Health Insurance Tax Forms

As if tax time isn’t stressful enough, there’s a new form regarding health insurance being introduced this year. Your tax preparer may have mentioned the 1095 form. It comes in a few different formats, depending on what type of coverage you had last year. Since the Affordable Care Act requires all Americans to have minimum essential health coverage (in order to avoid the tax penalty, which also increased this year), the 1095 form is your proof of insurance. Further, there are three different versions of the 1095 form… so how do you know which one to look for and what to do once you receive it?

Form 1095-A: this one is for you if you obtained health insurance from the Marketplace/Government Exchange with or without a subsidy. Whether you got a policy from an agent or directly from healthcare.gov, the Marketplace will be mailing this out sometime in February. It will help you complete Form 8962, which is for your Premium Tax Credit (subsidy). This will allow you to reconcile and figure out if you used the correct amount of tax credit and received the right subsidy. If your income was lower than what you estimated, you may receive a larger tax refund. If it was more, you may owe back a portion of the subsidy that was granted.

Form 1095-B: this one is for you if you had individual health coverage, not through the Marketplace and not from a large employer provided group plan. This is sent out by the specific insurance company, such as Florida Blue.

Form 1095-C: this one is for you if you received health coverage from a group plan and your employer is considered an Applicable Large Employer (50+ full-time employees). This form is provided by the employer with a deadline at the end of March. Some other employees, even if not enrolled in the group health plan, may receive this form to show that it was offered but not chosen.

Additional facts about these forms:

  • None of them need to be submitted with your taxes. They contain helpful information when filing taxes and answering questions about the health insurance requirements, but you can keep the actual form for your records.
  • Some circumstances may qualify you to be exempt from the health insurance requirement as well as the tax penalty. If so, the IRS will provide you with an exempt code to use on your taxes.
  • For 2015, the tax penalty is 2% of your household income or $325 per adult and $162.50 per child, to a maximum of $975. For 2016, the penalty will increase again to 2.5% of your income or $695 per adult and $347.50 per child, to a maximum of $2,085.

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