Reporting of health insurance coverage

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1094-B Form 1094-B, Transmittal of Health Coverage Information Returns	Form	Modified	Repair queued
Supporting Statement_1545-2252_MS.docx	Supporting Statement A	Uploaded 2022-06-21	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
213670	Form 1095-B, Health Coverage	Instruction	Modified
205933	Form 1094-B, Transmittal of Health Coverage Information Returns	Form	Modified

ICR Details

OMB Control No: 1545-2252	ICR Reference No: 202203-1545-011
Status: Received in OIRA	Previous ICR Reference No: 201710-1545-006
Agency/Subagency: TREAS/IRS	Agency Tracking No: Ready for Treas. Review
Title: Reporting of health insurance coverage
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 06/29/2022

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	06/30/2022
Responses	125,030,000	125,030,000
Time Burden (Hours)	2,088,333	2,088,333
Cost Burden (Dollars)	0	0

---

Abstract: This document contains regulations relating to an information reporting requirement enacted by the Patient Protection and Affordable Care Act, Public Law 111-148, and Health Care and Education Reconciliation Act, Public Law 111-152. These regulations are necessary to impose the reporting requirement under section 1502 of the Affordable Care Act (section 6055 of the Internal Revenue Code) on health insurance issuers, employer-sponsored self-insured plans and government-sponsored programs that provide minimum essential coverage. The IRS developed Form 1095-B, Health Coverage, to report this information about individuals who are covered by minimum essential coverage. Form 1094-B, Transmittal of Health Coverage Information Returns, serves as a transmittal for Form 1095-B.

---

Authorizing Statute(s): PL: Pub.L. 111 - 148 1501(b) Name of Law: Patient Protection and Affordable Care Act
   PL: Pub.L. 111 - 152 1002 Name of Law: Health Care and Education Reconciliation Act of 2010
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 1485	01/11/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 38831	06/29/2022
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Form 1094-B, Transmittal of Health Coverage Information Returns	1094-B	Transmittal of Health Coverage Information Returns
Form 1095-B, Health Coverage	1095-B	Health Coverage

---

ICR Summary of Burden

table that charts list of burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	125,030,000	125,030,000	0	0	0	0
Annual Time Burden (Hours)	2,088,333	2,088,333	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $197,467

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/29/2022

---