It’s tax time, so you may be receiving calls from your individual clients asking how they can obtain their form 1095-A and what they should do with it once they receive it. We’ve prepared a short Q&A to help you answer their questions. This information is also available on the Healthcare.gov website: https://www.healthcare.gov/tax-form-1095/
In the same way that employers issue a Form W-2 to their employees and Form 1099 to contract workers, the Health Insurance Marketplace sends a Form 1095-A to anyone who has a Marketplace plan. People who had Marketplace coverage in 2022 should have received their 1095-A by mail no later than mid-February, but if a client did not receive one (or cannot locate their copy), the document is also available in their HealthCare.gov account.
If you've signed up for a Marketplace plan, you can find your 1095-A by logging into your HealthCare.gov account. Select your 2022 application and then "Tax Forms" from the menu on the left. You can download all 1095-As shown on the screen.
Get screen-by-screen directions, with pictures
If you’re unable to locate your Marketplace account, you can contact the Marketplace Call Center for assistance.
Form 1095-A contains important information about the Marketplace plans you or anyone in your household had in 2022, including premiums paid, premium tax credits received, and the cost of the "second lowest cost Silver plan" (SLCSP). You'll use this information to fill out Form 8962, Premium Tax Credit, which helps you reconcile the difference between the premium tax credit you used and the amount you qualify for. This is required for anyone who has Marketplace coverage.
When you receive your Form 1095-A, be sure to check it for accuracy. You’ll want to ensure that all the information about your coverage and household is correct. If anything is wrong, contact the Marketplace Call Center before using this form to prepare your taxes. If you're not sure whether the monthly enrollment premium is correct, read the instructions on the back of the form.
It is also important to make sure the SLCSP premium is correct. Look at Part III, column B of your 1095-A, titled “Monthly second lowest cost silver plan (SLCSP) premium." It should show figures for each month that any member of your household had the Marketplace plan. If Part III, Column B has a “0” or is blank for any month someone in your household had the Marketplace plan, or if your monthly income changed and you didn’t tell the Marketplace, you'll need to use the HealthCare.gov tax tool to determine the premium for the second-lowest-cost Silver plan.
As HealthCare.gov explains, “Once you have an accurate 1095-A and second lowest cost Silver plan premium, you’re ready to fill out Form 8962, Premium Tax Credit.” To assist, they provide a step-by-step guide to reconciling your premium tax credit. Here are the high points:
Because the government provides advance payments of the Premium Tax Credit (APTC) based on expected income for the year, it is important to reconcile the expected income with the actual income to determine if the APTC was accurate or if the amount needs to be adjusted.
To do this, you “will compare the amount of premium tax credit used in advance during the year with the premium tax credit [you] actually qualify for” based on your final household income for the year, and “Any difference between the two figures will affect your refund or tax owed.”
You will use the Form 1095-A that you received in the mail or downloaded from the HealthCare.gov website to complete the Form 8962. Failing to reconcile your 2022 Premium Tax Credit could make you ineligible for premium savings in 2024.
Your clients may have additional questions. If they do, you can refer them to the HealthCare.gov website. For example:
Agents should resist the temptation to get too involved. It is important to point your clients in the right direction, but remember, you’re not your clients’ tax advisor. When you receive a question about Form 1095-A, Form 8962, or anything else related to reconciling the Premium Tax Credit, it’s a good idea to refer your clients to the resources available through HealthCare.gov.