Do I Get a 1095-A Form From My Employer?

Understanding the various tax forms related to health insurance can be confusing, especially when it comes to knowing which documents you should receive. One such form is the 1095-A, which is used to report health coverage for individuals purchasing insurance through the Health Insurance Marketplace.

Purpose of 1095 Forms

The 1095 series of forms—1095-A, 1095-B, and 1095-C—documents health insurance coverage under the Affordable Care Act (ACA) for both individuals and the IRS. Each form corresponds to a different coverage source. The 1095-A is for those who purchased insurance through the Health Insurance Marketplace. It details coverage dates, premium amounts, and any advance premium tax credits received. This form is essential for reconciling advance payments of the premium tax credit on tax returns, as discrepancies can impact tax liabilities.

The 1095-B is provided by insurance companies for individuals with non-Marketplace coverage, such as Medicaid or CHIP. Meanwhile, the 1095-C is issued by large employers to outline insurance coverage offered under the ACA’s employer mandate. This form assists the IRS in evaluating employer compliance with shared responsibility provisions.

Eligibility for 1095-A

You are eligible for a 1095-A if you obtained health insurance through the Health Insurance Marketplace. The Marketplace, established under the ACA, allows individuals and families to purchase insurance, often with subsidies called advance premium tax credits. The 1095-A confirms participation in the Marketplace and breaks down any credits applied to reduce monthly premiums. Recipients must reconcile these credits on their federal tax returns using Form 8962, Premium Tax Credit, to account for any income discrepancies.

Employer-Provided Insurance Forms

For those with employer-sponsored insurance, the 1095-B or 1095-C forms apply. Employees of large organizations receive the 1095-C, which outlines the coverage offered under the ACA’s employer mandate. Employers with 50 or more full-time employees must provide this form, which includes key details such as minimum essential coverage and affordability standards. The 2024 affordability threshold is 9.86% of an employee’s household income. The form also indicates whether coverage was accepted or declined, which can affect eligibility for Marketplace premium tax credits.

Smaller employers or third-party providers may issue a 1095-B, which details the months of coverage. This form ensures compliance with the ACA’s individual mandate, which remains active in certain states like California and New Jersey. Reviewing these forms is important, as any inaccuracies can affect tax filings.

How to Verify Which Form You Need

Determining the correct health insurance form requires identifying your insurance source. If you purchased coverage through the Health Insurance Marketplace, you will need the 1095-A. For employer-sponsored insurance, either the 1095-B or 1095-C will apply, depending on your employer’s size and coverage structure.

Employees of large companies typically receive the 1095-C, while those insured through smaller employers or third-party providers may receive the 1095-B, which reflects their months of coverage.

Steps If You’re Missing Required Documents

If you are missing a required form, such as the 1095-A, 1095-B, or 1095-C, act quickly to avoid tax filing delays or errors. First, confirm which form you should have received. If you purchased Marketplace insurance but lack a 1095-A, check your online Marketplace account for a digital copy, as these forms are not issued by the IRS.

For employer-provided insurance, contact your HR department or benefits administrator if your 1095-B or 1095-C is missing. Employers must provide these forms by January 31 of the following year. If this deadline has passed, inquire about any delays or errors. Even without the form, you must accurately report your insurance coverage on your tax return.

If you are unable to obtain the necessary documentation before filing, use alternative records such as pay stubs or insurance cards to estimate your coverage details. Report the months you were covered, but be prepared to amend your tax return if discrepancies arise after receiving the form. The IRS may request additional documentation, so keep thorough records. If uncertain, consult a tax professional for guidance on reconciling missing or incomplete information.