CHIP 1095-B Tax Form
FREQUENTLY ASKED QUESTIONS
What is the 1095–B form?
The 1095-B form provides information needed to answer questions about your children’s health
insurance coverage on your federal income tax form. The 1095-B form shows all of the children that had
CHIP health insurance coverage.
The form shows the months of CHIP coverage for the previous calendar year.
Why am I getting this form?
IRS regulations state that all health insurance providers must send this form to all enrollees that had
health insurance that meets the “Minimum Essential Coverage” requirements of the Affordable Care
Act. You must have this form by January 31.
What do I need to do with this form?
You will need to use the information on this form to answer questions about your children’s health
insurance coverage on your federal tax return.
You do not need to send it with your federal tax forms. You should keep a copy of the 1095-B form with
your tax records so that you have it for future reference. Even if you do not file a federal tax return,
keep this important information.
My 1095-B has only some months checked. Why aren’t all months checked?
The form will show only the months that your children had CHIP health insurance coverage. If you
believe there is an error, you should contact your CHIP insurance provider. Even if you no longer have
CHIP coverage, you can contact the last CHIP health insurance provider that you had.
What if my children were enrolled with multiple CHIP insurance companies during the tax year?
If your children were covered by CHIP but transferred between CHIP insurance providers, you will still
receive only one form showing all months of CHIP coverage.
What should I do if some of the information, such as my child’s name is spelled wrong, on the form?
If information is incorrect, such as a name or address, contact your current CHIP health insurance
provider. Even if you no longer have CHIP coverage, you can contact the last CHIP health insurance
provider that you had.