Colorado Medicaid IRS Form 1095-B Information
This document provides information on IRS Form 1095-B, Health Coverage, which serves as proof that individuals had qualifying health coverage under Medicaid or Child Health Plan Plus (CHP+) in Colorado. The document explains who will receive the form, what to do with it, and lists exclusions for those who may not receive it. Additionally, it provides contact information for further assistance.
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How do I fill this out?
Filling out Form 1095-B is an essential step for individuals enrolled in Medicaid or CHP+ to report their health coverage to the IRS. Follow the detailed instructions provided in this section to complete the form accurately. Ensure you have all the necessary information before you begin.

How to fill out the Colorado Medicaid IRS Form 1095-B Information?
1
Gather all necessary documents and information.
2
Enter your personal details in the specified fields.
3
Include information about your health coverage.
4
Review the completed form for accuracy.
5
Submit the form as instructed.
Who needs the Colorado Medicaid IRS Form 1095-B Information?
1
Individuals enrolled in Medicaid or CHP+ need this form to report their health coverage to the IRS.
2
Taxpayers must have this form to verify that they met the minimum essential coverage requirement.
3
Families enrolled in Modified Adjusted Gross Income (MAGI) Medicaid or CHP+ need this form.
4
Individuals enrolled in Non-MAGI Medicaid programs, such as Long-Term Care and SSI Mandatory Medicaid, need this form.
5
People enrolled in Old Age Pension-Medicaid need this form to report their health coverage.
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What are the instructions for submitting this form?
To submit IRS Form 1095-B, gather all necessary documents and ensure that the form is completed accurately. You can mail the completed form to the following address: Colorado Department of Health Care Policy & Financing, 1570 Grant Street, Denver, CO 80203. For electronic submissions, log into your PEAK account at Colorado.gov/PEAK and upload the completed form in the Mail Center. For any questions or assistance, contact Nina Schwartz at Nina.Schwartz@state.co.us.
What are the important dates for this form in 2024 and 2025?
The Department will start mailing IRS Form 1095-B in mid-January 2024. All 1095-B forms for 2024 coverage are scheduled to be mailed by February 1, 2024. The same schedule applies for the year 2025.

What is the purpose of this form?
IRS Form 1095-B is an essential document for individuals enrolled in health coverage programs such as Medicaid or Child Health Plan Plus (CHP+). It serves as proof that the individual had minimum essential coverage (MEC) during the months they were enrolled in such programs. This ensures compliance with the Affordable Care Act (ACA) which mandates that most individuals either have health coverage or pay a penalty. The Colorado Department of Health Care Policy and Financing provides IRS Form 1095-B to individuals who were enrolled in Medicaid or CHP+. The form enables these individuals to report their health coverage to the IRS accurately. It also helps in determining whether they are exempt from the Individual Shared Responsibility Payment penalty. By maintaining records of health coverage, IRS Form 1095-B assists individuals in tracking their compliance with the ACA. Accurate reporting of health coverage ensures that individuals receive the necessary documentation to prove their coverage during tax filing season. The form also clarifies which programs and coverage types qualify as MEC and how to handle exclusions.

Tell me about this form and its components and fields line-by-line.

- 1. Responsible Individual: Details of the person who holds the insurance coverage including name, social security number and address.
- 2. Employer Sponsored Coverage: Information about the employer-sponsored health coverage, if applicable including information about the employer.
- 3. Coverage Provider: Information about the coverage provider such as Medicaid or CHP+ including contact details.
- 4. Covered Individuals: Details about each individual who has health coverage under the plan such as name, social security number, and months of coverage.
What happens if I fail to submit this form?
Failing to submit this form can result in penalties and issues with verifying health coverage. It's crucial to submit the form on time to avoid complications.
- IRS Penalty: Failure to submit may lead to an IRS penalty for not meeting the health coverage requirement.
- Coverage Verification Issues: Challenges in verifying health coverage for the tax year, which could delay tax processing.
How do I know when to use this form?

- 1. Reporting Health Coverage: Individuals should use this form to report their health coverage to the IRS when filing taxes.
- 2. Proof of Coverage: The form serves as proof that the individual had minimum essential coverage during the months indicated.
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What should I do if I don’t have all the information needed for IRS Form 1095-B?
Gather all necessary documents and contact the Colorado Department of Health Care Policy & Financing for assistance with any missing information.
Will I receive IRS Form 1095-B if I’m not enrolled in Medicaid or CHP+?
No, only individuals enrolled in Medicaid or CHP+ programs in Colorado during the prior year will receive IRS Form 1095-B.
What if there is an error on my IRS Form 1095-B?
If there is an error on your form, contact the Colorado Department of Health Care Policy & Financing to request a corrected form.
Do I need to submit IRS Form 1095-B with my federal taxes?
While you don’t need to submit the form with your federal taxes, keep it with your tax documents as proof of health coverage.
How can I create a PEAK account to access my IRS Form 1095-B online?
Visit Colorado.gov/PEAK to create an account and access your IRS Form 1095-B in the Mail Center once it is available.
Can I receive IRS Form 1095-B electronically?
Once mailed, a copy of IRS Form 1095-B will be available through your online PEAK account in the Mail Center.
What if I didn’t receive IRS Form 1095-B in the mail?
Contact the Colorado Department of Health Care Policy & Financing if you did not receive your IRS Form 1095-B in the mail by February 1.
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