Looking for Form 1094a? You May Need Form 1095-A

Individual taxpayers searching for Form 1094-A are almost certainly looking for Form 1095-A, the Health Insurance Marketplace Statement. The 1094 series of forms are transmittal documents used by insurance providers and large employers to report coverage information to the IRS, not by individuals.

Form 1095-A is a document you receive if you or a household member enrolled in a health plan through the Health Insurance Marketplace. This statement is provided by the Marketplace and contains information necessary for your federal income tax return. Its primary purpose is to help you calculate your premium tax credit and reconcile any advance payments of that credit you received.

Decoding Your Form 1095-A

Your Form 1095-A is organized into three parts. Part I contains recipient information, such as your name, address, and the policy number assigned by the Marketplace. Part II lists all individuals covered by the policy, including their names, social security numbers, and the start and end dates of their coverage. It is important to review these sections for accuracy.

The core of the form is Part III, “Coverage Information,” which presents a monthly breakdown of your health plan financials in three columns. Column A shows the total monthly premium for your plan. Column C lists the amount of the advance payment of the premium tax credit (APTC) paid to your insurance company each month. This advance payment is based on the income you estimated when you first applied for coverage.

Column B of Part III is the premium for the applicable second-lowest cost silver plan (SLCSP). This is not necessarily the plan you chose, but it is a specific benchmark premium used by the IRS to calculate your final premium tax credit. The SLCSP premium is determined based on your location and the ages of the covered individuals.

Reconciling Your Premium Tax Credit with Form 8962

The information in Part III of your Form 1095-A is used to complete IRS Form 8962, Premium Tax Credit. You must file Form 8962 with your tax return if you received any advance payments or if you did not receive advance payments but wish to claim the premium tax credit. This form is used to reconcile the advance credit payments you received with the actual premium tax credit you are eligible for based on your final household income.

The process involves transferring the monthly figures from Form 1095-A onto Form 8962. The values from Column A (monthly premium), Column B (SLCSP premium), and Column C (APTC) are entered into the corresponding lines for each month of coverage. The form then calculates the actual credit you qualify for by comparing your actual household income to the federal poverty line for your family size.

The final calculation on Form 8962 will determine if there is a difference between the advance payments and the credit you earned. If the advance payments were less than the credit you qualify for, the difference increases your tax refund or lowers the tax you owe. Conversely, if you received too much in advance payments, you will need to repay the excess amount, which reduces your refund or increases your tax liability.

Correcting Errors and Receiving Your Form

If you review your Form 1095-A and believe the information is incorrect, you should not file your taxes with it. Common errors can include wrong coverage dates, incorrect premium amounts, or missing household members. To resolve this, contact the Health Insurance Marketplace call center to request a review and a corrected form. The Marketplace will send you a new Form 1095-A and report the updated information to the IRS. If you have already filed your return with the incorrect form, you may need to file an amended return, Form 1040-X.

Taxpayers enrolled in a Marketplace plan should receive their Form 1095-A by mail or find it in their online Marketplace account by mid-February. If you have not received your form by this time, first check your online account, as it is often available there first. If you still cannot locate it, contact the Marketplace call center to ensure they have your correct mailing address and request a copy. It is important to wait until you have an accurate Form 1095-A before filing your tax return.