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Human Resources Service Center

Affordable Care Act Form 1095-B FAQs

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  • What am I supposed to do with this form?

    You will need information provided on this form to indicate on your income tax return that you, your spouse and dependent children (if applicable) had minimum essential coverage.

    You should file this form with your income tax records and may need to provide a copy to other covered individuals identified in Part IV of the form.

    Note: Given the spring deadline for health coverage providers to furnish Form 1095-B to individuals enrolled in minimum essential health coverage, the IRS is providing transitional relief to those who file their individual tax returns prior to receiving this notice. You may prepare and file your tax return using other information about your health insurance.

  • What is the purpose of this form?

    Under the ACA’s Individual Shared Responsibility provision (known as the individual mandate), most individuals are required to maintain minimum essential health coverage. Individuals who do not maintain minimum essential coverage may be subject to a penalty.

    The ACA also requires every provider of minimum essential coverage to file annual reports with the IRS with information about individuals covered by minimum essential coverage and furnish a statement, Form 1095-B, by January 31 to individuals who had minimum essential coverage for at least one day during the preceding calendar year.

    The IRS will use information reported on this form to determine if an individual is complying with the ACA’s individual mandate.

  • Why did I get this this form?

    You received this form because you were enrolled in state-sponsored health or COBRA coverage, which provides minimum essential coverage, for at least one day during the preceding calendar year.

  • Who sent this form to me?

    This form was provided by your health coverage provider because you were enrolled in state-sponsored health or COBRA coverage for at least one day during the preceding calendar year.

  • Why didn't I receive this form?

    You did not receive this form because you were not enrolled in state-sponsored health or COBRA coverage for at least one day during the preceding calendar year.

  • Who should I contact if I believe I should have received this form and did not?

    You should contact your health coverage provider (contact information provided below) if you were enrolled in state-sponsored health or COBRA coverage for at least one day during the preceding calendar year and did not receive this form.

  • Who should I contact if I have additional questions from this form?

    You should contact your health coverage provider (contact information provided below) with questions or visit irs Affordable Care Act (ACA) Tax Provisions website.

  • Health Care Provider Contact Numbers
    Health Care Provider Numbers
    Health Coverage ProviderContact Number
    Anthem Blue Cross855-839-4524
    Blue Shield of California800-334-5847
    Kaiser Permanente800-464-4000
    PERS Select, PERS Choice, and PERS Care877-737-7776