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West Virginia Income Maintenance Manual Chapter 9

West Virginia Income Maintenance Manual Page 27 Chapter 9 Client Notification

9.5 1095-B VERIFICATION OF MINIMUM ESSENTIAL COVERAGE 9.5.1 WHO MUST FILE FORM 1095-B Medicaid and the West Virginia Children's Health Insurance Program (WVCHIP) provide health benefits coverage designated as Minimum Essential Coverage (MEC) under Section 5000(f) of Subtitle D of the Internal Revenue Code (IRC). The Affordable Care Act added Section 6055 to the IRC, which requires that every provider of MEC will report coverage information by filing an information return with the Internal Revenue Service (IRS) and by furnishing a statement to covered clients upon request. Medicaid and WVCHIP are required to file an annual 1095-B statement to clients enrolled in MEC, and to send an electronic copy of the same information to the IRS. The IRS requires a report on Form 1095-B for every client covered by MEC and for every month of coverage. Even if the client had only one day of coverage, it is reported as a month of coverage. The information furnished and reported is used by individuals and the IRS to verify the months in which clients were covered by MEC and, therefore, have satisfied the individual shared responsibility requirement of Section 5000A of the IRC. 9.5.2 FURNISHING FORM 1095-B The eligibility system will electronically send the 1095-B forms, along with form 1094-B, Transmittal of Health Coverage Information Returns, to the IRS. The forms must be submitted to the IRS on or before March 31 of the year following the calendar year in which MEC is provided. The 1095-B forms must be made available in the eligibility system on or before January 31 of the year following the calendar year in which MEC is provided. Upon request of the client, a worker may generate a 1095-B form out of the eligibility system. The requested document must be sent to the client within 30 days of the date of the request. 9.5.3 CORRECTIONS AND REPLACEMENTS TO FORM 1095-B