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Form 1095-B Still Required by the ACA for 2020 Coverage

Applies to: All Markets, excluding Medicare

On behalf of Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ), Thomson Reuters has begun mailing Form 1095-B to members who, in 2020, either bought coverage directly from Horizon BCBSNJ or who have Horizon BCBSNJ coverage through their employer-sponsored fully insured health plan. In addition to receiving the form through the mail, these members can sign in to to access their form.

  • Form 1095-A will be issued separately to On Exchange members by the Federally Facilitated Marketplace (FFM) (now known as the state-based exchange [SBE]). For the 2021 coverage year, Form 1095-A will be submitted by the SBE, Get Covered NJ.
  • Form 1095-C will be issued separately by each self-insured group, not by Horizon BCBSNJ.

You can view a sample of the letter to members and a sample of Form 1095-B.

Form 1095-B is informational and is issued to help our members comply with their responsibilities under the Affordable Care Act (ACA). The form doesn’t have to be attached to federal or state income tax returns.

Form 1095-B includes the following information for members and their covered dependents:

  • Name(s)
  • Last four digits of each member’s Social Security Number (SSN)
  • Date(s) of birth (if SSN is not available)
  • Months of fully insured health insurance coverage with Horizon BCBSNJ from January 1, 2020 through December 31, 2020

Horizon BCBSNJ will report to the IRS the months that the fully insured member and their covered dependents had qualifying health coverage through Horizon BCBSNJ.

If a member had coverage through a different employer or insurer, the member will receive a form from that employer or insurer.

Reporting obligations for self-insured groups

The ACA requires self-insured group health plans to be responsible for certain reporting obligations, including reporting the months of qualifying health insurance. As a courtesy, Horizon BCBSNJ may provide, upon request from the group to their Account Manager, a data file containing certain information that may be used in completing any required reporting.

New Jersey Individual Mandate

Under state law, residents of New Jersey must have purchased health insurance beginning January 1, 2020, or pay a penalty to the state. The requirement continues for 2021 as well.

New Jersey’s mandate, which mirrors the federal requirement, includes an annual penalty of 2.5 percent of a household’s income or a per-person charge — whichever is higher. More information can be found here regarding payment ranges.

A hardship exception for individuals who cannot afford coverage will be determined by the state treasurer. We are currently waiting for guidance regarding what form of reporting, if any, will be required of Horizon BCBSNJ.

This information should not be construed as tax or legal advice. Questions your clients or their employees may have about their specific circumstances should be referred to their tax or legal professional.

Published on: January 29, 2021, 16:33 p.m. ET
Last updated on: June 8, 2021, 22:14 p.m. ET