Form 1094-B, Transmittal of Health Coverage Information Returns

REG-132455-11 - Reporting of Minimum Essential Coverage (TD 9660 - final)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-2252 can be found here:

Documents and Forms

Document Name Document Type
Form 1094-B Form 1094-B, Transmittal of Health Coverage Information Returns Form
Instructions 1094B and 1095B (2014).pdf Instruction
1094-B Transmittal of Health Coverage Information Returns f1094b.pdf Form
REG-132455-11.pdf REG-132455-11 - Reporting of Minimum Essential Coverage (NPRM) IC Document
TD 9660.pdf TD 9660 IC Document

Information Collection (IC) Details

IC Title:	Form 1094-B, Transmittal of Health Coverage Information Returns	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 26 CFR 1.6055-1 26 CFR 1.6055-2

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1094-B	Transmittal of Health Coverage Information Returns	f1094b.pdf		Yes	Yes	Fillable Fileable
Instruction			Instructions 1094B and 1095B (2014).pdf		Yes	No	Fillable Printable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 430	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	430	430
Annual IC Time Burden (Hours)	72	72
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
REG-132455-11 - Reporting of Minimum Essential Coverage (NPRM)	REG-132455-11.pdf	02/24/2014
TD 9660	TD 9660.pdf	03/20/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.