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110116 Form1094BDepartment of the Treasury Internal Revenue Service OMB No. 15452252Transmittal of Health Coverage Information Returns2022Go to www.irs.gov/Form1094B for instructions and the latest
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How to fill out 1094 b 2022-2023 form

How to fill out 1094 b:
01
Fill in the name, address, and employer identification number (EIN) of the applicable large employer (ALE) member.
02
Provide the total number of Forms 1095-C filed for that ALE member for the calendar year.
03
Indicate whether you're a member of an aggregated ALE group or if the ALE member identified is filing as part of a centralized employer.
Who needs 1094 b:
01
Applicable large employers (ALEs) that are required to provide minimum essential coverage to their full-time employees under the Affordable Care Act (ACA) are required to file Form 1094-B.
02
Employers who sponsor self-insured group health plans are also required to file this form.
03
Form 1094-B is used to report specific information about the employer and the coverage they offer to the IRS, as well as to furnish a copy of Form 1095-B to employees.
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