TurboTax / Tax Calculators & Tips / All Tax Guides / Health Care / Does Your Company Need to File Form 1095-B?

Does Your Company Need to File Form 1095-B?

Updated for Tax Year 2016


OVERVIEW

A company is responsible for filing IRS Form 1095-B only if two conditions apply: It offers health coverage to its employees, and it is "self-insured." This means that the company itself pays its employees' medical bills, rather than an insurance company. A company that doesn't meet both conditions won't have to deal with Form 1095-B. Its employees might still receive a 1095-B, but from their insurer, not the employer.


The role of the 1095-B

The IRS created Form 1095-B to fulfill the requirements of the Affordable Care Act, also known as Obamacare. That law requires Americans to have basic level of health insurance in place, referred to as minimum essential coverage. Those who don't have such insurance may be required to pay a penalty.

Whoever provides minimum essential coverage to an individual is required to send that person a copy of Form 1095-B, or in the case of large employers, Form 1095-C, and to send the same information to the IRS. The form provides details about the coverage, including who in the individual's household was covered and when. The 1095-B forms became mandatory beginning in the 2015 tax year.

Sponsors vs. providers

Under federal regulations, it is the responsibility of insurance "providers" to send out 1095-B forms. But there's a vitally important distinction between "sponsors" of health coverage and "providers."

  • A sponsor is whoever arranges the health coverage. When people get health coverage through a job, the employer is the sponsor.
  • A provider, on the other hand, is a company or organization that actually pays the bills.
    • Often, that's an insurance company, in which case the insurer must send out the 1095-B form.
    • A self-insured employer is both the sponsor and the provider; in that case, the employer would send out the 1095-B.

How self-insurance works

Usually, when a company provides health insurance to its employees, it does so through a group insurance policy. The employer and employees pay premiums to the insurance company, and the insurer pays the workers' medical bills (minus deductibles, co-pays and other out-of-pocket expenses).

Some employers, though, would prefer to just pay the bills themselves rather than pay premiums to a health insurance company-- that is, to self-insure. Reasons for doing so include:

  • Gaining more flexibility in designing coverage for employees
  • Saving money on upfront premiums
  • Avoiding state taxes on premiums
  • Opting to for federal regulation over state regulation, as self-insured health plans are governed by federal rules, not state rules

Self-insured companies often hire an outside company -- perhaps even an insurance company -- to administer their health benefits. But the insurance provider is the employer itself, in which case it is ultimately responsible for the 1095-B.

Combining B and C on one form

A separate provision of the Affordable Care Act requires certain employers to sponsor health coverage for their workers. In general, any company with 50 or more employees, also known as Applicable Large Employers (ALEs) under the health care law, must offer minimum essential coverage. These companies are required to send their employees and the IRS a different form, called the 1095-C, detailing the coverage that the company made available.

Self-insured companies with more than 50 employees, then, are actually required to send covered workers both a 1095-B and a 1095-C. In such cases, the law allows the employer to combine the information onto a single 1095-C form.

Get every deduction you deserve

TurboTax Deluxe searches more than 350 tax deductions and credits so you get your maximum refund, guaranteed.

For only $54.99$34.99*
Start for Free

Looking for more information?

The above article is intended to provide generalized financial information designed to educate a broad segment of the public; it does not give personalized tax, investment, legal, or other business and professional advice. Before taking any action, you should always seek the assistance of a professional who knows your particular situation for advice on taxes, your investments, the law, or any other business and professional matters that affect you and/or your business.


Security is built into everything we do
Here's how
* Important Offer Details and Disclosures
  • TURBOTAX ONLINE/MOBILE

  • Try for Free/Pay When You File: TurboTax online and mobile pricing is based on your tax situation and varies by product. Free 1040EZ/1040A + Free State offer only available with TurboTax Federal Free Edition; Offer may change or end at any time without notice. Actual prices are determined at the time of print or e-file and are subject to change without notice. Savings and price comparisons based on anticipated price increase expected in March. Special discount offers may not be valid for mobile in-app purchases.
  • TurboTax Self-Employed ExpenseFinder: ExpenseFinder™ is available year round as a feature of QuickBooks Self-Employed (available with TurboTax Self-Employed, see the “QuickBooks Self-Employed Offer with TurboTax Self-Employed” details below.) ExpenseFinder™ expected late January (late February for mobile app). ExpenseFinder™ not available from within TurboTax Self-Employed for people with certain types of expenses and tax situations including paying contractors or employees, home office or vehicle actuals, inventory, self employed health insurance or retirement, asset depreciation, sale of property or vehicles, and farm income. Availability of historical transactions for import may vary by financial institution. Not available for all financial institutions or all credit cards.
  • QuickBooks Self-Employed Offer: File your 2016 TurboTax Self-Employed return by 4/18/17 and receive your complimentary subscription to QuickBooks Self-Employed until 4/30/18. Activation required. Log in to QuickBooks Self-Employed by 7/15/17 via mobile app or at https://selfemployed.intuit.com/turbotax; e-mail address used for activation and log-in. Offer valid only for new QuickBooks Self-Employed customers. See QuickBooks.com for price comparison.
    • When you use TurboTax Self-Employed to file your 2017 taxes, you will have the option to renew your QuickBooks Self-Employed subscription. If you do not file with TurboTax Self-Employed by 4/18/18, you will have the option of renewing your QuickBooks Self-Employed subscription by 4/30/18 for another year at the then-current annual subscription rate. You may cancel your subscription at any time from within the QuickBooks Self-Employed billing section.
  • Pays for itself: In order to pay for the price of TurboTax Self-Employed, you will need at least $600 in deductible business expenses. This calculation is based on the self-employment tax income rate for tax year 2016.
  • Anytime, anywhere: Internet access required; standard message and data rates apply to download and use mobile app.
  • Fastest refund possible: Fastest tax refund with e-file and direct deposit; tax refund time frames will vary.
  • Pay for TurboTax out of your federal refund: $X.XX Refund Processing Service fee applies to this payment method. Prices are subject to change without notice.
  • TurboTax Expert Help, Tax Advice and SmartLook: Included with Deluxe, Premier and Self-Employed (via phone or SmartLook); not included with Federal Free Edition. Feature availability varies by device. State tax advice is free. Service, experience levels, hours of operation and availability vary, and are subject to restriction and change without notice.
  • #1 best-selling tax software: Based on aggregated sales data for all tax year 2015 TurboTax products.
  • Most Popular: TurboTax Deluxe is our most popular product among TurboTax Online users with more complex tax situations.
  • CompleteCheck: Covered under the TurboTax accurate calculations and maximum refund guarantees.
  • TURBOTAX CD/DOWNLOAD SOFTWARE

  • TurboTax CD/Download products: Price includes tax preparation and printing of federal tax returns and free federal e-file of up to 5 federal tax returns. Additional fees apply for e-filing state returns. E-file fees do not apply to New York state returns. Savings and price comparison based on anticipated price increase expected in March. Prices subject to change without notice.
  • Fastest refund possible: Fastest tax refund with e-file and direct deposit; tax refund time frames will vary.
  • Pay for TurboTax out of your federal refund: $X.XX Refund Processing Service fee applies to this payment method. Prices are subject to change without notice. This benefit is available with TurboTax Federal products except TurboTax Business.
  • About our TurboTax Product Experts: Customer service and product support vary by time of year.
  • About our credentialed tax experts: Live tax advice via phone is included with Premier and Home & Business; fees apply for Basic and Deluxe customers. State tax advice is free. Service, experience levels, hours of operation and availability vary, and are subject to restriction and change without notice. Not available for TurboTax Business customers.
  • #1 best-selling tax software: Based on aggregated sales data for all tax year 2015 TurboTax products.
  • Data Import: Imports financial data from participating companies. Quicken and QuickBooks import not available with TurboTax installed on a Mac. Imports from Quicken (2015 and higher) and QuickBooks Desktop (2011 and higher); both Windows only. Quicken import not available for TurboTax Business. Quicken products provided by Quicken Inc., Quicken import subject to change.