Form 1094-B, Transmittal of Health Coverage Information Returns, is the Internal Revenue Service (IRS) cover form that must be filed with Form 1095-B, Health Coverage. It identifies the filer, names a contact person and reports how many Forms 1095-B are being submitted with it. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the form and its instructions are published by the IRS at www.irs.gov/Form1094B.
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What is Form 1094-B?
Form 1094-B, Transmittal of Health Coverage Information Returns, is the Internal Revenue Service (IRS) transmittal form that accompanies Forms 1095-B. It names the filer and reports the total number of Forms 1095-B submitted with it.
The IRS describes Form 1094-B as the transmittal form that must be filed with the Form 1095-B, which is titled Health Coverage. The 1094-B carries no coverage details of its own. Those appear on the Forms 1095-B it transmits.
The one-page form has nine numbered lines: the filer's name (line 1), employer identification number (EIN) (line 2), a contact person and telephone number (lines 3 and 4), the filer's address (lines 5 to 8) and the total number of Forms 1095-B submitted with the transmittal (line 9). A signature block below carries a declaration made under penalties of perjury, with signature, title and date.
The form is printed with OMB No. 1545-2252 and the year 2025. The IRS publishes the instructions as Instructions for Forms 1094-B and 1095-B.
Other IRS health coverage products are separate documents with their own pages: Form 1095-A (Health Insurance Marketplace Statement), Form 1095-C (Employer-Provided Health Insurance Offer and Coverage) and Form 8962 (Premium Tax Credit). Form 1094-B is not any of these.
Who needs to file Form 1094-B?
Filers who submit Forms 1095-B, Health Coverage, use Form 1094-B as the transmittal for those returns: the IRS states that it must be filed with the Form 1095-B. One 1094-B reports the total number of Forms 1095-B sent with it, on line 9.
The form asks for the filer's name and EIN, so it is completed in the name of the entity that submits the Forms 1095-B. It also asks for a person to contact and a telephone number, and it must be signed by someone who gives a title.
Form 1094-B is not the transmittal for other health coverage returns that the IRS lists separately, such as Form 1095-A or Form 1095-C. To find out who must file Form 1095-B itself, see the Instructions for Forms 1094-B and 1095-B at www.irs.gov/Form1094B.
When to file Form 1094-B
Form 1094-B is filed at the same time as the Forms 1095-B it transmits, because the IRS says it must be filed with the Form 1095-B. It has no due date printed on it and no separate filing window of its own.
The form is marked 2025 in its title block. Use the revision that matches the year of the Forms 1095-B you are transmitting; the IRS keeps all Form 1094-B revisions listed on its page at www.irs.gov/forms-pubs/about-form-1094-b. For deadlines, check the Instructions for Forms 1094-B and 1095-B at www.irs.gov/Form1094B.
Documents you need
- The Forms 1095-B, Health Coverage, that this transmittal covers: Form 1094-B must be filed with them, and line 9 reports how many are submitted.
How to fill out Form 1094-B
Enter the filer's name and EIN
Line 1: the filer's name. Line 2: the filer's employer identification number (EIN).
Add a contact person
Line 3: the name of the person to contact about the return. Line 4: that person's contact telephone number.
Enter the street address
Line 5: the filer's street address, including room or suite number. Line 6: the city or town.
Enter state and country
Line 7: the state or province. Line 8: the country and the ZIP or foreign postal code.
Report the number of Forms 1095-B
Line 9: enter the total number of Forms 1095-B submitted with this transmittal. Count the returns before you enter the number.
Sign, title and date the form
Below the declaration made under penalties of perjury, add the signature, the signer's title and the date.
Review and download the completed PDF
Check the EIN, the contact details and the line 9 count against your Forms 1095-B. Download or print the completed PDF from FillingPDF and assemble it with the returns as described under How to submit.
How to submit Form 1094-B
Form 1094-B is submitted together with the Forms 1095-B it transmits. The form itself prints no mailing address, portal or other channel.
- With the Forms 1095-B: put the completed, signed 1094-B with the returns it covers, and make the number on line 9 match the number of Forms 1095-B you submit.
- Channels and addresses: see the Instructions for Forms 1094-B and 1095-B, linked from the IRS page at https://www.irs.gov/forms-pubs/about-form-1094-b, and the IRS form page at www.irs.gov/Form1094B.
The declaration printed above the signature line states that the return and accompanying documents are true, correct and complete, so check line 9 and your entries before signing. FillingPDF lets you fill out and download the PDF; submission follows the IRS channels described in the instructions.
Common mistakes to avoid
- Filing Form 1094-B without the Forms 1095-B it transmits; the IRS says the transmittal must be filed with the Form 1095-B.
- Entering on line 9 a number that does not match the Forms 1095-B actually submitted with the transmittal.
- Leaving the signature, title or date blank under the declaration made under penalties of perjury.
- Using a different year's Form 1094-B instead of the revision for the Forms 1095-B you are filing; this version is marked 2025.
- Leaving out the EIN on line 2 or the contact name and telephone number on lines 3 and 4.
- Using Form 1094-B as the transmittal for Form 1095-A or Form 1095-C, which the IRS lists as separate products.
Frequently asked questions
What is Form 1094-B?
Form 1094-B is the IRS transmittal form that must be filed with Form 1095-B, Health Coverage. It identifies the filer and reports the total number of Forms 1095-B submitted with it on line 9. Coverage details appear on the 1095-B forms, not on the transmittal.
Do I have to file Form 1094-B with Form 1095-B?
Yes. The IRS states that Form 1094-B is the transmittal form that must be filed with the Form 1095-B. It is the cover sheet for the Forms 1095-B you submit, so the two are filed together.
What do I enter on line 9 of Form 1094-B?
Enter the total number of Forms 1095-B submitted with this transmittal. The number should match the Forms 1095-B you actually file with it.
Where can I find the instructions for Form 1094-B?
The IRS publishes Instructions for Forms 1094-B and 1095-B, a combined document, and links them from its Form 1094-B page at www.irs.gov/forms-pubs/about-form-1094-b. The form itself points to www.irs.gov/Form1094B for instructions and the latest information.
Can I fill out Form 1094-B online?
You can fill out the 1094-B PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not file the form with the IRS; you submit it through the IRS channels described in the instructions.
Is Form 1094-B the same as Form 1095-B?
No. Form 1094-B is the transmittal that reports how many returns are being sent. Form 1095-B, Health Coverage, is the separate return that it accompanies. The IRS also lists Forms 1095-A and 1095-C as separate products.
Does Form 1094-B need a signature?
Yes, the form has a signature block under a declaration made under penalties of perjury, with spaces for signature, title and date. The declaration states that the return and accompanying documents are true, correct and complete.
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