1095-B, Part II - Information About Certain Employer-Sponsored Coverage

The Form 1095-B, Part II — Information About Certain Employer-Sponsored Coverage is only completed in certain scenarios.

This should not be completed if you are an employer reporting your own self-insured coverage. Please see the snippet from the IRS instructions below for more information:

Employers reporting self-insured group health plan coverage on Form 1095-B, except for an individual coverage HRA, enter code B on line 8, but don't complete Part II. If you entered code B for self-insured coverage, skip Part II and go to Part III.

Please note: Columns P-X (yellow headers) in our spreadsheet template correspond to Lines 10-15 (Part II, Information About Certain Employer-Sponsored Coverage).