IRS Form 1095 B Information

The Affordable Care Act (ACA) includes a requirement that certain employers report to the IRS on the health coverage provided to their former employees. Form 1095-B provides both you and the IRS information about the health insurance coverage offered to you and, if applicable, your covered family members.

You would receive this form if you are a former employee who is under age 65 and during any month of 2023 you:

• Purchased health care insurance through the State of Minnesota (SEGIP) and paid your premiums directly to the health plan administrator; and/or
• Had had access to your Health Care Savings Plan (HCSP) administered through Minnesota State Retirement System (MSRS).

The federal government considers both of these benefits to be health care insurance (more on that below). The state has combined both of these coverages into one 1095 to meet federal requirements.

Keep the form with your tax documents. You do not submit the form as a part of your personal income tax filing. However, your tax preparer may request a copy.

No, a Form 1095-B is not required to file your 2023 taxes. If you want a Form 1095-B you must specifically request one and we will send it to you within 30 days.

No. Only the former employee (contract or account holder) will receive the 1095-B. We will not provide a separate form to others covered on your account, even those who do not reside with you. As the recipient of the form, you should provide a copy to any of these individuals if they request it for their records.

Contact SEGIP at 651-355-0100 or segip.mmb@state.mn.us. Include your name, employee ID number, a phone number or email address where you can be reached, confirm your mailing address, to request your 1095-B. The form will be mailed within 30 days.

A copy of your form will be sent to the IRS as required by law.

You may want to review information about Form 1095-B and Form 8962 Premium Tax Credit (PTC).

If you still think that there may be an error, contact SEGIP at 651-355-0100 or email at segip.mmb@state.mn.us. We will need your name, employee ID number, confirmation of your mailing address, and a phone number or email address where you can be reached. Please explain what information you think is wrong and why. We will research the issue and contact you.

Yes. The State offers a self-insured group health plan for employees, which meets the federal definition of minimum essential coverage.

This is important because most individuals who do not have minimum essential coverage or an exemption for each month of the year will need to make a payment with their tax return.

Yes, the State’s plan meets the minimum value standard. This means that it’s designed to pay at least 60 percent of the total cost of medical services.

Yes. Coverage is considered affordable if the employee’s cost for employee-only coverage does not exceed 9.56 percent of an employee's household income. The full employer contribution health coverage provided by the State meets this standard.

The IRS website provides information about these forms as well as the Form’s instructions.

Yes. As required by law, your 1095-B will include SSNs. SSNs on the form you receive will be truncated (meaning the first five numbers will be displayed as an asterisk). By law, we are required to send the IRS a copy of your form that displays the full SSN for both you and any other individual included on your coverage.

Yes, there are three versions:

• 1095-A is provided for coverage purchases through insurance exchanges such as MNsure.
• 1095-B is provided to enrollees by insurance providers such as insurance companies and public programs such as Medicaid, Medicare, and MinnesotaCare. It may also be used by certain employers providing coverage to former employees.
• 1095-C is completed by large employers and employers with self-insured health coverage.

You may receive one of these other forms if you were offered coverage through another entity.

Yes. The availability of dollars in the HCSP constitutes minimum essential coverage because those dollars are available for reimbursement of medical costs and health insurance premiums. Because it is considered “health care coverage” we are required to report on it to you and the IRS through this form.