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1095-B Tax Form

The Department of Human Services mailed/will mail 1095-B tax forms to all households who have a member receiving Medical Assistance (MA) insurance coverage.

Why are you receiving this form?

The Internal Revenue Service's (IRS) regulations state that all health insurance providers must send this form to all enrollees who have health insurance and meet the “minimum essential coverage” requirements of the Affordable Care Act (ACA). The ACA requires nearly all Americans who meet health care reform standards to have health insurance. The 1095-B form informs the IRS who had coverage and for how long. 

What information is on the 1095-B tax form?

For each person covered on your policy, the 1095-B lists:

    • Name
    • Address
    • Date of birth
    • Taxpayer identification number
    • Months of coverage

To reprint your 1095-B tax form, click here. Under “Helpful Links” at the bottom left of the page, click “1095-B Tax Form Reprint.”

    • Click here if you have more questions, or call 877-617-9906.
    • If your child receives CHIP insurance, visit the CHIP website