1095-B PROVIDER CALENDAR
Provider / coverage year:
Covered-individual count / return count:
Reporting-route review:

OBLIGATION ROW
IRS paper, IRS electronic, direct furnishing, notice or state:
Applicable date / authority URL / source year / checked date:
Eligibility or exception:
Internal feed cutoff / reconciliation cutoff / provider cutoff:
Primary owner / backup:
Actual event / evidence / remaining issue:

NOTICE/REQUEST METHOD, IF USED
Notice publication deadline and evidence:
Required availability-through date:
Website location and contact channels:
Request received date:
January 31 reference / request plus 30 days / later date:
Actual furnishing date and evidence:

ROLLOVER
[ ] New coverage-year dates independently verified
[ ] State requirements separately reviewed