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 2015


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*
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
  • Filing Deadline: IRS filing deadline for tax year 2015 is April 18, 2016 (except for residents of Massachusetts or Maine, where the IRS filing deadline for tax year 2015 is April 19, 2016).
  • Try for Free/Pay When You File: TurboTax online and mobile pricing is based on your tax situation and varies by product. Free 1040EZ/A + 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 3/18/16. Special discount offers may not be valid for mobile in-app purchases.
  • 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 efiling state returns. E-file fees do not apply to New York state returns. Savings and price comparison based on anticipated price increase expected 3/18/16. Prices subject to change without notice.
  • Anytime, anywhere: Internet access required; standard message and data rates apply to download and use mobile app.
  • Fastest refund possible: Fastest tax refund with efile and direct deposit; tax refund timeframes will vary.
  • Pay for TurboTax out of your federal refund: A $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 the TurboTax Home & Business/QuickBooks Self-Employed bundle offers.
  • About our TurboTax Product Experts: Customer service and product support vary by time of year.
  • About our credentialed tax experts: Live tax advice service is available via phone for your toughest tax questions; fees may apply. 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 2014 TurboTax products.
  • Most Popular: TurboTax Deluxe is our most popular product among TurboTax Online users with more complex tax situations.