ACA – 1095-B reporting

The Patient Protection and Affordable Care Act (PPACA) created new Internal Revenue Service (IRS) reporting requirements for your student health plan. Under these new reporting rules, information must be provided to the IRS about your health plan coverage for the 2018 tax year. This is called Form 1095-B for student health plans.

Under PPACA, the Washington University School of Medicine Student Health Service (WUSM SHS) Benefit Plan has been approved as Minimum Essential Coverage (MEC). MEC is the type of health insurance coverage individuals need in order to meet the PPACA individual shared responsibility requirement. Individuals that are subject to the individual shared responsibility requirement do not have to pay a penalty if they maintain enrollment in a MEC plan.

Please note: Student Health Plan meets the “Minimum Essential Coverage” definition.

PPACA places the responsibility on the IRS to administer the individual MEC mandate, as well as associated penalties should an individual not maintain MEC throughout the calendar year. In accordance with the IRS directives, WUSM is required to report to the IRS those persons that maintained MEC under WUSM SHS. The reporting will take place at the end of February. The IRS will match the data submitted from WUSM SHS to each individual’s or family’s federal tax return and will use the student’s social security number as the primary identifier.

Therefore, WUSM SHS was required to supply certain information for students and their enrolled family as covered persons to our third party administrator on behalf of WUSM Human Resource secure submittal to the United States Internal Revenue Service (IRS). The IRS also requires WUSM SHS to provide a statement of coverage (federal tax form 1095-B) to the primary covered person. If a student and/or family were enrolled in the WUSM SHS Benefit Plan during 2016, the student should receive a 1095-B form by U.S. postal mail. Please ensure your current address is update in WebSTAC.

The 1095-B form will contain the student’s name, address, date of birth, and Social Security Number (SSN) for you and for each covered member, and will include the months for which each individual was enrolled in coverage for at least one day. If a covered dependent does not have a SSN, the dependent’s date of birth will instead be reported on this form.

When preparing a federal income tax return, the student will complete the Health Care: Individual Responsibility section, indicating whether the student, their spouse and dependent children had minimum essential health coverage for the entire year. Form 1095-B will provide this required information for tax reporting purposes. The 1095-B form is not necessary to file a tax return. However, student should keep their 1095-B with their tax records.

More information about Form 1095-B and IRS reporting requirement is available on the IRS website by searching on Affordable Care Act tax provisions.