA Forms 1095 while some states like Massachusetts requires their own ACA Form MA 1099-HC instead of the federal 1095-B/C.

ACA reporting doesn’t have to be complicated.

Make 1095-B filing simple, accurate, and compliant with Tax1099.

Start filing now