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1095BPart Do not attach to your tax return. Keep for your records.2 Social security number (SSN or other TIN)XXXXX9876Retired Taylor4 Street address (including apartment no.)56City or town West DES

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What is 1095b-b custom layout 1?

1095b-b custom layout 1 is a specific format for reporting health care coverage information to the IRS.

Who is required to file 1095b-b custom layout 1?

Employers with self-insured health plans must file 1095b-b custom layout 1.

How to fill out 1095b-b custom layout 1?

You can fill out 1095b-b custom layout 1 by providing accurate information about the individuals covered under the health plan.

What is the purpose of 1095b-b custom layout 1?

The purpose of 1095b-b custom layout 1 is to report health care coverage information to the IRS.

What information must be reported on 1095b-b custom layout 1?

Information such as names, Social Security numbers, and months of coverage must be reported on 1095b-b custom layout 1.

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