The 1095 form provides documentation of your individual health insurance information. This form is sent to you annually by your insurance provider. Individuals can use the information on the 1095 to complete the "Health Care: Individual Responsibility" line on Form 1040. For more information, see www.HealthCare.gov.

This form will be postmarked by February 28. If you do not receive a 1095 form by March 15, contact your insurance provider to request a duplicate. It is not necessary to have a 1095 in hand to file your income tax return if you know you had health coverage throughout the year. If you misplaced your copy or find incorrect information, contact your insurance provider as soon as possible.

If you were enrolled in Medicare:
  • For the entire year, your insurance provider will not send a 1095 form. Retirees that are age 65 and older, and who are on Medicare, may receive instructions from Medicare about how to report their health insurance coverage.
  • For part of the year, you may receive a 1095 from your insurance provider reporting the coverage you had while you were not enrolled in Medicare. For example, if you were enrolled in the IYC Access Plan and your Medicare Part A and Part B became effective on May 1st, your insurance provider will send you a 1095 form reporting your coverage from January through April.

Form 1095-B

If you or your family members were covered by one of the providers in the Wisconsin Group Health Insurance Program, that provider will send you a Form 1095-B with information about your insurance coverage.

The 1095-B includes:
  • The type of health insurance coverage you have.
  • Your covered dependents.
  • The period of the coverage.

This form is used to verify (on your tax return) that you and your dependents have at least Minimum Essential Coverage (MEC). If you had a break in health care coverage during the tax year, you may have to pay an individual shared responsibility payment. It is not necessary to have a 1095-B in hand to file your income tax return if you know you had coverage throughout the year. If you misplaced your copy or find incorrect information, please contact your insurance provider as soon as possible.

Keep this form with your tax documents.