Simplify ACA Reporting: 1095-B Instructions for Payers

What Is Form 1095-B?

Form 1095-B reports minimum essential coverage (MEC) provided by a payer to individuals and their families in a year. It’s part of the Affordable Care Act (ACA) information reporting requirement for payers, helping the IRS identify and track individuals who received MEC during the year.

Who Needs to File 1095-B?

Not every business or payer needs to file Form 1095-B. Here’s a quick breakdown of every payer who needs to fulfill Form 1095-B filing requirements:

• Health insurance issuers and carriers (fully insured plans)
• Small employers (fewer than 50 full-time employees) with self-insured health plans
• Government agencies sponsoring programs (e.g., Medicaid, CHIP, Medicare Part A, TRICARE)

Filing Form 1095-B is not needed for:

• A large employer (50+ full-time employees). Instead, you will have to file 1099-C.
• An employer with a fully insured plan. Your insurance provider will handle 1095-B filing requirements
• Providing limited coverage (e.g., standalone dental or vision plans)

Note: Any payer that directly provides insurance or MEC must file 1095-B.

Form 1095-B Instructions: What to Report

Here’s a simple breakdown of how to file 1095-B:

Part I – Responsible Individual or the primary subscriber/taxpayer

• Enter the policyholder’s name, Social Security Number (or DOB if SSN is missing), address, and select the Origin of Health Coverage.

Part II – Employer Information (filed by insurers/carriers of insured employee plans)

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

Part III – Issuer or Other Coverage Provider

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

Part IV – Covered Individuals

• List all individuals covered under the plan check “All 12 months” or specific months covered, whichever is applicable.

Tip: Double-check coverage months and SSNs.errors usually occur here and can cause IRS rejections.

How to File 1095-B With Tax1099

IRS Form 1095-B instructions require you to file the form accurately or risk penalties and notices.:

1. Gather the required coverage details such as names, SSNs, addresses, and coverage months via Excel/CSV bulk data upload or import it directly from your system.
2. Use our built-in data validation tools like USPS address validation, to verify the addresses or TIN match to verify name and SSN (TIN).
3. Fill out one Form 1095-B for each primary policyholder
4. Capture recipient consent and furnish copies to each insured individual using our in-built eDelivery portal and automatic USPS mail options.

Directly e-file Form 1095-B with the IRS and store records securely for at least 4 years.

1095-B Deadlines IRS Wants You to Know

These are the ACA deadlines payers need to meet:

Avoid These Common Payer Mistakes

Some common 1095-B errors that payers should watch out for include:

• Incorrect SSNs (as per IRS records)
• Not including covered dependents
• Misreporting coverage (showing only partial instead of full-year)
• Filing paper forms instead of e-filing (10+ returns threshold)
• Not providing recipient copies to covered individuals and dependents

Note: Tax1099’s built-in error checks and data validations help you report coverage data accurately.

1095-B Penalties for Payers: What Happens If You Don’t File

Not filing or filing incorrectly can lead to penalties depending on how late the filing was done.

• $60, if 30 days late
• $130, if filed after 30 days or by Aug 1
• $330, if filed after Aug 1
• $660 for intentional disregard

1095-B vs. 1095-C Difference and How It Applies

While both 1095-B and 1095-C forms are related to health coverage, each has a different purpose.

How Tax1099 Makes It Easier to File 1095-B

• Direct IRS e-filing in minutes via the FIRE system
• Secure data uploads through API or bulk upload
• Recipient delivery (mail or digital)
• Built-in error checks
• Scalable filing for 10 to 10,000 forms

Real-Life Scenarios

FAQs

Q1. Do I need to send 1095-Bto both the IRS and the individual?

Yes, one copy goes to the IRS, and another goes to the insured person.

Q2. What if the MEC coverage only lasted part of the year?

Report only the months for which the individual was covered.

Q3. Is electronic filing required for 1095-B?

Yes, e-filing is required if you are filing 10 or more forms.

Q4. Can I correct mistakes after submitting 1095-B?

Yes. File a corrected form with the IRS to void the previous form..

Q5. Do large employers file 1095-B?

No. They must file 1095-C. Filing 1095-B is for insurers, small employers with self-funded plans, or government programs.

Final Thoughts

Filing Form 1095-B doesn’t have to be a headache. With the correct guidance and tools, payers can stay compliant, meet ACA reporting standards, and avoid penalties.

Use Tax1099 to file 1095-B forms online. It’s smart, secure, and IRS-approved.