This Post re-prints information from the IRS website published on January 11, 2016. Here is a Link to the Source Page:
We suggest you consult with a Tax Accountant to be sure that your 2015 health insurance premiums -- in particular any federal health insurance premium subsidies received -- are reported and reconciled as required on your 2015 tax return.
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Q&A:
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Q&A:
1. Will I receive any new health care tax forms in 2016 to help me
complete my tax return?
Starting early in
2016, you may receive one or more forms providing information about the health
care coverage that you had or were offered during the previous year. Much like
Form W-2 and Form 1099, which include information about the income you
received, these new health care forms provide information that you may need
when you file your individual income tax return. Also like Forms W-2 and 1099,
these new forms will be provided to the IRS by the entity that provides the
form to you.
The new forms are:
· Form 1095-A, Health Insurance Marketplace Statement. The
Health Insurance Marketplace (Marketplace) sends this form to individuals who
enrolled in coverage there, with information about the coverage, who was
covered, and when.
· Form 1095-B, Health Coverage. Health insurance providers (for
example, health insurance companies) send this form to individuals they cover,
with information about who was covered and when.
· Form 1095-C, Employer-Provided Health Insurance Offer and Coverage.
Certain employers send this form to certain employees, with information about
what coverage the employer offered. Employers that offer health coverage
referred to as “self-insured coverage” send this form to individuals they
cover, with information about who was covered and when.
2. When will I receive these health care tax forms?
The deadline for the
Marketplace to provide Form 1095-A is February 1, 2016. The deadline for
insurers, other coverage providers and certain employers to provide Forms
1095-B and 1095-C has been extended to March 31, 2016. Individual taxpayers
will generally not be affected by this extension and should file their returns
as they normally would.
3. Must I wait to file until I receive these forms?
If you are expecting
to receive a Form 1095-A, you should wait to file your 2015 income tax return
until you receive that form. However, it is not necessary to wait for
Forms 1095-B or 1095-C in order to file.
Some taxpayers may
not receive a Form 1095-B or Form 1095-C by the time they are ready to file
their 2015 tax return. While the information on these forms may assist in
preparing a return, they are not required. Individual taxpayers will generally
not be affected by this extension and should file their returns as they
normally would.
Like last year,
taxpayers can prepare and file their returns using other information about
their health insurance. You should not attach any of these forms to your tax
return.
4. What are the health care tax forms that I
might receive and how do I use them?
Health Care Form
|
Sent To
|
Sent By
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What to do with this form
|
Form
1095-A,
Health Insurance Marketplace Statement
|
Individuals who
enrolled in health coverage for themselves or their family members through
the Marketplace
|
Marketplace
|
This form provides information about your Marketplace
coverage.
Use Form 1095-A to complete Form
8962 and
reconcile advance payments of the premium
tax credit or
claim the premium tax credit on your tax return.
Use Form 1095-A for information on whether you and your
family members had coverage that satisfies the individual
shared responsibility provision.
· If Form 1095-A shows coverage for you and everyone in your
family for the entire year, check the full-year coverage box on your tax
return.
· If there are months when you or your family members did
not have coverage, determine if you qualify for an exemption or must make
an individual
shared responsibility payment.
Do not attach Form 1095-A to your tax return – keep it
with your tax records.
|
Form
1095-B,
Health Coverage
|
Individuals who had
health coverage for themselves or their family members that is not reported
on Form 1095-A or Form 1095-C.
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Health Coverage Providers –
· Insurance companies outside the Marketplace
· Government agencies such as Medicare or CHIP
· Employers who provide certain kinds of health coverage
(sometimes referred to as “self-insured coverage”) but are not required to
send Form 1095-C (see below).
· Other coverage providers
|
This form provides information about your health coverage.
Use Form 1095-B for information on whether you and your
family members had health coverage that satisfies the individual
shared responsibility provision.
· If Form 1095-B shows coverage for you and everyone in your
family for the entire year, check the full-year coverage box on your tax
return.
· If there are months when you or your family members did
not have coverage, determine if you qualify for an exemption or must make
an individual
shared responsibility payment.
Do not attach Form 1095-B to your tax return - keep it
with your tax records.
|
Form
1095-C,
Employer-Provided Health Insurance Offer and Coverage
|
Certain employees
of applicable large employers (See next column).
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Applicable
large employers– generally those
with 50 or more full-time employees, including full-time equivalent
employees
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Form 1095-C provides information about the health coverage
offered by your employer and, in some cases, about whether you enrolled in
this coverage.
· If you enrolled in a health plan in the Marketplace, you
may need the information in Part II of Form 1095-C to help determine your
eligibility for the premium tax credit.
· If you did not enroll in a health plan in the
Marketplace, the information in Part II of your Form 1095-C is not relevant
to you.
Use Form 1095-C for information on whether you or any
family members enrolled in certain kinds of coverage offered by your employer
(sometimes referred to as “self-insured coverage”).
· If Form 1095-C shows coverage for you and everyone in your
family for the entire year, check the full-year coverage box on your tax
return.
· If there are months when you or your family members did
not have coverage, determine if you qualify for an exemption or must make
an individual
shared responsibility payment.
Do not attach Form 1095-C to your tax return - keep it
with your tax records.
|
5. How will I receive these forms?
The Marketplace,
health coverage providers and applicable large employers will mail (or hand
deliver) these forms to you or provide them electronically to you, if you have
consented to electronic delivery.
6. My employer or health coverage provider has suggested that I
opt to receive these forms electronically rather than on paper. Are they
allowed to ask me that?
Yes. Employers and
health coverage providers may ask for your consent to receive the forms
electronically. This is entirely acceptable and may be more convenient for you.
Electronic forms provide the same information that is provided in the paper
forms.
7. Will I get at least one form?
Maybe. If you were
enrolled in health coverage for 2015, you should receive a Form 1095-A, 1095-B,
or 1095-C. In addition, if you were an employee of an employer that was
an applicable large employer in 2015, you may receive a Form 1095-C. If
you don’t fall in either of these categories, you won’t receive a form.
8. Will I get more than one form?
Maybe. You are
likely to get more than one form if you had coverage from more than one
coverage provider or if you worked for more than one employer that offered
coverage. You are also likely to get more than one form if you changed coverage
or employers during the year or if different members of your family received
coverage from different coverage providers.
The following
examples illustrate when you may get more than one Form 1095 and what to do
with the information on those forms.
Example 1: You are single with two dependent children. At the
beginning of 2015, you were unemployed, and you and your children were enrolled
in coverage through the Marketplace. You received the benefit of advance
payments of the premium tax credit to help pay for your coverage. In August of
2015, you started working 40 hours per week for an employer with 300 employees
(an applicable large employer) that offered health insurance coverage to you
and your children. However, that offer of coverage was considered unaffordable
to you for purposes of the premium tax credit, so you did not enroll in it and
instead continued your Marketplace coverage with advance payments of the
premium tax credit. Early in 2016, you receive Form 1095-A (from the
Marketplace) and Form 1095-C (from your employer).
When you complete
Form 8962, Premium Tax Credit, you will use the information on Form 1095-A to
reconcile advance payments of the premium tax credit and to verify that you had
health coverage for the entire year. You will use Form 1095-C to verify that
your employer coverage was unaffordable for you. You will not attach Form
1095-A or 1095-C to your return, but you should keep these forms with your tax
records.
Example 2: You are single with no dependents. At the beginning
of 2015, you were employed by employer A, which has 20 employees (and therefore
is not an applicable large employer). You had coverage through A’s
employer-sponsored plan, which is insurance that A purchases from health
insurance issuer Q (i.e., not a “self-insured plan”). In June of 2015,
you changed jobs and started working 40 hours per week for employer B, which
has 500 employees (and so is an applicable large employer). You immediately
began receiving coverage through that employer’s plan, which is insurance it
purchases from insurance issuer R. Early in 2016, both insurance companies will
send you a Form 1095-B providing information about the coverage in which you
were enrolled. You also will receive a Form 1095-C from employer B, the
applicable large employer, providing information about the health coverage B
offered you.
You will use the
information on Forms 1095-B to verify that you had health coverage for each
month during the year and will check the full-year coverage box on your tax
return. You will not need to use Form 1095-C to help complete your return
because the information about the offer of health coverage made by your
employer relates to whether you are eligible for the premium tax credit and you
cannot get a premium tax credit if you were not enrolled in a health plan in
the Marketplace. You will not attach Form 1095-B or Form 1095-C to your tax
return, but you should keep both forms with your tax records.
9. Will I get a Form 1095-C from each of my employers?
Not necessarily. You
will only receive a Form 1095-C from your employer if that employer is an
applicable large employer, meaning it had 50 or more full-time employees
(including full-time equivalent employees) in the year before the year to which
the form relates. Most employers have fewer than 50 employees and therefore are
not applicable large employers required to provide Form 1095-C to their
full-time employees.
Even if your employer
is an applicable large employer, you will only receive a Form 1095-C for that
employer if you were a full-time employee for that employer for at least one
month of the year or if you are enrolled in an applicable large employer’s
self-insured health plan, even if you are a part-time employee.
10. How are the forms similar?
· They all provide information about your health coverage during the
prior year.
· They are all used to determine if you, your spouse and your
dependents had health coverage for the entire year and if not, for which months
you did have coverage. (The Form 1095-C includes this information
only if your employer is an applicable large employer and the coverage you
enrolled in was a certain kind of coverage referred to as “self-insured
coverage”).
· None of these forms should be filed with your tax return; they
should be kept for your records with your other tax documents.
11. How are the forms different?
·
The forms are provided by different entities.
o
Form 1095-A, Health Insurance Marketplace Statement, is provided by the Marketplace to individuals who enrolled or who have enrolled a
family member in health coverage through the Marketplace.
o
Form 1095-B, Health Coverage, is provided by insurance companies
and other coverage providers. However, if your coverage was
insurance purchased through the Marketplace or was a type of coverage referred
to as “self-insured coverage” that was provided by an applicable large
employer, you will receive a different form.
o
Form 1095-C, Employer-Provided Health Insurance Offer and
Coverage, is issued by applicable large employers to their full-time employees
and, in some cases, to other employees.
· The forms are provided to different groups of people.
· Form 1095-A - Only individuals who enroll in coverage through the
Marketplace will get this form.
· Form 1095-B – Individuals who have health coverage outside of the
Marketplace will get this form (except for employees of applicable large
employers that provide self-insured coverage, who will receive Form 1095-C
instead).
· Form 1095-C - Individuals who work full-time for applicable large
employers will get this form. Also, part-time employees also will get
this form if they enroll in self-insured coverage provided by an applicable
large employer.
· The forms contain some different information. Form 1095-A,
Form 1095-B, and some Forms 1095-C show who in your family enrolled in health
coverage and for what months. Form 1095-A also provides premium information and
other information you will need to reconcile advance payments of premium tax
credit and claim the premium tax credit on Form 8962. And Form 1095-C
shows coverage that your employer offered to you even if you chose not to take
that coverage.
12. What do I need to do with these forms?
· You will use the information on these forms to verify that you,
your spouse and any dependents had coverage for each month during the year.
· Like last year, if you and your family members had minimum essential
coverage for every month of the year, you will check a box on your
return to report that coverage. If you or any family members did not have
coverage for the entire year, a coverage exemption may apply for the months
without coverage. If you or any family members did not have coverage or
an exemption, you may have to
make an individual shared
responsibility payment.
· If you or anyone in your family receives a Form 1095-A from the
Marketplace, you will use the information on the form to complete a Form 8962
to reconcile any advance payments of the premium tax credit or to claim the
premium tax credit.
· Do not file these forms with your tax return. Keep them in your records with your other important tax documents.
· Do not file these forms with your tax return. Keep them in your records with your other important tax documents.
13. What should I do if:
·
I have a question about the form I received,
·
I think I should have gotten a form but did not get it,
·
I need a replacement form, or
·
I believe the form I received has an error?
In any of these situations,
you should contact the provider of the form (or the entity that you think
should have provided you a form, if you think you should have gotten a form but
did not get it):
· For questions about the Form 1095-A, contact the Marketplace.
· For questions about the Form 1095-B, contact the coverage provider
(see line 18 of the Form 1095-B for a contact telephone number).
· For questions about the Form 1095-C, contact your employer (see
line 10 of Form 1095-C for a contact telephone number).
14. Can I file my tax return if I have not received any or all of
these forms?
If you enrolled in
coverage through the Marketplace you will need the information on Form 1095-A
to complete Form 8962 to reconcile any advance payments of the premium tax
credit or claim the premium tax credit, and to file a complete and accurate tax
return. If you need a copy of your Form 1095-A, you should go to HealthCare.gov
or your state Marketplace website and log into your Marketplace account, or
call your Marketplace call center. Although information from the Form 1095-C –
information about an offer of employer provided coverage - can assist you
in determining eligibility for the premium tax credit, it is not necessary to
have Form 1095-C to file your return. See Publication 974 for additional
information on claiming the premium tax credit.
You do not have to
wait for either Form 1095-B or 1095-C from your coverage provider or employer to
file your individual income tax return. You can use other forms of
documentation, in lieu of the Form 1095 information returns to prepare your tax
return. Other forms of documentation that would provide proof of your
insurance coverage include:
· insurance cards,
· explanation of benefits
· statements from your insurer,
· W-2 or payroll statements reflecting health insurance deductions,
· records of advance payments of the premium tax credit and
· other statements indicating that you, or a member of your family,
had health care coverage.
If you and your
entire family were covered for the entire year, you may check the full-year
coverage box on your return. If you or your family members did not
have coverage for one or more months of the calendar year, you may claim an
exemption or make an individual shared responsibility payment.
You will not need to
send the IRS proof of your health coverage. However, you should keep any
documentation with your other tax records. This includes records of your
family’s employer-provided coverage, premiums paid, and type of coverage.
15. Am I required to file a tax return if I receive one of these
forms?
If you receive a Form
1095-A, Health Insurance Marketplace Statement, showing that advance payments
of the premium tax credit were paid for coverage for you or your family member,
you generally must file an individual income tax return and submit a Form 8962
to reconcile those advance payments, even if you would not otherwise be
required to file a tax return. You also must file an individual income
tax return and submit a Form 8962 to claim the premium tax credit, even if no
advance payments of the premium tax credit were made for your coverage.
For more information, see the instructions to Form 8962,
However, you are not
required to file a tax return solely because you received a Form 1095-B or a
Form 1095-C. For example, if you are enrolled in Medicaid you will receive a
Form 1095-B. If you do not have a tax filing requirement, you do not have to
file a tax return solely because you received the Form 1095-B reflecting your
Medicaid coverage.
The health care law
tax filing requirements are the same as last year.
· If you enrolled in coverage through the Marketplace, you must file
a tax return and reconcile any advance payments of the premium tax credit that
were paid on your behalf.
· If you have a filing requirement and everyone in your family had
coverage for the entire year, you should check the full-year coverage box on
your tax return.
· If you or any family members did not have coverage for the entire
year, you should claim any applicable coverage exemption or make an individual
shared responsibility payment.
16. Should I attach Form 1095-A, 1095-B or 1095-C to my tax
return?
No. Although you may
use the information on the forms to help complete your tax return, these forms
should not be attached to your return or sent to the IRS. The issuers of the
forms are required to send the information to the IRS separately. You should
keep the forms for your records with your other important tax documents.
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Until next time,
Andrew Herman, President
AH Insurance Services, Inc.
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Until next time,
Andrew Herman, President
AH Insurance Services, Inc.
