1095-B Import Spreadsheet: Required Fields (Tax Year 2025)

This guide covers the required fields for importing Form 1095-B data into BoomTax. Download the 1095-B template here.

Form 1095-B, Health Coverage

Part I: Responsible Individual (Blue Headers)

1. First name and Last name
2. Social security number (SSN)*
3. Date of birth* (only if SSN is not available)
4. Street address (including apartment number)
5. City or town
6. State or province
7. Country code: Use "US" for United States
7. Zip or foreign postal code
8. Origin of Health Coverage: Enter the letter code identifying the origin. See Line 8 Codes Guide.

*When available, SSN is preferred over date of birth.

Part II: Employer-Sponsored Coverage (Yellow Headers)

Complete this section only if the issuer or carrier of a group health plan (including SHOP coverage):

10. Employer name
11. Employer EIN
12. Employer street address
13. City or town
14. State (abbreviated)
15. Country code

Part III: Covered Individuals (Green Headers)

a. First name and Last name
b. SSN*
c. DOB* (only if SSN is not available)
d. Coverage months: Use "Covered all 12 Months" or fill in each month individually

Multiple covered individuals: List each on a subsequent row. You can fill in only the green columns and leave the rest blank, or duplicate the responsible individual data for each row.

Download Template

Download the BoomTax 1095-B Excel Template

This article covers Tax Year 2025. Sources: Import Spreadsheet Guidelines, Line 8 Codes for Form 1095-B (blog.boomtax.com)