Do I Need a 1095 Form for Health Insurance?

Individual and Family

Do I Need a 1095 Form for Health Insurance?

Published on April 06, 2018

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If anything’s inevitable in life, it’s taxes. Almost every financial activity has some effect on your taxable income, and getting health insurance is no exception. Depending on where you get your insurance, what it covers, and other factors, coverage may have a significant impact on your tax situation, making it essential for the government to keep track of it.

What is the 1095-A form?

The 1095-A form is a tax form designed specifically for people who buy health insurance on the individual marketplaces, whether it’s state, federal, or a private site like eHealth. This form originally made sure that people were complying with the individual insurance mandate, which required everyone to buy health insurance; if someone didn’t comply, it would let the government know to fine them. But while the individual mandate was repealed under the Tax Cuts and Jobs Act of 2017 for tax years 2019 and later, the 1095-A form remains essential for coordinating:

  • Tax credits– The Affordable Care Act provides subsidies to help people with low incomes pay for their health insurance, which are distributed in the form of tax credits. If you are buying your own insurance and qualify for such a credit, filling out the 1095-A form lets the government know to send you one.
  • Advance returns– If you make an advance payment of your tax credit for health insurance, it’s necessary to reconcile that with the credit itself. The 1095-A form gives you space for this.
  • Tax return accuracy– You need a record of your reconciled tax credit in order to file an accurate tax return. With the 1095-A form, you can assemble this record.

Below you can see what subsidies look like under current health-care policy.

The 1095-A tax form is one of three 1095 forms. The other two forms, 1095-B and 1095-C, are designed for different circumstances. 1095-B is typically distributed by health insurance companies and self-insured small businesses to everyone whom they cover. Meanwhile, 1095-C is distributed by businesses that have 50 full-time employees or more to every member of their insurance plan. Typically, if you buy your own health insurance, you’ll need to fill out the 1095-A form instead of one of these other 1095 forms.

How do I get a 1095-A form?

You may have your 1095-A form sent to you through the mail, but if not, make sure to check with your insurance provider about receiving it. Once you’ve downloaded the 1095-A form, you will see information such as:

  • Coverage information (Part III) – For every Marketplace policy that covers a member of your household, the form shows the amount you paid in premiums and the amount of tax credits you receive for every month of the year. The form should list which marketplace you got this policy from, the name of the provider, the number the marketplace assigned to this policy, and other such details.
  • SLCSP– There should be a section on the 1095-A form called the “second lowest cost Silver plan (SLCSP),” which describes the second least expensive coverage option in the Silver category that you qualify for. This doesn’t necessarily have to be the one you enrolled in.
  • Premium tax credit– If you used tax credits to pay for your health insurance, you must write down the total amount you used and then figure out how much you qualify for. Visit healthcare.gov for more guidance to get more information on this process.

Besides obtaining the 1095-A form online, you can also get it in the mail, typically by mid-February or earlier. However you choose to receive this form, make sure it is accurate.
This article is for general information and may not be updated after publication. Consult your own tax, accounting, or legal advisor instead of relying on this article as tax, accounting, or legal advice.
For more information on finding affordable health insurance and filling out all the applicable documentation, contact eHealth today.

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