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Form 1095-A online Washington: What You Should Know

What the 1095-B Tax Form Says ‹You› are a qualified household.› How to Make the 1095-B​ Form: The 1095-B Tax Form must be completed and signed by someone other than the person listed on it. Include the following information in the form: Your social insurance number (SIN) Your tax filing status (and state if eligible). Your employer's name with city if eligible in the state where you work. If you are a family member, a relative, relative's employer or a relative's employer's employer who is a qualifying family member listed on your 1040 form. The name of the person who paid your share of the qualified medical expenses (as defined), in the form of a dollar amount not greater than your standard deduction, and the date and reason, including why the amount was paid. If your application claims an exemption, include a paragraph that says the exclusion was used but provides: “Note: If your application does not claim an exemption from the social security tax, it cannot be used for the purpose of reporting your coverage under an exemption. Your employer may ask for an additional form to provide information for this purpose. To get an exemption form or information for this purpose: Call the IRS at from 8 a.m. to 4 p.m. Contact your state exchange, Healthcare.gov, or Medicare Advantage organization/provider to obtain the exemption form or information. If you are a qualifying family member, include your 1095-B tax form with each application for coverage (as defined) for which you are eligible. If you are not a qualifying family member, provide only the information necessary to determine eligibility. You do not have to provide the 1095-B information for any other person, including a relative, a sibling or parent or for your employer. The date or date of birth of all children living (or deceased) with you, and the date the youngest child began living with you. The state or federal government may provide birth Certificate information. The date of your birth.

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