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, will make Form 1095-B available to members who had medical coverage through the Texas Employees Group Benefits Program (GBP).

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 made available to them. 

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 a 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 are 65 or older and were covered by Medicare Part A for the entire calendar year, you will not get a Form 1095-B. Centers for Medicare and Medicaid Services (CMS) reports your coverage to the IRS. You will get the form if you enrolled in Medicare Part A for the first time, you had Medicare Part A for part of the year or you are under age 65 with Medicare Part A. If you need a copy of Form 1095-B from Medicare, call 1-800-MEDICARE (1-800-633-4227).

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.

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
  • Centers for Medicare and Medicaid Services (CMS) for medical plans listed below: (800) MEDICARE or (800) 633-4227*

*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 have a Form 1095-B made available to them from the administrator of the plan (or plans) in which he or she had medical coverage during the calendar year.

If you participated in a Texas Employees Group Benefits Program (GBP) health plan and were not enrolled in Medicare in the calendar year (January–December), Form 1095-B is available from your health plan.

CMS will mail Form 1095-B only to participants who meet the following criteria:

  • Participants under the age of 65 with Medicare Part A,
  • Enrolled in Medicare Part A for the first time in the last calendar year or
  • 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 reports your coverage to the IRS.

This includes members enrolled in HealthSelectSM Medicare Advantage Plan, a preferred provider organization (MA PPO) administered by UnitedHealthcare.

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

If you also had coverage under TRICARE, TRICARE will make the Form 1095-B available to you upon request.

You can expect the form to be available 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 medical plans contact information.

Use Form 1095-B to verify medical coverage for yourself and your covered 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 make Form 1095-B available. Each GBP provider will report medical coverage for each month of your enrollment in its medical plan to the IRS.

You do not need to report additional benefits such as dental, vision, life, accidental death and dismemberment (AD&D), or short-term or long-term disability coverage to the federal government. Form 1095-B only includes medical insurance.

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 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 is the best way to ensure your employer and medical insurance provider report correct information to the IRS. 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, 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.