Forms 1095-A, 1095-B, and 1095-C

There are three versions of Form 1095. The purpose of these forms is to verify health insurance coverage for the individual(s) named on the form, and indicate for how many months of the year each individual had coverage.

Clicking on the cropped form image in the following list will bring up a full-size image of the form in a new tab.

Form 1095-A is issued to individuals who purchased health insurance from the Federal Government Marketplace. This insurance is commonly called "Obama-care."

Form 1095-B is issued by Insurance companies outside the Marketplace, Government agencies such as Medicaid or CHIP, and employers with fewer than 50 employees.

Form 1095-C is issued by employers with 50 or more employees.