Instructions for Forms 1094-B and 1095-B

• Issuer: Treasury Department
• Section: Treasury Department

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2023

Instructions for Forms

1094-B and 1095-B

Department of the Treasury

Internal Revenue Service

Section references are to the Internal Revenue Code unless

otherwise noted.

Future Developments

For the latest information about developments relating to Forms

1094-B, Transmittal of Health Coverage Information Returns, and

1095-B, Health Coverage, and their instructions, such as

legislation enacted after they were published, go to IRS.gov/

Form1094B and IRS.gov/Form1095B.

What’s New

The electronic filing threshold for information returns required to

be filed on or after January 1, 2024, has been decreased to 10 or

more returns. See Electronic Filing, later.

Additional Information

For information relating to the Affordable Care Act, visit IRS.gov/

ACA.

For the final regulations relating to Form 1095-B reporting,

see T.D. 9660, 2014-13 I.R.B., at IRS.gov/IRB/2014-13_IRB/

AR08.html and T.D. 9970, 2023-02 I.R.B. 311, at IRS.gov/irb/

2023–02_IRB.

For additional guidance and proposed regulatory changes

relating to Form 1095-B reporting, including the requirement to

solicit the taxpayer identification number (TIN) of each covered

individual for purposes of the reporting of health coverage

information, see Proposed Regulations section 1.6055-1(h) and

Regulations section 301.6724-1.

For additional information relating to reporting by providers of

minimum essential coverage, go to IRS.gov/Affordable-Care-Act/

Employers/Information-Reporting-by-Providers-of-Minimum-

Essential-Coverage.

For information relating to filing Forms 1094-B and 1095-B

electronically, visit IRS.gov/For-Tax-Pros/Software-Developers/

Information-Returns/Affordable-Care-Act-Information-Return-Air-

Program.

General Instructions for Forms

1094-B and 1095-B

Purpose of Form

Form 1095-B is used to report certain information to the IRS and

to taxpayers about individuals who are covered by minimum

essential coverage. Eligibility for certain types of minimum

essential coverage can affect a taxpayer's eligibility for the

premium tax credit.

Minimum essential coverage includes government-sponsored

programs, eligible employer-sponsored plans, individual market

plans, and other coverage the Department of Health and Human

Services designates as minimum essential coverage. Minimum

essential coverage is described in more detail under Who Must

File, later.

Minimum essential coverage doesn't include coverage

consisting solely of excepted benefits. Excepted benefits

include vision and dental coverage not part of a

comprehensive health insurance plan, workers’ compensation

coverage, and coverage limited to a specified disease or illness.

Who Must File

Every person that provides minimum essential coverage to an

individual during a calendar year must file an information return

reporting the coverage. Filers will use Form 1094-B (transmittal)

to submit Forms 1095-B (returns).

Employers (including government employers) subject to the

employer shared responsibility provisions sponsoring

self-insured group health plans, including individual coverage

health reimbursement arrangements (HRAs), will generally

report information about the coverage in Part III of Form 1095-C

instead of on Form 1095-B. However, employers that offer

employer-sponsored self-insured health coverage to

nonemployees who enroll in the coverage may use Form

1095-B, rather than Form 1095-C, Part III, to report coverage for

those individuals and other family members. In general,

employers with 50 or more full-time employees (including

full-time equivalent employees) during the prior calendar year

are subject to the employer shared responsibility provisions. See

the Instructions for Forms 1094-C and 1095-C for more

information about who must file Forms 1094-C and 1095-C and

for more information about reporting coverage for

nonemployees. Small employers that aren't subject to the

employer shared responsibility provisions sponsoring

self-insured group health plans will use Forms 1094-B and

1095-B to report information about covered individuals.

Insured coverage. Health insurance issuers and carriers must

file Form 1095-B for most health insurance coverage, including

individual market coverage and insured coverage sponsored by

employers. However, health insurance issuers and carriers don't

report coverage under the Children’s Health Insurance Program

(CHIP), Medicaid, Medicare (including Medicare Advantage), or

the Basic Health Program provided through health insurance

companies. These types of coverage are reported by the

government sponsors of those programs.

In addition, health insurance issuers and carriers aren't

required to file Form 1095-B to report coverage in individual

market qualified health plans that individuals enroll in through

Health Insurance Marketplaces. This coverage is generally

reported by Marketplaces on Form 1095-A. However, health

insurance issuers are required to file Form 1095-B to report on

coverage for employees obtained through the Small Business

Health Options Program (SHOP). For coverage in 2023 (filing in

2024), health insurance issuers and carriers are encouraged

(but not required) to report coverage in catastrophic health plans

enrolled in through the Marketplace.

Eligible Employer-Sponsored Plans

Eligible employer-sponsored plans are minimum essential

coverage and include the following.

1. Group health insurance coverage for employees under the

following.

TIP

Sep 27, 2023 Cat. No. 63017B