What Is Form 1095-A From Covered California?
Learn how your Form 1095-A from Covered California is used to reconcile your health insurance subsidy and accurately calculate your premium tax credit.
Individuals who purchase health insurance through a Health Insurance Marketplace receive Form 1095-A, Health Insurance Marketplace Statement. If you enrolled in a marketplace plan, you must use this form to complete your federal income tax return and reconcile your eligibility for the premium tax credit. You should receive this form from your marketplace by mid-February. It details any financial help you received, known as the advance premium tax credit (APTC), and is used to reconcile the aid you received with the amount you were eligible for based on your final annual income.
Understanding Your Form 1095-A
The Form 1095-A is divided into three parts. Part I, Recipient Information, lists your name, address, and policy number. Part II, Covered Individuals, details every person covered by the health plan, including their name, social security number, and the months they had coverage.
Part III, Coverage Information, is a monthly breakdown in three columns. Column A shows the total monthly premium for your health plan before any financial help was applied.
Column B lists the premium for the second-lowest cost Silver plan (SLCSP) available to you in your area. The SLCSP is a specific benchmark plan used by the marketplace to calculate the amount of premium tax credit you are eligible for. Even if you did not enroll in a Silver plan, this figure is reported on your Form 1095-A because it is the baseline for determining your financial assistance.
Column C shows the amount of the advance premium tax credit (APTC) that was paid on your behalf to lower your out-of-pocket premium payment.
Using Form 1095-A to File Your Taxes
When you file your federal income tax return, the information from Form 1095-A is used to complete IRS Form 8962, Premium Tax Credit. This process is called reconciliation. You must compare the APTC you received with the actual premium tax credit you qualify for based on your final income.
The figures from Part III of your Form 1095-A are transferred to Form 8962 to calculate your final premium tax credit. This calculation takes into account your actual household income and family size for the year.
Two outcomes are possible after completing Form 8962. If the APTC you received was less than the premium tax credit you are ultimately eligible for, you will claim the difference. This may result in a larger tax refund or a lower amount of tax owed. This often happens if your income for the year was lower than you estimated when you enrolled.
Conversely, if the APTC you received was more than the credit you qualify for, you will have to repay the excess amount. This is known as an excess advance premium tax credit repayment. This situation can occur if your income was higher than you estimated or if you failed to report changes like a marriage or a new job to the marketplace during the year. The repayment may reduce your tax refund or increase your tax liability, though there are repayment limits based on income level.
Correcting or Obtaining Your Form 1095-A
If you did not receive your Form 1095-A or have misplaced it, you can access it through your online marketplace account. After logging in, you can find a digital copy in your secure inbox or tax documents section. If you cannot access your online account, call your marketplace’s service center to request a mailed copy.
Should you find an error on your Form 1095-A, such as incorrect premium amounts or personal information, you must request a correction from your marketplace. Filing with an incorrect form can lead to errors in your tax credit calculation, so you may be asked to provide documentation like billing statements to support your claim.
Once your request is processed and the information is verified, the marketplace will issue a corrected Form 1095-A. You must use this new version to complete your Form 8962 and file your taxes.