Loading
Form preview
  • US Legal Forms
  • Form Library
  • More Forms
  • More Multi-State Forms
  • Irs 1094-b_dsa

Get Irs 1094-b_dsa

110116 Form1094BDepartment of the Treasury Internal Revenue Service OMB No. 15452252Transmittal of Health Coverage Information Returns Go2021to www.irs.gov/Form1094B for instructions and the latest.

This website is not affiliated with IRS

How it works

  1. Open form

    Open form follow the instructions

  2. Easily sign form

    Easily sign the form with your finger

  3. Share form

    Send filled & signed form or save

How to fill out the IRS 1094-B_DSA online

Filing the IRS 1094-B_DSA form correctly is essential for reporting health coverage information. This guide will lead you through each step in a clear and concise manner, ensuring a smooth process for online submission.

Follow the steps to complete the form accurately.

  1. Click ‘Get Form’ button to obtain the form and open it in your editing tool.
  2. Enter the filer’s name in the first field. This is the name of the entity or person reporting the health coverage information.
  3. In the second field, provide the employer identification number (EIN) associated with the filer.
  4. Fill in the name of the person to contact for further information regarding the report in the third field.
  5. Input the contact telephone number in the fourth field, ensuring it is a valid number for follow-up communications.
  6. Complete the fifth field by entering the street address, including any room or suite numbers, where the filer is located.
  7. Fill in the city or town of the filer in the sixth field.
  8. In the seventh field, select the appropriate state or province the filer operates in.
  9. Provide the country and ZIP or foreign postal code in the eighth field to ensure accurate geolocation.
  10. In the ninth field, enter the total number of Forms 1095-B that are being submitted along with this transmittal.
  11. Review the declarations regarding the accuracy of the return. Once you have confirmed that all provided information is true, sign the form in the designated area.
  12. Indicate your title, and enter the date of signing in the appropriate fields.
  13. Once completed, save your changes, download a copy for your records, and print it if necessary. You can also share the completed form if required.

Start completing your IRS 1094-B_DSA form online today to ensure timely and accurate submission.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Related content

Sheet1 - Internal Revenue Service
1094, 510245418, DEPARTMENT OF ILLINOIS LADIES AUXILIARY VFW INC, % CINDY BECKER...
Learn more
www.adobe.com 10002 www.microsoft.com 2 www.google...
... 6943 www.usc.edu 10002 www.sec.gov 10002 news.bbc.co.uk 10002 www.irs.gov...
Learn more
Valaris plc - cloudfront.net
Mar 2, 2021 — Securities registered pursuant to Section 12(b) of the Act: None ... The...
Learn more

Related links form

Rbl Bank Dsa Registration Pearson Vue Cna License Renewal 2020 Physical Exam Template Mar 2020

Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

1094-B vs. 1094-C: If you provide fully-insured health coverage to your employees, no matter the size of your business, 1094-B will be completed for you by your carrier. Form 1094-C is a requirement for Applicable Large Employers (ALE), or those with 50 or more full-time equivalent employees.

Form 1095-B, Health Coverage, is provided by insurance companies and other coverage providers. However, if your coverage was insurance purchased through the Marketplace or was a type of coverage referred to as “self-insured coverage” that was provided by an applicable large employer, you will receive a different form.

Usually, insurance companies are responsible for filing forms 1095-B and 1094-B. In some cases, the form might be filed by an employer.

Purpose of Form. Form 1095-B is used to report certain information to the IRS and to taxpayers about individuals who are covered by minimum essential coverage. Eligibility for certain types of minimum essential coverage can affect a taxpayer's eligibility for the premium tax credit.

Filing the Report with the IRS Please note that employers with 50 or more employees may have obligations for filing 1094-C and 1095-C (see below). Self-insured small employers (with less than 50 employees) will furnish information to the IRS using Form 1095-B and the IRS transmittal Form 1094-B.

Call 1-800-MEDICARE (1-800-633-4227) to ask for a copy of your IRS Form 1095-B. TTY users can call 1-877-486-2048.

Every person that provides minimum essential coverage to an individual during a calendar year must file an information return reporting the coverage. Filers will use Form 1094-B (transmittal) to submit Forms 1095-B (returns).

1094-B vs. 1094-C: If you provide fully-insured health coverage to your employees, no matter the size of your business, 1094-B will be completed for you by your carrier. Form 1094-C is a requirement for Applicable Large Employers (ALE), or those with 50 or more full-time equivalent employees.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.
If you believe that this page should be taken down, please follow our DMCA take down processhere.

Industry-leading security and compliance

US Legal Forms protects your data by complying with industry-specific security standards.
  • In businnes since 1997
    25+ years providing professional legal documents.
  • Accredited business
    Guarantees that a business meets BBB accreditation standards in the US and Canada.
  • Secured by Braintree
    Validated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.
Get IRS 1094-B_DSA
  • Adoption
  • Bankruptcy
  • Contractors
  • Divorce
  • Home Sales
  • Employment
  • Identity Theft
  • Incorporation
  • Landlord Tenant
  • Living Trust
  • Name Change
  • Personal Planning
  • Small Business
  • Wills & Estates
  • Packages A-Z
  • Affidavits
  • Bankruptcy
  • Bill of Sale
  • Corporate - LLC
  • Divorce
  • Employment
  • Identity Theft
  • Internet Technology
  • Landlord Tenant
  • Living Wills
  • Name Change
  • Power of Attorney
  • Real Estate
  • Small Estates
  • Wills
  • All Forms
  • Forms A-Z
  • Form Library
  • Legal Hub
  • About Us
  • Help Portal
  • Legal Resources
  • Blog
  • Affiliates
  • Contact Us
  • Delete My Account
  • Site Map
  • Industries
  • Forms in Spanish
  • Localized Forms
  • State-specific Forms
  • Forms Kit
  • Real Estate Handbook
  • All Guides
  • Notarize
  • Incorporation services
  • For Consumers
  • For Small Business
  • For Attorneys
  • USLegal
  • FormsPass
  • pdfFiller
  • signNow
  • altaFlow
  • DocHub
  • Instapage
Form Packages
  • Adoption
  • Bankruptcy
  • Contractors
  • Divorce
  • Home Sales
  • Employment
  • Identity Theft
  • Incorporation
  • Landlord Tenant
  • Living Trust
  • Name Change
  • Personal Planning
  • Small Business
  • Wills & Estates
  • Packages A-Z
Form Categories
  • Affidavits
  • Bankruptcy
  • Bill of Sale
  • Corporate - LLC
  • Divorce
  • Employment
  • Identity Theft
  • Internet Technology
  • Landlord Tenant
  • Living Wills
  • Name Change
  • Power of Attorney
  • Real Estate
  • Small Estates
  • Wills
  • All Forms
  • Forms A-Z
  • Form Library
Customer Service
  • Legal Hub
  • About Us
  • Help Portal
  • Legal Resources
  • Blog
  • Affiliates
  • Contact Us
  • Delete My Account
  • Site Map
  • Industries
  • Forms in Spanish
  • Localized Forms
  • State-specific Forms
  • Forms Kit
Legal Guides
  • Real Estate Handbook
  • All Guides
Prepared for you
  • Notarize
  • Incorporation services
Our Customers
  • For Consumers
  • For Small Business
  • For Attorneys
Our Sites
  • USLegal
  • FormsPass
  • pdfFiller
  • signNow
  • altaFlow
  • DocHub
  • Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
© Copyright 1999-2026 airSlate Legal Forms, Inc. 3720 Flowood Dr, Flowood, Mississippi 39232
  • Your Privacy Choices
  • Terms of Service
  • Privacy Notice
  • Content Takedown Policy
  • Bug Bounty Program
IRS 1094-B_DSA
This form is available in several versions.
Select the version you need from the drop-down list below.
2024 IRS 1094-B
Select form
  • 2024 IRS 1094-B
  • 2022 IRS 1094-B
  • 2020 IRS 1094-B
  • 2019 IRS 1094-B
  • 2018 IRS 1094-B
  • 2017 IRS 1094-B
  • 2016 IRS 1094-B
  • 2015 IRS 1094-B
  • 2014 IRS 1094-B
  • IRS 1094-B_DSA
Select form