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Affordable Care Act Form 1095-B FAQs

What is Form 1095-B? Why do we need one?

The Affordable Care Act is a federal law that requires almost everyone in the United States to have medical coverage.  The law stipulates that beginning in tax year 2015, people who don't have at least a minimal level of coverage could have to pay a fine to the Internal Revenue Service (IRS).  When filing taxes in 2016, most people will have to report to the federal government whether they, along with their covered dependents, had medical insurance coverage during the previous year.

Form 1095-B is a tax form (like a W-2 or 1099-R) that you will receive from your Teachers’ Retirement System Program (TRIP) medical coverage provider as proof that you and your covered dependents had the required medical coverage during 2015. 

What do I do with my Form 1095-B?

You will use Form 1095-B to verify medical coverage for yourself and your covered dependents on your federal income tax filing, much like you use your W-2 to report wages or your 1099-R to report annuity income. Receiving Form 1095-B does not mean you owe income taxes on the value of the healthcare benefits you receive.  You should keep your Form 1095-B with all your tax records as supporting documentation.

Who will get Form 1095-B?

TRIP members who were enrolled in the Teachers' Choice Health Plan (TCHP), HealthLink OAP, Coventry OAP, Health Alliance HMO, Coventry HMO, HMO Illinois, or BlueAdvantage HMO sometime during the year, will receive a 1095-B form.  Retirees and Survivors enrolled in a Medicare Advantage plan offered through the TRIP Total Retiree Advantage Illinois (TRAIL) Program will not receive a Form 1095-B from the individual plans or from CMS. Individuals enrolled in a TRAIL plan may receive Form 1095-B from the Federal Centers for Medicare and Medicaid Services.

The form will also list any covered dependent for each month during the year.  If any covered dependent listed on Form 1095-B is not the member’s tax dependent or otherwise files a separate income tax return, it is the responsibility of the member to provide copies of the form to the dependent or the person claiming the dependent for income tax purposes.

Who will send my Form 1095-B?

Form 1095-B will be sent by the issuer of the medical coverage in which a person was enrolled during the calendar year.  This means you will receive the form from either CMS or the plan as follows, based on plan(s) in which you were enrolled in calendar year 2015:

  • If enrolled in one of the self-insured plans (Teachers' Choice Health Plan, HealthLink OAP or Coventry OAP), you will receive the form from the Department of Central Management Services (CMS).
  • If enrolled in one of the fully-insured plans (Health Alliance HMO, Coventry HMO, HMO Illinois or BlueAdvantage HMO), you will receive the form directly from the HMO plan.
  • If enrolled in both types of plans during the calendar year, you will receive a form from both CMS and the HMO plan.

When will I receive my Form 1095-B?

Medical coverage providers are required to mail Form 1095-B to members by March 31, 2016.

Can I file my federal income tax return before I receive my Form 1095-B and 1095-C?

It is not necessary to wait for Forms 1095-B or 1095-C in order to file.  Some taxpayers may not receive a Form 1095-B or Form 1095-C by the time they are ready to file their 2015 tax return.  While the information on these forms may assist in preparing a return, they are not required.  Like last year, taxpayers can prepare and file their returns using other information about their health insurance.  You should not attach any of these forms to your tax return.  If you and your entire family were covered for the entire year, you may check the full-year coverage box on your return.  If you or your family members did not have coverage for one or more months of the calendar year, you may claim an exemption or make an individual shared responsibility payment.  You will not need to send the IRS proof of your health coverage.

For more information visit the website below:

Who do I contact if I have questions about the information on my Form 1095-B?

Form 1095-B has the contact phone number for the Teachers’ Retirement System (TRS) listed in Part III, Line 18.  Call TRS to discuss any questions you have about the form you have received.

What should I do if I don't receive a Form 1095-B or if I lose my form?

If you do not receive your Form 1095-B by early April 2016, or if you lose it, you can call the applicable medical coverage issuer, as described above, to request another copy:

BlueAdvantage HMO (800) 868-9520
Coventry HMO (800) 431-1211
Health Alliance HMO (800) 851-3379
HMO Illinois (800) 868-9520
State of Illinois, Group Insurance Division (217) 558-4671

What happens if I don't report the information from my Form 1095-B?

If you don't report information from your Form 1095-B, the IRS may assume you did not have medical coverage and may assess the Individual Mandate Penalty. Please see the Department of Health and Human Services website for detailed information on how the penalty is calculated.  If you have further questions, you should contact a tax advisor.

What if I cover an eligible dependent for medical insurance, but do not claim him or her on my taxes?

Form 1095-B will be sent to the person who provides medical coverage for the dependent, even if that person does not claim the dependent on his or her taxes.

What happens if I had medical coverage through TRIP for part of the year and through another employer/carrier for the rest of the year? Who will send my Form 1095-B?

Every medical coverage provider that covered you (and any dependents) for at least one day in 2015 is required to send you a Form 1095-B.  Therefore, if you had medical coverage during 2015 from another employer and its respective carrier, or any other non-TRIP plan, you should receive a separate Form 1095-B from each plan.