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The IRS 1095-A form plays a crucial role in the Affordable Care Act's reporting requirements, serving as a key document for individuals who enrolled in health insurance plans through the Health Insurance Marketplace. Issued by the marketplace, this form provides essential information, including details about the coverage received, the individuals covered under the plan, and the premiums paid. It also outlines whether the coverage met the minimum essential criteria stipulated by federal regulations. Taxpayers utilize the information provided in the 1095-A to complete IRS Form 8962, a necessary step for claiming the Premium Tax Credit. This credit significantly reduces the cost of health insurance for eligible individuals and families. Accurate reporting via the 1095-A is imperative, as discrepancies can lead to complications during the tax filing process. Understanding the various components of this form is integral for effectively navigating the intersection of health insurance and tax obligations.

Form Sample

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

2020

Part I Recipient Information

1Marketplace identifier

2Marketplace-assigned policy number

3Policy issuer’s name

4Recipient’s name

5Recipient’s SSN

6Recipient’s date of birth

7Recipient’s spouse’s name

8Recipient’s spouse’s SSN

9Recipient’s spouse’s date of birth

10Policy start date

11Policy termination date

12Street address (including apartment no.)

13City or town

14State or province

15Country and ZIP or foreign postal code

Part II Covered Individuals

A. Covered individual name

B. Covered individual SSN

C. Covered individual

date of birth

D. Coverage start date

E. Coverage termination date

16

17

18

19

20

Part III Coverage Information

 

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 (2020)

Form 1095-A (2020)

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. For your protection, this form may show only the last four digits. However, the Marketplace has reported your complete social security number to the IRS.

Line 6. A date of birth will be entered if there is no social security number 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, social security number, 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 one 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 one 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 still must 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.

Document Specifications

Fact Name Description
Purpose The IRS 1095-A form is used to report information about health insurance coverage obtained through the Health Insurance Marketplace.
Who Receives It Individuals who enrolled in a health plan through the Marketplace will receive the 1095-A form. This includes families and individuals alike.
Filing Requirements Taxpayers must include the information from the 1095-A form when filing their federal tax returns if they received premium tax credits or had Marketplace insurance.
State-Specific Laws Some states require filings that may correlate with the federal 1095-A. For instance, California's law requires similar reporting for state insurance under Assembly Bill 1455.
Correction Process If there are mistakes on the 1095-A, individuals should contact the Marketplace to request a corrected form, as accurate information is crucial for tax reporting.

Steps to Filling Out IRS 1095-A

Once you have received your IRS Form 1095-A, it’s important to fill it out carefully. This form is essential for accurately completing your tax filing. Follow these steps to ensure everything is filled out correctly.

  1. Gather all necessary information, including your Health Insurance Marketplace information, your household details, and any relevant income documents.
  2. Locate the "Part I" section of the form. Here, you will enter details about the individual in the tax household.
  3. In "Part II," provide information regarding the coverage. Fill in the box showing the start and end dates of your coverage.
  4. Move to "Part III" and document the monthly premium amounts for the coverage you received.
  5. Ensure you accurately report any advance premium tax credits you received, if applicable, in the corresponding section.
  6. Double-check all information entered for accuracy, including names, amounts, and dates.
  7. Sign and date the form if submission is required. You may also need to include it with your tax return.

Now that your form is completed, you can proceed with filing your taxes. Make sure to keep a copy for your records, as you'll need this information when completing your return.

More About IRS 1095-A

What is the IRS 1095-A form?

The IRS 1095-A form is an important document used to report information about health care coverage through the Health Insurance Marketplace. If you received health insurance through this marketplace, you should receive a 1095-A from your provider. This form includes details about the coverage periods, the premiums paid, and any financial assistance you may have received, such as a premium tax credit. It is necessary for filling out your federal tax return accurately.

Who receives a 1095-A form?

Individuals and families who purchased health insurance through the Health Insurance Marketplace will receive a 1095-A. If you enrolled in a Marketplace plan any time during the tax year, an issuer should send you this form. Even if you didn't receive financial assistance, you still need the 1095-A to report your coverage status when filing your taxes.

How do I use the information on the 1095-A form for my taxes?

The information on your 1095-A is critical for accurately completing your tax return, especially when it comes to the Premium Tax Credit. You'll use the details on this form to complete IRS Form 8962, which helps determine if you're eligible for a premium tax credit or if you need to repay any excess credit. It's important to ensure that the information, like the amount of premium tax credit received, is correctly reported to avoid complications with your tax filings.

What should I do if I didn’t receive a 1095-A form?

If you believe you should have received a 1095-A but haven't, don’t panic. Start by checking with the health insurance provider or Marketplace through which you obtained your coverage. They can verify your enrollment and send you a replacement form if necessary. Keep in mind that the 1095-A is essential for accurately reporting your health coverage to the IRS, so it's vital to resolve this issue before filing your taxes.

Common mistakes

  1. Not including the correct Social Security number. Each person listed on the form should have their own accurate Social Security number. Missing or incorrect numbers can lead to delays and confusion.

  2. Failing to report all members in the household. It’s important to include everyone covered by the health plan, not just the policyholder. This ensures that the information is complete.

  3. Entering incorrect coverage amounts. People sometimes forget to check the monthly premium amounts, especially if these changed throughout the year. Accurate figures are necessary for the IRS to process the return properly.

  4. Not retaining a copy of the form. After filling out the 1095-A, it’s crucial to save a copy for personal records. This can serve as a reference for future tax filings and avoid issues if questions arise.

Documents used along the form

The IRS 1095-A form, often referred to as the Health Insurance Marketplace Statement, plays a crucial role in reporting an individual’s health insurance coverage obtained through the Marketplace. This form helps taxpayers understand their insurance status and is vital for accurately completing tax returns. Several other forms and documents are commonly used alongside the 1095-A, enhancing understanding and aiding in the overall health coverage reporting process.

  • IRS Form 1040: This is the standard individual income tax return form that taxpayers use to report their annual income. It plays a significant role in the overall tax filing process, as it incorporates data from various other forms, including the 1095-A.
  • IRS Form 8962: Known as the Premium Tax Credit form, this document is necessary for taxpayers who wish to claim the premium tax credit. It helps determine the amount of tax credit for which an individual qualifies based on their income and coverage details from the 1095-A.
  • IRS Form 1095-B: This form provides information on minimum essential health coverage. Issued by insurers or employers, it informs taxpayers about their health insurance status for the tax year, ensuring that they meet the requirements of the Affordable Care Act.
  • IRS Form 1095-C: Employers with 50 or more full-time employees must provide this form, which details the health coverage offered to employees. It is crucial for those covered by employer-sponsored insurance to understand their eligibility for various tax credits and implications.
  • Form 1099: This form is used to report various types of income other than wages, salaries, and tips. Depending on your situation, you may receive a 1099 for investment income or other earnings that need to be reported on your tax return alongside your health coverage documents.

Understanding these accompanying documents will help taxpayers navigate the complexities of health coverage reporting. Each form serves its purpose, collectively providing the needed clarity for responsible tax filing and compliance. Keeping accurate records of these documents is vital, ensuring a smoother tax experience and avoiding future complications.

Similar forms

The IRS 1095-B form is similar to the 1095-A in that both provide information about health coverage. The 1095-B is used primarily by health insurance providers to report who is covered by minimum essential health coverage. It serves as proof that you had health coverage during the tax year, which is necessary for compliance with the Affordable Care Act. While the 1095-A reports information about coverage obtained through a Health Insurance Marketplace, the 1095-B focuses on coverage obtained through employers or government programs.

The IRS 1095-C form also closely resembles the 1095-A. Employers with 50 or more full-time equivalent employees use the 1095-C to report the health insurance coverage they offer to their employees. This form details who was offered coverage, what type of coverage it was, and whether the employee enrolled. Just like the 1095-A, the 1095-C provides important information for determining whether an individual meets the health coverage requirement.

The IRS W-2 form has some similarities with the 1095-A in that it provides crucial information for filling out your tax return. The W-2 reports an employee's annual wages and the amount of taxes withheld. While it does not specifically deal with health insurance coverage like the 1095-A, the W-2 can affect your overall tax liability and eligibility for certain credits and deductions related to health care costs.

The 1099-HC form is relevant for Massachusetts residents and serves a purpose similar to that of the 1095-A. Insurance companies provide the 1099-HC to report the health insurance coverage status of individuals. Specifically, it offers a certification that helps residents meet the state's health insurance requirements, similar to how the 1095-A helps demonstrate compliance with federal regulations.

The Schedule H form is another document that shares similarities with the 1095-A, particularly in reporting information related to healthcare coverage. It is used by non-profit organizations to report information on their health initiatives or benefits provided to employees. While its scope is broader and encompasses various aspects of organizational health benefits, like the 1095-A, it plays a role in reporting compliance with health care mandates.

The IRS Form 8962 also parallels the 1095-A, particularly when it comes to reconciling premium tax credits. This form is used to calculate the premium tax credit that can help lower the cost of premiums for those who purchased coverage through the Marketplace. When filling out the Form 8962, you will rely on information from the 1095-A to complete it accurately and determine your eligibility for savings.

The Form 8862 relates to the earned income tax credit and while it is not a direct counterpart to the 1095-A, it is similar in that they both involve eligibility determinations based on provided information. The 8862 is filed by individuals who have previously been denied the credit and are seeking to prove their eligibility again. Just as the 1095-A provides essential data for health coverage compliance, the 8862 supports an individual's claims for credits based on their specific circumstances.

The IRS Form 4506-T, while seemingly different, can serve as a tool for accessing documents required for confirming insurance coverage, including the 1095-A. This form allows taxpayers to request a transcript of their tax returns, which may include pertinent health care information when needed. By using the 4506-T, individuals can obtain previously filed tax information that may include the details necessary to clarify their health coverage and any associated credits.

Dos and Don'ts

When filling out the IRS 1095-A form, accuracy is crucial. Here’s a helpful list of things to do and avoid:

  • Do verify your personal information is correct. Ensure your name, address, and Social Security number are accurate.
  • Don't leave any sections blank. Fill out all required fields to prevent delays.
  • Do double-check the coverage start and end dates. Mistakes can lead to complications in your tax return.
  • Don't forget to include all members covered under the plan. Everyone enrolled should be listed.
  • Do use the correct premium amounts. Reference your insurance documents to ensure accuracy.
  • Don't ignore any instructions provided by the IRS or your health insurance provider. They are there to help you.
  • Do keep a copy of the completed form for your records. You may need it for future reference or audits.

Misconceptions

Here are some common misconceptions about the IRS 1095-A form that can lead to confusion:

  1. The 1095-A form is only for those with health insurance through their employer. This is not true. The 1095-A form is specifically for those enrolled in a health plan through the Health Insurance Marketplace.
  2. You do not need the 1095-A form if you did not receive premium tax credits. Even if you did not use premium tax credits, you still need the form to report your health coverage status on your tax return.
  3. The 1095-A form is the same as the 1095-B and 1095-C forms. These forms serve different purposes. The 1095-B is for health coverage provided by other sources, while the 1095-C is for employer-provided coverage.
  4. You can ignore the 1095-A if you have other proof of health insurance. It is essential to file the 1095-A with your tax return because it specifically details your Marketplace insurance and any applicable tax credits.
  5. You will automatically receive a 1095-A form each year. While most people do receive it from the Marketplace, it’s important to confirm that your health plan sent it, as there may be issues or updates that affect your coverage.
  6. The information on the 1095-A is always correct. Mistakes can happen. If you find discrepancies, contact the Marketplace immediately to correct the information before filing your taxes.
  7. You can complete your tax return without the 1095-A. If you are filing your return and don't have the form, it may delay your return. It's necessary to include it for an accurate filing.

Understanding these misconceptions can help you navigate the tax filing process more smoothly. Remember to review your documents carefully and reach out for guidance if you're unsure.

Key takeaways

The IRS 1095-A form is an important document for those who enrolled in a health plan through the Health Insurance Marketplace. Here are some key takeaways to consider:

  • Purpose: The form provides information about your health insurance coverage, including months covered, premiums, and any premium tax credits received.
  • Required for Filing: You'll need the 1095-A when you file your federal tax return. It helps you report your health coverage and reconcile any premium tax credits.
  • Accuracy Matters: Double-check all entries for accuracy. Mistakes can lead to delays in your tax refund or affect the amount you owe.
  • Where to Get It: Your insurance provider or the Health Insurance Marketplace will send you the form. Make sure to keep an eye out for it, typically delivered by early February.
  • Multiple Forms: If you had multiple coverage sources during the year, you might receive more than one 1095-A. Each one will need to be reported correctly on your return.
  • Seek Help if Needed: If you have questions about how to fill out the form or how it impacts your taxes, consider consulting a tax professional for guidance.