As healthcare compliance and reporting requirements continue to evolve, IRS Forms 1095-A, 1095-B, and 1095-C play a critical role in documenting health insurance coverage under the Affordable Care Act (ACA). For healthcare providers, medical billing companies, and Applicable Large Employers (ALEs), understanding these forms is essential to avoid penalties, ensure accurate reporting, and maintain regulatory compliance.
At Allzone, we help healthcare organizations and employers navigate complex reporting requirements with confidence. This comprehensive guide explains the purpose of each 1095 form, who must file them, key differences, common mistakes, and how expert support can simplify the process.
Understanding the Purpose of IRS Form 1095
IRS Form 1095 is used to report information about an individual’s health insurance coverage. These forms help the IRS verify compliance with the ACA’s individual mandate (prior to 2019) and the employer mandate, and they assist individuals in preparing accurate federal tax returns.
There are three distinct versions of Form 1095:
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- 1095-A – Health Insurance Marketplace Statement
- 1095-B – Health Coverage
- 1095-C – Employer-Provided Health Insurance Offer and Coverage
Each serves a unique function depending on the type of coverage and the reporting entity.
IRS Form 1095-A: Health Insurance Marketplace Statement
What Is Form 1095-A?
Form 1095-A is issued to individuals who enrolled in health insurance coverage through the Health Insurance Marketplace (Exchange). It is generated by the Marketplace, not employers or healthcare providers.
Who Receives Form 1095-A?
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- Individuals or families who purchased coverage via the federal or state Marketplace
- Taxpayers who received Advance Premium Tax Credits (APTC)
Why Form 1095-A Is Important
Form 1095-A is required to:
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- Reconcile advance premium tax credits using Form 8962
- Determine whether additional credits are owed or must be repaid
- Accurately file federal income tax returns
Key Information Included
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- Monthly premiums
- Second Lowest Cost Silver Plan (SLCSP) amounts
- Advance premium tax credits paid on the taxpayer’s behalf
Errors on Form 1095-A can delay tax filings or trigger IRS notices, making accuracy critical.
IRS Form 1095-B: Health Coverage
What Is Form 1095-B?
Form 1095-B reports minimum essential coverage (MEC) provided by insurers, small employers, or government programs.
Who Files Form 1095-B?
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- Health insurance carriers
- Self-insured small employers (fewer than 50 full-time employees)
- Government programs such as Medicare, Medicaid, and CHIP
Who Receives Form 1095-B?
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- Individuals who had health coverage for all or part of the year
Key Details Reported
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- Covered individuals’ names
- Months of coverage
- Policyholder information
- Employer or insurer details
Although the federal individual mandate penalty is no longer enforced, some states still require proof of coverage, making Form 1095-B relevant.
IRS Form 1095-C: Employer-Provided Health Insurance Offer and Coverage
What Is Form 1095-C?
Form 1095-C is used by Applicable Large Employers (ALEs)—those with 50 or more full-time employees—to report health insurance offers made to employees.
Who Must File Form 1095-C?
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- Employers classified as ALEs
- Self-insured large employers (who also report coverage details)
Who Receives Form 1095-C?
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- Full-time employees
- Part-time employees enrolled in self-insured plans (in some cases)
Key Information Included
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- Whether health coverage was offered
- Employee share of the lowest-cost monthly premium
- Months of coverage
- Safe harbor codes and affordability indicators
Why Form 1095-C Matters
This form supports enforcement of the employer shared responsibility provisions of the ACA and helps the IRS determine whether employers owe penalties.
Key Differences Between Forms 1095-A, 1095-B, and 1095-C
| Form | Issued By | Purpose | Primary Audience |
| 1095-A | Health Insurance Marketplace | Reports Marketplace coverage & tax credits | Individuals |
| 1095-B | Insurers & small self-insured employers | Confirms minimum essential coverage | Individuals |
| 1095-C | Applicable Large Employers | Reports employer coverage offers | Employees & IRS |
Understanding which form applies to your organization prevents incorrect filings and compliance risks.
Common Mistakes in 1095 Reporting
Healthcare organizations and employers often face challenges such as:
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- Incorrect employee classification (full-time vs part-time)
- Inaccurate coverage dates
- Missing or incorrect Social Security Numbers
- Failure to meet IRS filing deadlines
- Misreporting affordability or safe harbor codes
These errors can result in IRS penalties, employee confusion, and increased administrative burden.
Filing Deadlines and Compliance Considerations
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- Forms must be furnished to employees/individuals by the IRS-specified deadline (typically January)
- Forms must be filed with the IRS electronically or by paper, depending on volume
- Penalties apply for late, incomplete, or inaccurate filings
Staying current with IRS updates and ACA rules is essential, especially as regulations continue to change.
How Allzone Helps with IRS Form 1095 Compliance
At Allzone billing company, we understand that ACA reporting is time-consuming and highly technical. Our compliance and revenue cycle experts help healthcare providers and employers streamline the entire process.
Allzone’s Support Includes:
- ACA eligibility and employee classification analysis
- Accurate preparation of Forms 1095-A, 1095-B, and 1095-C
- Error identification and correction
- IRS-compliant electronic filing
- Ongoing regulatory guidance and reporting support
By partnering with Allzone billing company, organizations reduce compliance risks, avoid penalties, and free internal teams to focus on patient care and business growth.
Final Thoughts
IRS Forms 1095-A, 1095-B, and 1095-C are essential components of ACA compliance for individuals, healthcare organizations, insurers, and employers. While each form serves a different purpose, all require accuracy, timely filing, and a thorough understanding of regulatory requirements.
With increasing scrutiny and evolving healthcare regulations, working with a trusted partner like Allzone ensures your ACA reporting is handled efficiently, accurately, and compliantly.
If your organization needs expert assistance with IRS reporting, medical billing compliance, or revenue cycle management, Allzone is here to help.