Covered individuals

Part IV - Covered Individuals

Line 23 to 28: Covered Individuals

In Lines 23-28, enter information about those covered under the health insurance offered to the responsible individual of this 1095-B. You'll need to include their full name(s), SSN or date of birth (if SSN unavailable), and the months they were covered.

If there are more than six covered individuals for this 1095-B, you can enter additional information on the continuation lines below.