Insurance tax - Form 1095-B

Health insurance - Form 1095-B

Form 1095-B is a tax form (like a W-2 or 1099-R) you may get from your State of Texas-sponsored medical provider as proof that you and your tax dependents had medical coverage. The State of Texas, like other employers that offer medical coverage to their employees, works with its medical insurance providers to send Form 1095-B to members who had medical coverage through the Texas Employees Group Benefits Program (GBP). You may want to keep your Form 1095-B with all your tax or insurance records. 

Every current or former State of Texas employee and retiree who had medical coverage through the GBP during the Calendar Year (January 1 – December 31) will have Form 1095–B sent. 

Please go to question 4 for more information about which Medicare members will get Form 1095-B from The Centers for Medicare & Medicaid Services (CMS). If you covered a spouse or children under your GBP plan, they will be included on your form; you will not get a separate Form 1095-B for each of your dependents.

If anyone reported as covered by GBP medical coverage on Form 1095-B files a separate income tax return or is listed as tax dependent on another person’s income tax return, the GBP member is responsible for providing copies of the Form 1095-B to the person filing the tax return for that dependent.

If you do not receive your Form If you do not receive your Form 1095-B by mid-March, or if you lose it, you can call your medical insurance provider toll-free to ask for another copy:

  • Blue Cross and Blue Shield of Texas: (800) 252-8039 (TTY: 711), 7 a.m. – 7 p.m. CT Monday – Friday, 7 a.m. – 3 p.m. CT Saturday
  • Community First Health Plans: (877) 698-7032 (TTY: (210) 358-6080), 8.30 a.m. – 5 p.m. CT Monday - Friday
  • KelseyCare powered by Community Health Choice: (844) 515-4877, 8 a.m. – 7 p.m. CT Monday – Friday
  • Scott and White Health Plan: (800) 321-7947, (TTY: (800) 735-2989), 24 hours, seven days a week
  • *Centers for Medicare & Medicaid Services (CMS) for medical plans listed below: (800) MEDICARE or (800) 633-4227
    • HealthSelect Medicare Advantage Plan, a preferred provider organization (MA PPO) administered by Humana 
    • KelseyCare Advantage Medicare health maintenance organization (MA HMO)

*Go to question 4 to learn which Medicare and Medicaid members will get a Form 1095-B from CMS. CMS will not send a Form 1095-B to all members. 

Every current or former State of Texas employee and retiree who had medical coverage through the GBP will get Form 1095-B from the administrator of the plan (or plans) in which he or she had medical coverage during the calendar year.  

If you have Medicare Part A, you may get Form 1095-B from Medicare. If you don't get a Form 1095-B, don't worry. Not everyone will get this form from Medicare, and you don't need it to file your taxes. CMS will mail Form 1095–B only to participants who meet the following criteria: 

  • Are under age of 65 with Medicare Part A
  • Enrolled in Medicare Part A for the first time in the last calendar year
  • Had Medicare Part A for part of the calendar year   

If you were covered by Medicare Part A for all 12 months of the year, just check the box on your federal income tax return indicating you had qualifying health coverage all year. CMS is reporting your coverage to the IRS. 

This includes members enrolled in:  

  • HealthSelectSM Medicare Advantage Plan, a preferred provider organization (MA PPO) administered by Humana or 
  • KelseyCare Advantage Medicare health maintenance organization (MA HMO).

People enrolled in the Medicare Advantage plans will not get a separate Form 1095-B from those plans. 

If you also had coverage under TRICARE, TRICARE will send a Form 1094-B. 

Medical coverage providers are required to mail Form 1095-B to members early in the calendar year. You can expect to get the form by mid-March. If you had GBP medical coverage in the previous year and don’t get Form 1095-B by mid-March, please call your medical plan directly. See question 3 for contact information for medical plans. 
Use Form 1095-B to verify medical coverage for yourself and your covered tax dependents on your federal income tax filing – like you use your W-2 to report wages or your 1099-R to report annuity income. You may want to keep Form 1095-B with all your tax or insurance records. 

Every medical coverage provider that covered you (and any dependents) for at least one day is required to send you a Form 1095-B. Each GBP provider will report medical coverage for each month of your enrollment in its medical plan. 

If you had coverage from more than one GBP plan – for example, if you were in an HMO January through August, but switched to HealthSelect of Texas® in September – you will get Form 1095-B from each plan. If you did not have medical coverage through the GBP at any time during the calendar year, you will not get a Form 1095-B from any of the GBP plans.

You do not need to report additional benefits – such as dental, vision, life, accidental death & dismemberment (AD&D), or short-term or long-term disability coverage – to the federal government. They will not be included on Form 1095-B.

The Form 1095-B will be sent to the person who has medical coverage for the dependent, even if that person does not claim the dependent on his or her taxes. Please see question 2 for more information. 

Please make sure your name, Social Security number (SSN), the names and SSNs of any dependents you cover, and your mailing address are correct on your Form1095-B. If you’re an active employee, contact your benefits coordinator or human resources department to update any incorrect information. If you’re a former employee or retiree, contact ERS to update incorrect information. Once you update the information, contact your medical coverage provider to see if you need an updated Form 1095-B. Please see question 3 for contact information for GBP medical coverage providers.

Providing accurate SSNs on all income and healthcare benefit documentation to your agency is the best way to ensure your employer and medical insurance provider report correct information to the IRS. ERS gets the information from your employer and sends it to medical insurance providers so they can issue Form 1095-B in your name. The IRS will send written notice to you with instructions on how to respond to any questions they have about differences in reporting. Your employer or health insurance provider is not responsible for incorrect or missing employee or dependent IRS reporting information. It is your responsibility to contact your benefits coordinator, your HR department or ERS for any corrections to your personal information on your Form 1095-B.

Many employers (such as your agency or institution) are required to send Form 1095-C to their employees, to verify that the employer offered medical coverage to eligible employees. If you have questions about Form 1095-C, please contact the benefits coordinator or HR department at your agency or institution.