Form 1095-B

This is the fastest and most secure way to receive Form 1095-B. Important: The Form 1095-B can only be accessed this way by the subscriber on the policy; however, the subscriber can print multiple copies of the form as needed. It is not available via a spouse or dependent log on.

Enable online access in Paperless Settings

Step 1. Log into your Excellus BCBSUnivera Healthcare account. If you do not have an account, you can easily create an account.

Step 2. Click the Account Settings link. The link is located in the upper right-hand corner.

Step 3. Click on Paperless Settings.

Step 4. Click on the General Member Communications.

Step 5. Click the Online button and then click the Save button to enable online access to the document.

View or Print Form 1095-B

Step 1. Log in to your account. Select My Account in the navigation bar.

Step 2. Click the View Statements/Documents link under My Information.

Step 3. Click the Document Name drop down and select 1095-B.

Step 4. Click the Update Button.

Step 5. Click the Form 1095-B PDF link. Once open you can view, print or download the document.

We will email your Form 1095-B within 30 days if you submit your request via our secure email contact form and clearly indicate this is a request for the Form 1095-B.

We will mail your Form 1095-B within 30 days if you submit your request via postal mail.

Please include: Your Name, Name of Employer: (if coverage is through an employer), Subscriber ID, Your Address, Coverage Year Start and End Date and clearly indicate this is a request for the Form 1095-B and mail it to:

P.O. Box 21146 Eagan, MN 55121-0146
Attn: Form 1095-B Request

(May take up to 30 days to receive)

For more information on how to request a Form 1095-B by phone, call the number below.

Call: 1-877-889-7182