1095-B forms for 2020 available upon request

According to the Internal Revenue Service, because the individual shared responsibility payment is zero in 2020, an individual does not need the information on Form 1095-B to file income taxes with the IRS. Therefore the IRS is allowing reporting entities to furnish 1095-B forms upon request. I you would like to receive your 2020 Form 1095-B, please submit your request using one of three contact options below:

1095B Email Address: MsMedicaid1095B@Conduent.com

PO Box:
Conduent
PO Box 23080
Jackson Mississippi 39225

Call Center :
1-800-884-3222

Step 1:

If you are a beneficiary, Press 1.

Step 2:

If you are calling about the statement of health coverage or proof of insurance form, Press the star key.
There is a prerecorded message that must be updated. Conduent will advise DOM when the message has been updated.

Step 3:

If you would like to request the 1095B form, Press the star key

Step 4:

Validate, enter Medicaid beneficiary number or beneficiary social security number

For more information, read the IRS Notice: Transition Relief Related to Health Coverage Reporting Required by Sections 6055 and 6056 for 2020