The IRS 1095-A form, also known as the Health Insurance Marketplace Statement, is a critical document for individuals who have obtained health insurance through the Marketplace. This form contains vital information needed for preparing tax returns, particularly regarding premium tax credits. Individuals use it to ensure they meet health coverage requirements and to reconcile any credits received during the fiscal year.
The IRS 1095-A form is a crucial document for individuals who have obtained health insurance coverage through the Health Insurance Marketplace. This form serves as a statement of the insurance that an individual or a family has purchased over a given tax year, and it plays a pivotal role during the tax filing process. The 1095-A form not only provides detailed information about the policy, such as the monthly premiums paid but also includes information on any subsidies or advanced premium tax credits that policyholders may have received to help make their health insurance more affordable. Taxpayers require this form to reconcile their premium tax credits or to claim them on their tax return if they did not receive them in advance. Understanding the 1095-A form is essential for accurately reporting healthcare coverage information and ensuring proper tax compliance, as well as for potentially securing a refund or paying any taxes owed.
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.
Filling out the IRS 1095-A form is a crucial step during tax season for people who have enrolled in a health plan through the Health Insurance Marketplace. This document helps in determining your eligibility for a premium tax credit or if you need to pay some back. The process can seem daunting at first, but by following these step-by-step instructions, you can complete the form accurately. Make sure you have all the necessary information handy, such as social security numbers and details about your health insurance plan, before you begin.
After submitting your Form 1095-A, the next steps include waiting for the IRS to process your tax return. This could affect your tax refund or the amount you owe, especially regarding the premium tax credit. If there are any discrepancies or additional information needed, the IRS will contact you directly. Staying organized and thorough in your submission can help expediate this process.
What is the IRS 1095-A form?
The IRS 1095-A form, also known as the Health Insurance Marketplace Statement, is a document sent to individuals who purchase health insurance through the Health Insurance Marketplace. This form provides information about their insurance coverage, including the premiums paid, premium tax credits received, and periods of coverage. It is crucial for filing an accurate tax return, particularly for those claiming the premium tax credit or reconciling advance payments of the premium tax credit.
Who receives a 1095-A form?
Individuals who enroll in a health insurance plan through the Health Insurance Marketplace will receive a 1095-A form. This includes those who use the federal marketplace (HealthCare.gov) or a state marketplace. This form is issued by the Marketplace, not the insurance companies or the Internal Revenue Service (IRS).
When should I expect to receive my 1095-A form?
The Health Insurance Marketplace is required to send out Form 1095-A by January 31st following the covered calendar year. If January 31st falls on a weekend, the deadline is extended to the next business day. If you have not received your form or if it is incorrect, you are advised to contact the Marketplace as soon as possible.
Why do I need the 1095-A form?
You need the 1095-A form to file your federal income tax return if you or someone in your family enrolled in a health plan through the Marketplace. It includes information necessary for completing your tax return, such as the amount of the premium tax credit you’re entitled to and any advance payments of the premium tax credit made to your insurance company on your behalf. This form helps to ensure that you get the correct amount of tax credits and that your tax obligations are accurately reported.
What information is included in Form 1095-A?
Form 1095-A includes the following information: the name, Social Security number, and address of the policyholder; information about the health insurance policy, like the start and end dates; monthly premiums paid; the amount of premium tax credit advanced to the insurance company on your behalf; and the cost of a silver plan in your area, which is used to calculate the premium tax credit.
What should I do if information on my 1095-A form is incorrect?
If you notice any errors on your 1095-A form, such as incorrect coverage dates, incorrect premium amounts, or incorrect information about household members, you should contact the Marketplace from which you purchased your insurance as soon as possible. They will issue a corrected Form 1095-A that you can use for your taxes. It's important to wait for the corrected version before filing your tax return to avoid the need for amendments later.
How do I use Form 1095-A to fill out my tax return?
Use the information from Form 1095-A to fill out IRS Form 8962, Premium Tax Credit (PTC). This form is used to calculate your premium tax credit amount and reconcile it with any advance payments of the premium tax credit. The difference will affect your tax liability or refund. Instructions for Form 8962 provide a detailed guide on how to use the information from your 1095-A to complete the form correctly.
Can I file my taxes without a 1095-A form?
If you were enrolled in Marketplace insurance but have not received your Form 1095-A, or if it is delayed, you should first contact the Marketplace to request a copy. Technically, it is possible to file your taxes without your 1095-A by using other documentation that reflects your insurance coverage, such as bank statements or online account summaries. However, filing without Form 1095-A or filing with incorrect information can lead to errors in calculating your premium tax credit, potentially requiring amendments to your tax return later. Therefore, it's highly recommended to wait for the correct 1095-A form to file your taxes accurately.
Filing taxes can be a complex process, especially when it comes to forms related to health insurance coverage. The IRS 1095-A form is an essential document for individuals who have purchased health insurance through the Marketplace. It is crucial for calculating the premium tax credit or reconciling the credit received during the tax year. However, taxpayers often stumble over several common mistakes when completing this form.
One of the frequent errors is not reporting the form at all. This usually happens when the form is misplaced or the taxpayer is unaware that they need to file it along with their tax return. The IRS uses the information on Form 1095-A to verify that you and your family members had health insurance coverage during the year.
Another mistake is entering incorrect information. Names, social security numbers, and the coverage dates need to be perfectly aligned with those on file with the Marketplace and the IRS. Mismatches in this data can lead to processing delays or incorrect calculation of tax credits.
Some taxpayers mistakenly neglect to use the Second Lowest Cost Silver Plan (SLCSP) premium to calculate their premium tax credit. The form's Part III column B provides this information, crucial for accurately determining the amount of credit you're eligible for or need to repay.
Ignoring the instructions for shared policies is another common error. If you share a policy with someone not in your tax household, you need to allocate policy amounts properly, which can get complicated. The form instructions provide detailed guidance on how to manage these situations but are often overlooked, leading to inaccuracies.
Also, individuals frequently fill out the form without updating their information with the Marketplace. Life changes such as marriage, divorce, or a move can affect your premium tax credit. If the Marketplace isn't aware of these changes, it could result in discrepancies on your 1095-A form.
Another oversight is not checking the form for errors. Mistakes can happen on the insurer's or the Marketplace's end. It's the taxpayer's responsibility to verify the accuracy of all information on their 1095-A form before filing. This includes checking the number of months covered and ensuring all household members who had coverage are listed.
Some filers incorrectly report premium amounts. Premiums should be reported as they were paid, not as they were billed. This error can significantly impact the computation of the premium tax credit.
Forgetting to amend your tax return if you receive a corrected 1095-A after you have already filed is another mistake. Corrections can lead to changes in your tax liability or refund, and the IRS expects taxpayers to amend their returns to reflect accurate information.
Failing to keep a copy of the 1095-A form for personal records is yet another oversight. Should any discrepancies arise later with the IRS, having documentation readily available will be invaluable.
Last but not least, a major mistake is procrastination. Waiting until the last minute to gather, complete, or submit your 1095-A form can lead to rushed decisions, overlooked errors, and potentially missing the tax filing deadline, resulting in penalties.
By avoiding these common pitfalls, taxpayers can ensure they accurately complete their 1095-A form, thereby averting unnecessary delays, audits, or penalties from the IRS. The aim is to streamline the tax filing process, ensuring peace of mind when it comes to health insurance coverage and tax credits.
The IRS 1095-A form is a crucial document for individuals in the United States who have obtained health insurance through the Marketplace under the health care law. It contains important information about the insurance policy, coverages, and any subsidies received, which are essential for accurately completing tax returns. To support or complement the information declared on the IRS 1095-A form, several other forms and documents are often utilized. Each of these plays a vital role in ensuring the completeness and accuracy of an individual's tax filings.
In conclusion, while the IRS 1095-A form is pivotal for individuals filing their taxes with health insurance obtained through the Marketplace, it does not stand alone. The forms listed above are commonly needed to provide a complete and accurate tax filing related to health coverage and financial information. Together, they ensure that individuals comply with tax laws and accurately report their financial situation, ultimately affecting their tax liabilities and entitlements to credits or refunds.
The IRS Form 1099-INT is akin to the 1095-A form in that both are used to report specific information to the Internal Revenue Service (IRS) that can affect an individual's tax liabilities and potential refunds. While the 1099-INT form is used to report interest income from savings accounts, certificates of deposit, and other interest-bearing accounts, the 1095-A form details health insurance marketplace coverage, which is essential for determining premium tax credits. Both documents must be included when filing a tax return, underscoring their importance in tax preparation processes.
Similarly, the IRS Form W-2 shares common ground with the 1095-A as they are both integral to the tax filing process, providing vital information that impacts one's income tax calculations. The W-2 form reports an employee's annual wages and the amount of taxes withheld from their paycheck, contrasting with the 1095-A's focus on health insurance coverage. However, both contribute essential data that ensures tax compliance and helps taxpayers claim any eligible benefits or credits.
The IRS Schedule K-1 is another document resembling the 1095-A form in its role within the taxation framework, albeit serving a distinct purpose. Utilized in reporting incomes, deductions, and credits of a partnership or S corporation, the Schedule K-1 affects the tax obligations of individuals in those business arrangements, similar to how the 1095-A informs on healthcare subsidies and premiums that can affect personal tax calculations. Both forms are pivotal for accurate income reporting and tax liability assessment.
Moreover, the IRS Form 1040-ES is related to the 1095-A through its involvement in the tax estimation and payment process for individuals who do not have taxes withheld at source. While the 1040-ES is used for calculating and paying estimated quarterly taxes, primarily for self-employed individuals, the 1095-A provides information necessary for reconciling health care premium tax credits, affecting overall tax due or refund amounts. Both forms play crucial roles in ensuring taxpayers meet their tax obligations throughout the year.
Finally, the IRS Form 8962, Premium Tax Credit (PTC), is directly related to the 1095-A, as it is used to calculate the premium tax credit amounts and reconcile any discrepancies between the advance credit payments received and the actual amount eligible for. The information provided by the 1095-A is essential for accurately completing the 8962 form, demonstrating their interconnected nature in managing and applying health care-related tax credits. Both documents are key to navigating the complexities of health insurance premiums and tax credits within the tax filing process.
Filling out the IRS 1095-A form, an essential document that provides details about health insurance marketplace coverage, is a critical annual task for many individuals. It's important to approach this task diligently to ensure accuracy and compliance with tax laws. Here are six do's and don'ts that can guide you through the process:
Understanding the IRS 1095-A form is crucial for accurately reporting health insurance information on your tax return. However, there are several misconceptions about the form that can lead to confusion. Here are nine common misunderstandings:
Clearing up these misconceptions ensures you understand the importance of the 1095-A form and how it affects your tax filing process. Always verify your personal information and consult with a tax professional if you have questions or concerns about your specific situation.
If you're navigating the world of health coverage through the Health Insurance Marketplace, the IRS 1095-A form is a key document you'll encounter. Understanding this form can make a big difference in managing your taxes effectively. Here are seven takeaways to help you confidently handle your 1095-A form.
Having a good grasp of your 1095-A form is crucial for a smooth experience during tax season, especially if you're benefiting from the premium tax credit. With this information in hand, you're now better prepared to navigate your health insurance benefits and tax obligations with greater ease.
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