IMPORTANT HEALTH COVERAGE TAX DOCUMENTS

IRS Form 1095-B

This notice applies to individuals with fully-insured coverage that is administered by PreferredOne Insurance Company. If you have self-insured coverage, please contact your human resources department representative.

As a result in a change in the federal tax law, most fully insured members will not receive a paper copy of the Form 1095-B. The IRS penalty for not having health coverage was reduced to zero starting with the 2019 tax year. Thus, individuals no longer need the information on the Form 1095-B to file a federal income tax return. However, if you would like a copy of the IRS Form 1095-B for your state income tax return or for other purposes you will need to contact PreferredOne to request a copy.

How to Request a Copy of Form 1095-B

If requested, a Form 1095-B will be produced for insured members no later than the annual deadline set by the IRS. Members can view and/or download and print an electronic copy of the form at their convenience from the member portal, if desired, by logging into their secure My Account at PreferredOne.com.

Additionally, a request for a paper form can be made in one of the following ways:

• Call PreferredOne at:
  Phone: 763-847-4477
  Toll Free: 1-800-997-1750
  TTY: 763-847-4013
  
• Submit a written request to PreferredOne at:
  PreferredOne Insurance Company
  Attn: Customer Service
  6105 Golden Hills Drive
  Golden Valley, MN 55416

After you contact PreferredOne to request a paper form, a Form 1095-B will be mailed to the address you provide within 30 days of the date the request is received from you. If you have any questions about your Form 1095-B or your address has changed, contact PreferredOne by calling:

Phone: 763-847-4477

Toll Free: 1-800-997-1750

TTY: 763-847-4013

PreferredOne insurance Company
6105 Golden Hills Drive
Golden Valley, MN 55416