Skip to main content

Form 1095-B Still Required by the ACA for Coverage in 2018

January 22, 2019

Applies to: All Markets, excluding Medicare

On or aboutJanuary 22, 2019, Horizon Blue Cross Blue Shield of New Jersey will begin mailing Form 1095-B to members who either bought their coverage directly from Horizon BCBSNJ and not through Healthcare.gov OR who have Horizon BCBSNJ coverage through their fully insured employer-sponsored health plan.

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 income taxreturns.

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, 2018 through December 31, 2018

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. Horizon BCBSNJ can only provide our members with the months that they and their qualified dependents had fully insured Horizon BCBSNJ coverage. In addition to receiving the form through the mail, members with fully insured coverage can also sign in to HorizonBlue.com to view their form.


If a member had coverage through a different employer or insurer, the member will receive a form from that employer or insurer. If a member bought their coverage through the Exchange (federal Marketplace), the member will receive Form 1095-A from the Centers for Medicare & Medicaid Services (CMS).


Reporting obligations for self-insured groups
The ACA requires self-insured group health plans to be responsible for certain reporting obligations. As a result, Horizon BCBSNJ will not provide the IRS with the months of qualifying health insurance on behalf of its clients with self-insured plans, nor will we send any information about months of coverage to their employees. However, 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 for 2019: New Jersey Individual Mandate
Under a new state law, residents of New Jersey must have health insurance beginning January 1, 2019, or pay a penalty. New Jersey enacted this mandate because Congress repealed the penalties of the ACA’s individual mandate, effective December 31, 2018. This action ended the federal requirement that all individuals have health insurance. Although the ACA’s individual mandate has been repealed, the reporting requirement of Horizon BCBSNJ will still continue for 2019 and the foreseeable future.

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. The maximum penalty based on a per-person charge will be $2,085 for the 2019 tax year.

Individuals who purchase coverage directly from an insurance company or are covered under a group health plan must comply with this mandate. 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.

If you have questions, please contact your Horizon BCBSNJ sales executive or account manager.

Sample Letter

Sample Form

 

Published on: January 22, 2019, 03:08 a.m. ET
Last updated on: May 21, 2019, 06:57 a.m. ET