Form 1095-B Information


Under the Affordable Care Act, health plans have been required to provide to participants a Form 1095-B reporting enrollment information. In the past, the Plan would mail Form 1095-B to participants at the end of February each year. Participants would then determine whether they are subject to an individual shared responsibility penalty for federal tax liability based on this enrollment information. However, because the individual shared responsibility penalty was reduced to zero as of 2019, taxpayers no longer need this information to compute federal tax liability. Accordingly, the IRS has advised that health plans do not need to automatically mail the 1095-B Forms.

If you would still like your 2021 Form 1095-B mailed to you, you can request a copy via email to – or by regular mail to AFL Hotel & Restaurant Workers Claims Administrative Office, 560 N. Nimitz Hwy., Ste. 114B, Honolulu, HI 96817. Upon receipt of your request, the Plan will mail your 2021 1095-B within 30-days. Please contact PSWA’s Customer Service at (808) 275-2520 should you have any questions.