Why are you receiving this form?
The Internal Revenue Service (IRS) requires all health insurance providers send this form upon request to all enrollees who have health insurance and meet the "minimum essential coverage" requirements of the Affordable Care Act (ACA) and requested the form. The ACA requires nearly all Americans who meet health care reform standards to have health insurance. The 1095-B form informs the IRS who had coverage and for how long.
What information is on the 1095-B tax form?
For each person covered on your policy, the 1095-B lists:
- Name
- Address
- Date of birth
- Taxpayer identification number
- Months of coverage
If you need a copy of your 1095-B tax form, you can:
- Print the form or go to your myCOMPASS account to obtain the form.
You can also request the form by:
- Calling 877-617-9906
- Sending an email to RA-PWPA1095-B@pa.gov
- Mailing a written request to your local county assistance office
Additional Information
- Have more questions? Read the 1095-B Tax Form FAQ — English & Spanish