1095a Health Insurance

Health insurance is an essential aspect of life. The Affordable Care Act (ACA) mandates that every individual must have health insurance coverage to avoid penalties. One of the crucial documents that taxpayers need to understand is the 1095A health insurance form. This form is issued by the Marketplace to the enrollees who have qualified coverage. In this article, we will discuss everything you need to know about the 1095A health insurance form.

What is the 1095A Health Insurance Form?

The 1095A form is an information return used by the Marketplace to report information about subsidized health insurance coverage to the IRS by individuals who purchased coverage through the Marketplace. It shows monthly health insurance coverage information, including the number of individuals covered, the total amount of advanced premium tax credits (APTC) received, and the amount of affordable care act/Obamacare premium tax credit (PTC) that was reconciled at the end of the year.

Individuals enrolled in marketplace insurance, also known as qualified health plans (QHPs), will receive Form 1095A from the Marketplace either by mail or electronically by January 31st of each year.

What Information is Included in the Form 1095A?

The 1095A form contains the following information:

Recipient Information

The recipient information includes the name, address, and social security number or taxpayer identification number (TIN) of the individual who was enrolled in a QHP through the Marketplace. This information is used to identify the taxpayer and the policy covered under the Marketplace.

Covered Individual Information

The covered individual information section lists the name, social security number, and the months of coverage for each individual who was covered under the policy. If the policy covered individuals who were not related to the taxpayer, their information would have to be included in this section.

Monthly Coverage Information

This section is perhaps the most critical section of the 1095A form since it provides the monthly premium amount, APTC, and PTC received for each month of coverage. The monthly premium reflects the total amount paid by the enrollee, including the APTC amount, for that month of coverage. The APTC amount represents the subsidy amount paid by the government to the insurance provider on behalf of the enrollee. The PTC amount is the amount of tax credit the enrollee is eligible for based on their income.

The monthly premium for the second lowest-cost silver plan in the area with similar coverage is also included in this section. This information is used to calculate the amount of the PTC the enrollee is eligible for.

Reconciliation Information

At the end of the year, the PTC and APTC received information is reconciled to determine if the enrollee received the correct amount of subsidy. This section provides the PTC amount, PTC repayment amount, APTC amount, and the APTC repayment amount. If the enrollee received more APTC than they were entitled to, they would have to repay the excess amount on their tax return. If they received less than they were entitled to, they would be eligible for a refundable tax credit.

FAQs about 1095A Health Insurance Form

1. Who receives the 1095A form?

The 1095A form is provided to taxpayers who enrolled in a QHP through the Marketplace and received financial assistance with their premium payments during the year. Anyone who purchased health insurance through the Marketplace is eligible to receive this form.

2. Do I need the 1095A form to file my taxes?

Yes. The information provided on the 1095A form is used to calculate the PTC and APTC received during the year. This information is needed to complete Form 8962, Premium Tax Credit, which is used to calculate the individual’s final tax liability or refund. Without the 1095A, you would not be able to complete Form 8962 accurately, which could result in errors on your tax return.

3. What happens if I don’t receive my 1095A form?

If you don’t receive your 1095A form, you will need to contact the Marketplace. You can also log in to your healthcare.gov account to download a copy of your 1095A form.

4. What is the deadline for receiving the 1095A form?

The Marketplace must provide the 1095A form to enrollees by January 31st of each year.

5. What should I do if there are errors on my 1095A form?

If there are errors on your 1095A form, you will need to contact the Marketplace immediately to have them corrected. Incorrect information on your 1095A could result in errors on your tax return, which could lead to penalties or an incorrect refund.

Conclusion

The 1095A health insurance form is an essential document that helps individuals calculate their eligibility for subsidies and reconcile the PTC and APTC they received during the year. It provides valuable information that is needed to complete Form 8962, which is used to calculate the final tax liability or refund. Whether you receive your 1095A form by mail or electronically, it is essential to review the information carefully and contact the Marketplace if there are any errors.