Form 1095-B - Line by Line Instructions

Updated on December 10, 2021 - 10:30am by TaxBandits

Being a non-ALE member or healthcare provider, you should provide proof of healthcare coverage offered to your employee/individual. The proof document is Form 1095-B. It should be completed with the required information and submitted to the IRS. And a copy of this form must be furnished to the corresponding individual. To complete this form error-free, you should be aware of 1095 B instructions for 2021. While submitting this form to the IRS, 1094-B transmittal form should be submitted.

Note: Non-ALE member is an employer with less than 50 full-time employees.

Read this article to know about how to complete 1095 B and what information is required for it.

In this article, we cover the following topics that address 1095 B instructions.

1. Part I- Responsible Individual

This part should be filled with the personal information of the individual/employee. In total, there are nine lines. They are as follows:

Part I- Responsible Individual

Part I- Responsible Individual

  • Line 1 - Name of the responsible individual–First name, middle name, last name

    Enter the full name of the responsible individual.

  • Line 2 - Social Security Number (SSN) or other TIN

    Enter the 9-digit Social Security Number of the individual. If SSN is available, enter the other TIN of the individual.

  • Line 3 - Date of birth (if SSN or other TIN is not available)

    Enter the date of birth. This line should be completed only if you leave line 2 blank.

  • Line 4 - Street address (including apartment no.)

    Enter the full street address, including the apartment number. If there is no street address and the individual has a P.O. box, enter the box number.

  • Line 5 - City or town

    Enter the city or town of the individual.

  • Line 6 - State or province

    Enter the state or province of the individual.

  • Line 7 - Country and ZIP or foreign postal code

    Enter the country and ZIP code of the individual.

  • Line 8 - Enter letter identifying Origin of the Health Coverage

    In this line, enter the code relevant to the coverage offered to the individual and his/her dependents.

    • A - Small Business Health Options Program (SHOP)
    • B - Employer-sponsored coverage
    • C - Government-sponsored program
    • D - Individual market insurance
    • E - Multiemployer plan
    • F - Other designated minimum essential coverage
    • G - Individual coverage health reimbursement arrangement (HRA)
  • Line 9 - Reserved for future use

2. Part II- Information About Certain Employer-Sponsored Coverage

This part should be completed by issuers or carriers of insured group health coverage plans, including coverage purchased through the shop.

Note: Insurance companies that enter codes A or B on line 8 should complete Part II. Employers who report self-insured group health plan coverage on Form 1095-B, enter code B on line 8, should not fill Part II. If you have entered code B for self-insured coverage, skip Part II, and complete Part III. If the coverage is provided through a multiemployer plan, you should not complete Part II.

Part II- Information About Certain Employer-Sponsored Coverage

Part II- Information About Certain Employer-Sponsored Coverage

  • Line 10 - Employer name

    Enter the full name of the employer.

  • Line 11 - Employer identification number (EIN)

    Enter the Employer Identification Number (EIN)

  • Line 12 - Street address (including room or suite no.)

    Enter the full street address, including the apartment number. If there is no street address and the employer has a P.O. box, enter the box number.

  • Line 13 - City or town

    Enter the city or town of the employer.

  • Line 14 - State or province

    Enter the state or province of the employer.

  • Line 15 - Country and ZIP or foreign postal code

    Enter the country and ZIP code of the employer.

3. Part III - Enter the Issuer or coverage provider information

Part III should be completed by the provider of the coverage. The provider can be the issuer or carrier of insured coverage, a government agency providing government-sponsored coverage, a sponsor of a self-insured employer plan, or other coverage sponsors.

Part III - Enter the Issuer or coverage provider information

Part III - Enter the Issuer or coverage provider information

  • Line 16 - Name

    Enter the name of the provider.

  • Line 17 - Employer Identification Number (EIN)

    Enter the Employer Identification Number of the provider.

  • Line 18 - Contact telephone number

    Enter the telephone number of the provider.

  • Line 19 - Street address (including room or suite no.)

    Enter the street address, including room or suite number.

  • Line 20 - City or town

    Enter the city or town of the provider.

  • Line 21 - State or province

    Enter the state or province of the provider.

  • Line 22 - Country and ZIP or foreign postal code

    Enter the country and ZIP code of the provider.

4. Part IV - Individuals Covered

In Part IV, the individual and dependents who were enrolled under this coverage should be involved. If you are adding more than six covered individuals, you can attach the Continuation Sheets.

  • (a) Name of covered individual(s) First name, middle initial, last name
  • (b) SSN or other TIN
  • (c) DOB (if SSN or other TIN is not available)
  • (d) Covered all 12 months
  • (e) Months of coverage

After completing 1095-B, you need to complete the 1094-B and send both the forms to the IRS. And a copy of 1095-B should be sent to the recipient.

If you are looking for a trusted e-file service provider to complete your 1095-B filing for 2021, TaxBandits is here to help you.

TaxBandits is an IRS-authorized e-file service provider. We support the e-filing of IRS Form 1095 B/C, Form 1094 B/C, and other tax forms. Our support team is here to help you complete your ACA Forms this year. We have updated our application as per the recent updates from the IRS. You can now e-file 1095-B with the IRS without any hassle.

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