Form 1095-B

What is Form 1095-B?

Form 1095-B is used to report information to the IRS and to taxpayers about individuals who are covered by minimum essential coverage.

You are not required to include a copy of Form 1095-B when filing your tax return.


What's New?

For the 2019 tax year, the federal tax penalty for not having health insurance has been lifted, and health insurers are no longer required to send Form 1095-B to members.

However, if you still want a copy of Form 1095-B for your records, CDPHP has made it easy to access.


Download or print Form 1095-B (recommended)

This is the fastest and most secure way to receive Form 1095-B. 

Simply log on to your CDPHP member account, select Form 1095-B, and click to open and print the form. 

Get the form


Request a Form 1095-B by mail

We will mail your Form 1095-B within 30 days if you submit your request via postal mail.

Please include: 

  • Name

  • Address

  • Employer Name (if coverage is through an employer)

  • Subscriber ID

  • Coverage year start and end date

Please clearly indicate this is a request for Form 1095-B and mail it to:

Attention: Membership and Billing – 1095-B
500 Patroon Creek Blvd.
Albany, NY 12206


Call to obtain Form 1095-B

You can call CDPHP at the number on your member ID card to request a copy of Form 1095-B.