Jeffrey Wade
There are several tax forms related to medical insurance, including Form 1095-A, Form 1095-B, and Form 8962. Form 1095-A, Health Insurance Marketplace Statement, is used to reconcile Advance Premium Tax Credits (APTC) and to claim Premium Tax Credits (PTC) on federal tax returns. Individuals who had a Marketplace plan or qualified health plan in 2024 should receive Form 1095-A by mail no later than mid-February. Form 1095-B is provided by health insurance companies and certain employers to individuals they cover, containing information about who was covered and when. Form 8962, Premium Tax Credit, is used to determine if the correct amount of premium tax credit was used during the year and to reconcile APTC with the allowable premium tax credit. These forms help taxpayers reconcile their health insurance coverage and credits with their tax filings.
| Characteristics | Values |
|---|---|
| Form name | 1095-A, Health Insurance Marketplace Statement |
| Who issues the form? | Health Insurance Marketplace or health insurance companies |
| Who receives the form? | Individuals enrolled in a qualified health plan through the Health Insurance Marketplace |
| Purpose of the form | To reconcile Advance Premium Tax Credits (APTC) and to claim Premium Tax Credits (PTC) on federal tax returns |
| Additional forms | Form 8962, Premium Tax Credit (PTC) |
| Form availability | By mail no later than mid-February or in your Marketplace account from mid-January to February 1 |
| Instructions | Read the cover letter sent with the form carefully. Make sure the information about coverage and household is correct |
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What You'll Learn
Form 1095-A: Health Insurance Marketplace Statement
Form 1095-A, also known as the Health Insurance Marketplace Statement, is a form used to report certain information about individuals who enrol in a qualified health plan through the Health Insurance Marketplace. This form is used to reconcile Advance Premium Tax Credits (APTC) and claim Premium Tax Credits (PTC) on federal tax returns.
If anyone in your household had a Marketplace plan in 2024, you should receive Form 1095-A by mail no later than mid-February. It may also be available in your Marketplace account from mid-January to February 1. It is important to ensure that you have received your Form 1095-A before filing your taxes, as it contains important information about the Marketplace plans used by members of your household.
The form includes details about the months you had a Marketplace plan, and it is essential to verify that this information is accurate. If any corrections are required, you should contact the Marketplace Call Center. You may also need to file an amended return using the information on your corrected 1095-A form.
Form 1095-A also provides information about the "second lowest cost Silver Plan" (SLCSP), which is used to fill out Form 8962, Premium Tax Credit. Form 8962 allows you to determine if you used the correct amount of premium tax credit during the year and make any necessary adjustments on your tax return.
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Form 1095-B: Information on health coverage
Form 1095-B is a tax form used to report certain information to the Internal Revenue Service (IRS) and to taxpayers about individuals who are covered by minimum essential coverage. This form verifies that the individual and their dependents meet the minimum health insurance requirements of the Affordable Care Act.
Form 1095-B has four parts: Part I identifies the person whose name is on the insurance policy. For an employer-sponsored plan, this would be the name of the employee. Part II identifies the employer, if the coverage is provided by the employer. Part III identifies the insurance company providing the coverage. Part IV lists the people in the insured person's household who are covered by the insurance. For each name, there is a box that will be checked if the person had insurance coverage for all 12 months of the year. If a person did not have coverage for the full year, there are separate boxes for each month, and the applicable months will be checked.
Having a Form 1095-B serves as proof of the type of coverage required by the Affordable Care Act. This form has been required to be sent out by insurance providers and employers with fewer than 50 full-time employees to individuals with health insurance coverage since the 2015 tax year.
It is important to note that some individuals with employer-sponsored insurance may receive a similar form, Form 1095-C, instead of or in addition to Form 1095-B. This form is generated by large employers with 50 or more full-time employees and contains similar information about the individual's health coverage.
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Form 8962: Premium Tax Credit
Form 8962, Premium Tax Credit, is used to determine whether you used the correct amount of premium tax credit during the year. This form is used to compare the amount of advance premium tax credit you used with the amount you qualify for based on your final income. If you used too much, you will need to repay the excess through taxes. On the other hand, if you used too little, you can claim the difference as a credit.
Form 8962 must be filed with your federal income tax return if you had Marketplace coverage and used the premium tax credit to lower your monthly plan premiums. This form includes details about the Marketplace insurance you and your household members had. You will need to have received Form 1095-A before filing Form 8962. Form 1095-A is the Health Insurance Marketplace Statement, which is mailed to individuals with a Marketplace plan. This form includes information about the months you had a Marketplace plan and the second lowest cost Silver Plan premium.
You can use the HealthCare.gov tax tool to get the premium for your second lowest cost Silver plan. Once you have an accurate Form 1095-A and second lowest cost Silver plan premium, you can fill out Form 8962. If you are missing a Form 1095-A or if any information is incorrect, you should contact the Marketplace Call Center.
If you did not use the premium tax credit and do not qualify for it, you do not need to include Form 8962 when filing your taxes.
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Form 1095-C: Information on employer-provided coverage
Form 1095-C, titled Employer-Provided Health Insurance Offer and Coverage, is a statement of health coverage offered to eligible employees by Applicable Large Employers (ALEs). ALEs are defined as companies or organizations with at least 50 full-time workers or full-time equivalents. A full-time worker is legally defined as someone who works at least 30 hours per week. A full-time equivalent is when two or more part-time employees' hours add up to a full-time workload. For example, two employees working 15 hours a week each would constitute one full-time equivalent.
Form 1095-C identifies the employee and employer, the months the employee was eligible for coverage, and the cost of the cheapest monthly premium under the plan. Applicable Large Employers have been required to file and furnish Form 1095-C to their full-time employees since the 2015 tax year. This form must be provided to employees who worked full-time for one or more months of the calendar year, and ALEs must report this information for all twelve months of the calendar year for each employee.
When sending Form 1095-C to the IRS, businesses should accompany it with Form 1094-C, titled "Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Return". Form 1094-C provides an IRS summary of the 1095-C forms, helping the IRS determine whether the business owes payment and if employees are eligible for the premium tax credit.
While Form 1095-C may assist in preparing a tax return, it is not required. Individual taxpayers should not wait to receive this form and should file their returns as normal. Form 1095-C should not be attached to your tax return. The Marketplace, health coverage providers, and applicable large employers will mail or hand-deliver these forms, or provide them electronically if consent has been given.
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Advance Premium Tax Credits (APTC)
The APTC is based on the estimated income reported for the calendar year and the composition of the tax household. At the end of the year, when filing federal taxes, the IRS will compare the APTC received with the reported income. If an individual received too much APTC, they may need to repay a portion during tax season. Conversely, if they received less APTC than they were eligible for, they can claim the remaining amount as a tax credit.
To reconcile Advance Premium Tax Credits, individuals use Form 1095-A, the Health Insurance Marketplace Statement. This form provides information about the months during which an individual had a Marketplace plan. It is essential to ensure that the information on Form 1095-A is accurate, including coverage details and household composition. Any discrepancies should be addressed by contacting the Marketplace Call Center.
In addition to Form 1095-A, Form 8962 is used to reconcile premium tax credits. This form allows individuals to compare the advance amount they received with the amount they qualify for based on their final income. By completing Form 8962, individuals can determine if they need to repay excess APTC or claim any remaining credit.
It is important to note that state-specific processes may vary. For instance, in Maryland, individuals can choose to apply their tax credit directly to lower their monthly insurance premium or receive it as part of their annual tax return. Similarly, Vermont residents must promptly report any changes in income or household status to Vermont Health Connect to ensure they receive the correct amount of APTC during the year.
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Frequently asked questions
Form 1095-A is a Health Insurance Marketplace Statement that provides information about your health care coverage. It includes details such as the effective date, amount of the premium, and APTC paid for the year of coverage.
If anyone in your household had a Marketplace plan in 2024, you should receive Form 1095-A by mail no later than mid-February. It may also be available in your Marketplace account from mid-January to February 1.
If your Form 1095-A is missing or contains incorrect information, you should contact the Marketplace Call Center. You may need to file an amended return using the information on your corrected 1095-A.
Form 1095-B provides important tax information about your health coverage. It is available for consumers enrolled in Medicaid, Child Health Plus, or the Essential Plan (EP).
