Form 1095‑B is the official IRS document that proves you had qualifying health coverage for the tax year. It is used to verify compliance with the Affordable Care Act and to avoid the individual shared‑responsibility penalty.
The form is issued by health insurers, government programs (like Medicaid or CHIP), or employers who provide self‑insured coverage. It lists the months you were covered, the type of coverage, and the individual's name and Social Security number.
Traditional scanned PDFs require a separate editor, which can be slow and error‑prone. Our Formize fillable PDF loads directly in your browser, letting you type, select dates, and save without installing any software.
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Form 1095‑B is typically attached to your individual tax return (Form 1040) when filing electronically. If you file a paper return, include the PDF as a printed attachment.
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If you file electronically, the IRS receives the information directly from the insurer, so you don’t need to attach it. For paper returns, include a printed copy.
No. Each form is specific to a tax year. Use the version that matches the year you are filing.
Contact your health insurance provider and request a copy. You can also request a duplicate from the IRS by calling the toll‑free number.
Yes. All data is processed locally in your browser and never stored on our servers unless you choose to save it.
No. Formize’s online filler works in any modern browser—no additional software required.
Open the saved PDF again with Formize, correct the fields, and re‑save. The original file can be overwritten or saved as a new version.
For tax years 2019 onward, the individual shared‑responsibility penalty was eliminated, but insurers still must provide Form 1095‑B for record‑keeping.
Yes. The Formize filler is mobile‑responsive and works on smartphones and tablets.
IRS Form 1095-B は連邦税フォームの 1 つで、米国の内国歳入庁 (IRS) に連邦所得税を報告および提出するために使用される文書です。これらのフォームは、個人、企業、組織が連邦税負担の計算に必要な所得、控除、その他の関連情報を報告するために使用されます。
最も一般的に使用される連邦税フォームはフォーム 1040 で、個人の納税者が個人所得税を報告するために使用します。その他の一般的に使用されるフォームには、パートナーシップ用の フォーム 1065、フォーム 1120、非課税組織の場合はフォーム 990。
連邦税フォームでは通常、納税者に対し、賃金、給与、チップなどのさまざまな収入源のほか、投資、賃貸不動産、その他の収入源からの収入を報告するよう求めています。このフォームを使用すると、納税者は慈善寄付金、住宅ローン利子、医療費などのさまざまな費用の控除やクレジットを請求することもできます。
連邦税フォームを正確かつ期限内に提出することが重要です。これを怠ると、IRS から罰金や利息が課される可能性があります。
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