The IRS 1095-A form, officially known as the Health Insurance Marketplace Statement, serves a critical function for individuals who have obtained health insurance through the marketplace. This document not only provides details about the insurance coverage, including the start and end dates, but also is essential for accurately completing federal income tax returns. It particularly plays a pivotal role in determining eligibility for premium tax credits.
Navigating the intricacies of health insurance documentation becomes an annual ritual for many Americans, especially as they prepare their tax filings. Among the forms that play a crucial role in this process is the IRS 1095-A form, a document that provides detailed information about health insurance coverage purchased through the Marketplace. It serves as a vital piece of the puzzle for taxpayers, enabling them to verify their coverage, reconcile any advance payments of the premium tax credit, and to file an accurate tax return. The form outlines the type of coverage, the period covered, and any premiums paid, making it indispensable for taxpayers seeking to comply with the Affordable Care Act's requirements. Its importance cannot be overstated, as it not only affects an individual's tax liabilities but also helps to ensure that they are taking full advantage of available tax credits. Understanding the nuances of the 1095-A form is essential for anyone looking to navigate the tax season smoothly, avoid common pitfalls, and maximize their potential benefits.
CAUTION: NOT FOR FILING
Form 1095-A is provided here for informational purposes only.
Health Insurance Marketplaces use Form 1095-A to report information on enrollments in a qualified health plan in the individual market through the Marketplace. As the form is to be completed by the Marketplaces, individuals cannot complete and use Form 1095-A available on IRS.gov. Individuals receiving a completed Form 1095-A from the Health Insurance Marketplace will use the information received on the form and the guidance in the instructions to assist them in filing an accurate tax return.
Form 1095-A
Department of the Treasury Internal Revenue Service
Health Insurance Marketplace Statement
▶ Do not attach to your tax return. Keep for your records.
▶Go to www.irs.gov/Form1095A for instructions and the latest information.
VOID
CORRECTED
OMB No. 1545-2232
2021
Recipient Information
Part I
1
Marketplace identifier
2
Marketplace-assigned policy number
3
Policy issuer’s name
4
Recipient’s name
5
Recipient’s SSN
6
Recipient’s date of birth
7
Recipient’s spouse’s name
8
Recipient’s spouse’s SSN
9
Recipient’s spouse’s date of birth
10
Policy start date
11
Policy termination date
12
Street address (including apartment no.)
13
City or town
14
State or province
15
Country and ZIP or foreign postal code
Covered Individuals
Part II
A. Covered individual name
B. Covered individual SSN
C. Covered individual
D. Coverage start date
E. Coverage termination date
date of birth
16
17
18
19
20
Coverage Information
Part III
Month
A. Monthly enrollment premiums
B. Monthly second lowest cost silver
C. Monthly advance payment of
plan (SLCSP) premium
premium tax credit
21
January
22
February
23
March
24
April
25
May
26
June
27
July
28
August
29
September
30
October
31
November
32
December
33
Annual Totals
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.
Cat. No. 60703Q
Form 1095-A (2021)
Page 2
Instructions for Recipient
You received this Form 1095-A because you or a family member enrolled in health insurance coverage through the Health Insurance Marketplace. This Form 1095-A provides information you need to complete Form 8962, Premium Tax Credit (PTC). You must complete
Form 8962 and file it with your tax return (Form 1040, Form
1040-SR, or Form 1040-NR) if any amount other than zero is shown in Part III, column C, of this Form 1095-A (meaning that you received premium assistance through advance payments of the premium tax credit (also called advance credit payments)) or if you want to take the premium tax credit. The filing requirement applies whether or not you’re otherwise required to file a tax return. If you are filing Form 8962, you cannot file Form 1040-NR-EZ, Form
1040-SS, or Form 1040-PR. The Marketplace has also reported the information on this form to the IRS. If you or your family members enrolled at the Marketplace in more than one qualified health plan policy, you will receive a Form 1095-A for each policy. Check the information on this form carefully. Please contact your Marketplace if you have questions concerning its accuracy. If you or your family members were enrolled in a Marketplace catastrophic health plan or separate dental policy, you aren’t entitled to take a premium tax credit for this coverage when you file your return, even if you received a Form 1095-A for this coverage. For additional information related to Form 1095-A, go to www.irs.gov/Affordable-Care-Act/Individuals-and- Families/Health-Insurance-Marketplace-Statements.
Additional information. For additional information about the tax provisions of the Affordable Care Act (ACA), including the premium tax credit, see www.irs.gov/Affordable-Care-Act/Individuals-and-Families or call the IRS Healthcare Hotline for ACA questions (800-919-0452).
VOID box. If the “VOID” box is checked at the top of the form, you previously received a Form 1095-A for the policy described in Part I. That Form 1095-A was sent in error. You shouldn’t have received a Form 1095-A for this policy. Don’t use the information on this or the previously received Form 1095-A to figure your premium tax credit on Form 8962.
CORRECTED box. If the “CORRECTED” box is checked at the top of the form, use the information on this Form 1095-A to figure the premium tax credit and reconcile any advance credit payments on Form 8962. Don’t use the information on the original Form 1095-A you received for this policy.
Part I. Recipient Information, lines 1–15. Part I reports information about you, the insurance company that issued your policy, and the Marketplace where you enrolled in the coverage.
Line 1. This line identifies the state where you enrolled in coverage through the Marketplace.
Line 2. This line is the policy number assigned by the Marketplace to identify the policy in which you enrolled. If you are completing Part IV of Form 8962, enter this number on line 30, 31, 32, or 33, box a.
Line 3. This is the name of the insurance company that issued your policy.
Line 4. You are the recipient because you are the person the Marketplace identified at enrollment who is expected to file a tax return and who, if qualified, would take the premium tax credit for the year of coverage.
Line 5. This is your social security number (SSN). For your protection, this form may show only the last four digits. However, the Marketplace has reported your complete SSN to the IRS.
Line 6. A date of birth will be entered if there is no SSN on line 5.
Lines 7, 8, and 9. Information about your spouse will be entered only if advance credit payments were made for your coverage. The date of birth will be entered on line 9 only if line 8 is blank.
Lines 10 and 11. These are the starting and ending dates of the policy. Lines 12 through 15. Your address is entered on these lines.
Part II. Covered Individuals, lines 16–20. Part II reports information about each individual who is covered under your policy. This information includes the name, SSN, date of birth, and the starting and ending dates of coverage for each covered individual. For each line, a date of birth is reported in column C only if an SSN isn’t entered in column B.
If advance credit payments are made, the only individuals listed on Form 1095-A will be those whom you certified to the Marketplace would be in your tax family for the year of coverage (yourself, spouse, and dependents). If you certified to the Marketplace at enrollment that one or more of the individuals who enrolled in the plan aren’t individuals who would be in your tax family for the year of coverage, those individuals won’t be listed on your Form 1095-A. For example, if you indicated to the Marketplace at enrollment that an individual enrolling in the policy is your adult child who will not be your dependent for the year of coverage, that child will receive a separate Form 1095-A and won’t be listed in Part II on your Form 1095-A.
If advance credit payments are made and you certify that one or more enrolled individuals aren’t individuals who would be in your tax family for the year of coverage, your Form 1095-A will include coverage information in Part III that is applicable solely to the individuals listed on your Form 1095-A, and separately issued Forms 1095-A will include coverage information, including dollar amounts, applicable to those individuals not in your tax family.
If advance credit payments weren’t made and you didn’t identify at enrollment the individuals who would be in your tax family for the year of coverage, Form 1095-A will list all enrolled individuals in Part II on your Form 1095-A.
If there are more than 5 individuals covered by a policy, you will receive one or more additional Forms 1095-A that continue Part II.
Part III. Coverage Information, lines 21–33. Part III reports information about your insurance coverage that you will need to complete Form 8962 to reconcile advance credit payments or to take the premium tax credit when you file your return.
Column A. This column is the monthly premiums for the plan in which you or family members were enrolled, including premiums that you paid and premiums that were paid through advance payments of the premium tax credit. If you or a family member enrolled in a separate dental plan with pediatric benefits, this column includes the portion of the dental plan premiums for the pediatric benefits. If your plan covered benefits that aren’t essential health benefits, such as adult dental or vision benefits, the amount in this column will be reduced by the premiums for the nonessential benefits. If the policy was terminated by your insurance company due to nonpayment of premiums for 1 or more months, then a -0- will appear in this column for these months regardless of whether advance credit payments were made for these months.
Column B. This column is the monthly premium for the second lowest cost silver plan (SLCSP) that the Marketplace has determined applies to members of your family enrolled in the coverage. The applicable SLCSP premium is used to compute your monthly advance credit payments and the premium tax credit you take on your return. See the instructions for Form 8962, Part II, on how to use the information in this column or how to complete Form 8962 if there is no information entered. If the policy was terminated by your insurance company due to nonpayment of premiums for 1 or more months, then a -0- will appear in this column for the months, regardless of whether advance credit payments were made for these months.
Column C. This column is the monthly amount of advance credit payments that were made to your insurance company on your behalf to pay for all or part of the premiums for your coverage. If this is the only column in Part III that is filled in with an amount other than zero for a month, it means your policy was terminated by your insurance company due to nonpayment of premiums, and you aren’t entitled to take the premium tax credit for that month when you file your tax return. You must still reconcile the entire advance payment that was paid on your behalf for that month using Form 8962. No information will be entered in this column if no advance credit payments were made.
Lines 21–33. The Marketplace will report the amounts in columns A, B, and C on lines 21–32 for each month and enter the totals on line 33. Use this information to complete Form 8962, line 11 or lines 12–23.
Once you've obtained your IRS Form 1095-A, also known as the Health Insurance Marketplace Statement, the next step is to fill it out correctly. This form is essential for individuals who have purchased health insurance through the Marketplace and is used to report certain information to the IRS about their health coverage. The form also plays a crucial role in determining your eligibility for premium tax credits. Accurately completing this form is crucial for ensuring compliance with tax laws and avoiding potential issues.
To accurately complete the IRS 1095-A form, follow these steps:
After the IRS 1095-A form is correctly filled out and submitted with your tax return, the IRS will use the information provided to verify your coverage status, calculate any premium tax credit you're eligible for, and reconcile it with any advance payments. This step is crucial in fulfilling your tax obligations regarding health insurance coverage. Remember, keeping a copy of the completed form for your records is always a good practice.
What is a 1095-A form?
The 1095-A form, also known as the Health Insurance Marketplace Statement, is a document sent to anyone who has purchased health insurance through the Marketplace. It contains information about the insurance policy, premiums paid, and any advance payments of the premium tax credit. This form is necessary for filing your taxes, as it helps you determine if you need to pay back any tax credit or if you're eligible for a larger tax refund.
Why did I receive a 1095-A form?
You received a 1095-A form because you or a family member enrolled in a health plan through the Marketplace in the past year. This form is sent to you by the Marketplace, not the IRS, and it's an important document for completing your tax return. It shows the government that you had health insurance coverage and helps you see if you used your premium tax credit correctly.
What should I do if I didn't receive my 1095-A form or if it's incorrect?
How does the 1095-A form affect my taxes?
The 1095-A form plays a critical role in preparing your tax return. It provides the information needed to fill out Form 8962, Premium Tax Credit (PTC). This form determines your actual premium tax credit eligibility and any adjustments required. If you received more advance payments of the premium tax credit than you were eligible for, you might have to repay some or all of the excess when you file your federal tax return. Conversely, if you were eligible for more credit than you received, you might get the additional amount as a refund.
One common mistake people make when filling out the IRS Form 1095-A is not reporting all members of their household. This form, which is crucial for reporting health insurance information for tax purposes, requires accurate details about everyone in the household who was covered by the insurance plan. Omitting a family member can lead to discrepancies and could affect tax credits and liabilities.
Another issue arises when individuals incorrectly report their income. The IRS uses the information from Form 1095-A to determine eligibility for premium tax credits. If income is underreported or overreported, it can lead to an incorrect calculation of these credits, potentially resulting in a larger tax bill or a smaller refund than rightfully owed.
Entering information in the wrong sections is also a frequent error. The form is divided into parts that specify the insurer, the policy number, and the coverage details, among other things. Placing information in the incorrect section can lead to confusion, processing delays, and inaccurately assessed taxes or credits.
A significant number of errors come from not using the correct form version. The IRS occasionally updates its forms, including the 1095-A, to reflect changes in tax laws or health insurance reporting requirements. Using an outdated version can mean missing crucial updates and making mistakes in reporting.
Failure to reconcile the premium tax credit is another issue. Individuals who received a premium tax credit must reconcile it on their tax return using the information from Form 1095-A. Neglecting to do this correctly can lead to discrepancies and potential issues with the IRS.
Not double-checking information before submission is a basic yet critical mistake. Typos in policy numbers, incorrect dates, or misreported coverage months can all lead to the need for amendments and may impact the processing of tax credits and deductions related to health insurance.
Last but not least, many people forget to submit Form 1095-A altogether. Whether it’s an oversight or misunderstanding of its importance, not filing this form can have significant consequences. It’s essential for calculating the premium tax credit and proving health insurance coverage, both of which are crucial for complying with tax laws.
When dealing with health insurance information for tax purposes, the IRS Form 1095-A is a vital document that signifies coverage details for individuals who have purchased health insurance through the Marketplace. This form is essential for accurately reporting health insurance information on tax returns. However, to fully comply with the tax reporting requirements, individuals often need additional forms and documents alongside the IRS Form 1095-A. These serve various purposes, from adjusting income to reporting specific health coverage scenarios.
Together, these forms and documents provide a comprehensive framework for managing and reporting health insurance information on tax returns. They ensure taxpayers can accurately report their health insurance coverage, calculate potential credits or exemptions, and comply with the Affordable Care Act requirements. Each plays a unique role in the broader context of health-related tax reporting, and understanding how they interlink is crucial for accurate and compliant tax return preparation.
IRS Form 1040: IRS Form 1040 is the U.S. individual income tax return form. It’s similar to the 1095-A in that it’s a pivotal document used by individuals to report their annual income to the Internal Revenue Service (IRS). While Form 1095-A focuses on health insurance information, Form 1040 encompasses the broad spectrum of income, deductions, and credits to calculate the taxpayer's total tax liability or refund.
IRS Form 1095-B: This form is issued by health insurance providers to individuals confirming that they, along with any dependents, had some form of health coverage during the tax year. It's similar to the 1095-A as they both deal with reporting health coverage status to the IRS but differ in the source of the insurance; 1095-B is for private, government, or employer-sponsored plans outside of the Marketplace.
IRS Form 1095-C: Provided by employers, this form reports to employees the health insurance coverage offered to them under the employer's plan. Like the 1095-A, it is integral for tax reporting purposes, particularly under the Affordable Care Act (ACA) compliance. However, 1095-C focuses on employer-provided health coverage specifics.
IRS Form 8962: This form is used to calculate and report the premium tax credit (PTC). It directly relates to the information on Form 1095-A, as taxpayers use details from the 1095-A to fill out Form 8962. This form is crucial for those who purchased health insurance through the Marketplace and want to reconcile or claim the credit.
W-2 Form: The Form W-2, Wage and Tax Statement, is issued by employers to report an employee’s annual wages and the amount of taxes withheld from their paycheck. Although it’s primarily for wage and tax reporting, like the 1095-A, the W-2 Form is essential for individuals to file their taxes accurately and verify their income to the IRS.
IRS Form W-9: Used to request the taxpayer identification number (TIN) of a U.S. person, including providing the correct name to an entity (or individual) that is required to file an information return with the IRS. It’s linked to the concept of 1095-A in terms of providing necessary taxpayer identification information for filing purposes, even though it serves different reporting requirements.
IRS Form 1099-MISC: This document is used to report various types of income other than wages, salaries, and tips. It’s akin to the 1095-A as it involves reporting financial information crucial for tax filing. However, while the 1095-A deals with health insurance information, the 1099-MISC encompasses miscellaneous income payments.
Filling out the IRS 1095-A form is an important task that provides essential information about your health insurance. To ensure accuracy and avoid common pitfalls, here is a list of do's and don'ts you should follow:
The IRS 1095-A form, often surrounded by myths and misconceptions, plays a crucial role in the tax filing process for individuals who have obtained health insurance through the Marketplace. Here are 10 common misconceptions about the 1095-A form, explained to shed light on its actual purpose and requirements.
It's the same as forms 1095-B and 1095-C. While all related to health coverage, they serve different purposes. Form 1095-A is issued by the Marketplace, not employers, unlike forms 1095-B and 1095-C, which are sent by insurers and large employers.
You don’t need it to file taxes. If you had Marketplace insurance, you need Form 1095-A to file your taxes accurately. It helps calculate the Premium Tax Credit or reconcile any credit received in advance.
It will come automatically to everyone. Only those who purchased health insurance through the Marketplace will receive this form. If you didn't get it but should have, contact the Marketplace.
Errors on the form are the taxpayer's responsibility. If there are errors, you should contact the Marketplace to issue a corrected form. You should not attempt to correct it yourself or ignore the discrepancies.
You can’t file your taxes without Form 1095-A. Technically, you should wait for the form to ensure accuracy, but if you know your coverage and premium details, you can file. However, amending your return might be necessary if the information used differs from what's on the form once received.
Only the primary insured needs the information. All individuals listed on the form, including dependents, may need information from 1095-A, particularly if they are filing taxes separately.
If you didn’t get a subsidy, the form is unnecessary. Even without a subsidy, the form provides essential information for your tax records and verifies your compliance with health coverage requirements.
The information on the form doesn’t impact your tax return. The data helps determine whether you owe back part of your subsidy or are eligible for a larger tax credit, directly affecting your tax liability or refund.
You only need the form once. You must use the information from a new Form 1095-A each tax year you've had Marketplace insurance, as your premiums and the advance payments of the premium tax credit may change.
Form 1095-A contains no critical information. This document includes crucial information such as the monthly premium paid, monthly premium of the second lowest cost Silver plan, and portions of the premium covered by any subsidy. This affects tax credits and overall tax filings.
Understanding the facts about Form 1095-A can make a significant difference in accurately filing your taxes and avoiding unnecessary complications. Always verify your form's information for accuracy and consult with a tax professional if you have questions about your specific situation.
Understanding and accurately filling out the IRS 1095-A form is vital for individuals who have received health insurance through a government marketplace. This document plays a pivotal role in managing health insurance information for tax purposes. Here are key takeaways to ensure the process is handled efficiently:
Ensure you're eligible to receive Form 1095-A, which is typically distributed to those who have enrolled in health insurance via the Health Insurance Marketplace. This form is crucial for reporting specific health insurance details on your tax return.
Verify the accuracy of all information on Form 1095-A, including personal details and the coverage months. Inaccuracies can lead to issues with tax filings and potential discrepancies in premium tax credits.
Understand the three main sections of the form: Part I contains essential information about the policyholder and the insurance policy. Part II outlines the monthly premium amounts for the second-lowest cost Silver plan (SLCSP), which is used to calculate tax credits. Part III details the actual premiums paid and the amount of advance payment of the premium tax credit.
Use the information from Form 1095-A to complete Form 8962, Premium Tax Credit (PTC). This step is necessary to reconcile any advance payments of the premium tax credit or to claim the premium tax credit on the tax return.
Report any changes in circumstances to the Health Insurance Marketplace throughout the year, as these changes may affect the amount of your premium tax credit. This includes changes in income, employment, family size, or residence.
If you receive a corrected Form 1095-A, ensure to amend your tax return if you've already filed it, as this could affect your premium tax credit calculation.
Keep Form 1095-A for your records, even after you've completed your tax return. It serves as proof of insurance coverage and may be needed for future reference.
For individuals who did not receive Form 1095-A but believe they should have, contact the Health Insurance Marketplace. Timing can be critical, especially during tax season, so prompt action is advised.
By thoroughly understanding these key elements of Form 1095-A, individuals can navigate the complexities of reporting health insurance information on their tax returns more confidently and accurately. It's not just about filling out a form—it's about securing the correct amount of health coverage benefits and tax credits.
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