2025 Printable Template
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Form last updated: 03/2024. Please verify this is the current version before use.
Easily complete & submit your 1094-B form
Follow these simple steps to fill, sign, and send your 1094-B form online.
Fill out your form
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Sign the form
Add your electronic signature to the fillable 1094-B form to certify it came directly from you.
Send it to the requester
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What is a 1094-B used for?
Form 1094-B is used by certain health coverage providers to transmit Forms 1095-B to the IRS. It serves as a cover sheet for the 1095-B forms, which report information about individuals who have minimum essential coverage.
Who needs to fill out a 1094-B form
Health insurance issuers or carriers and other providers of minimum essential coverage.
How to fill out a 1094-B online?
Follow these steps to complete your 1094-B form online.
Frequently Asked Questions
Find quick answers to common questions about our PDF editor.
It is used to transmit health coverage information to the IRS along with Form 1095-B.
You need to provide the filer's name, EIN, contact information, and the total number of Forms 1095-B.
Penalties may apply for late filing, but specific amounts should be verified with the IRS guidelines.
