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IRS Form 1095-B

In accordance with IRS Notice 2019-63, Form 1095-B Forms will NOT be automatically provided to all employees.  Responsible individuals may receive a copy of their 2019 Form 1095-B upon request, accompanied by an email address and a physical address to which a request may be sent, as well as a telephone number that responsible individuals can use to contact the reporting entity with any questions.  The reporting entity furnishes a 2019 Form 1095-B to any responsible individual upon request within 30 days of the date the request is received. 

Requests shall be sent to: