Because of the health care law, you might receive some new forms in the first few months of 2016 providing you with information about the health coverage you had or were offered in 2015. The information below is intended to help individuals understand these new forms, including who should expect to receive them and what to do with them.
The Basics
1. Will I receive any new health care tax forms in 2016 to help me complete my tax return?
Starting early in 2016, you may receive one or more forms providing information about the health care coverage that you had or were offered during the previous year. Much like Form W-2 and Form 1099, which include information about the income you received, these new health care forms provide information that you may need when you file your individual income tax return. Also like Forms W-2 and 1099, these new forms will be provided to the IRS by the entity that provides the form to you.
The new forms are:
• Form 1095-A, Health Insurance Marketplace Statement. The Health Insurance Marketplace (Marketplace) sends this form to individuals who enrolled in coverage there, with information about the coverage, who was covered, and when.
• Form 1095-B, Health Coverage. Health insurance providers (for example, health insurance companies) send this form to individuals they cover, with information about who was covered and when.
• Form 1095-C, Employer-Provided Health Insurance Offer and Coverage. Certain employers send this form to certain employees, with information about what coverage the employer offered. Employers that offer health coverage referred to as “self-insured coverage” send this form to individuals they cover, with information about who was covered and when.
2. When will I receive these health care tax forms?
The deadline for the Marketplace to provide Form 1095-A is February 1, 2016. The deadline for insurers, other coverage providers and certain employers to provide Forms 1095-B and 1095-C has been extended to March 31, 2016. Individual taxpayers will generally not be affected by this extension and should file their returns as they normally would.
3. Must I wait to file until I receive these forms?
If you are expecting to receive a Form 1095-A, you should wait to file your 2015 income tax return until you receive that form. However, it is not necessary to wait for Forms 1095-B or 1095-C in order to file.
Some taxpayers may not receive a Form 1095-B or Form 1095-C by the time they are ready to file their 2015 tax return. While the information on these forms may assist in preparing a return, they are not required. Individual taxpayers will generally not be affected by this extension and should file their returns as they normally would.
As last year, taxpayers can prepare and file their returns using other information about their health insurance. You should not attach any of these forms to your tax return.
4. What are the health care tax forms that I might receive and how do I use them?
Health Care Form Sent To Sent By What to do with this form
Form 1095-A, Health Insurance Marketplace Statement Individuals who enrolled in health coverage for themselves or their family members through the Marketplace
Marketplace This form provides information about your Marketplace coverage.
Use Form 1095-A to complete form 8962 and reconcile advance payments of the premium tax credit or claim the premium tax credit on your tax return.
Use Form 1095-A for information on whether you and your family members had coverage that satisfies the individual shared responsibility provision.
• If Form 1095-A shows coverage for you and everyone in your family for the entire year, check the full-year coverage box on your tax return.
• If there are months when you or your family members did not have coverage, determine if you qualify for an exemption or must make an individual shared responsibility payment.
Do not attach Form 1095-A to your tax return – keep it with your tax records.
Form 1095-B, Health Coverage Individuals who had health coverage for themselves or their family members that is not reported on Form 1095-A or Form 1095-C.
Health Coverage Providers
• Insurance companies outside the Marketplace
• Government agencies such as Medicare or CHIP
• Employers who provide certain kinds of health coverage (sometimes referred to as “self-insured coverage”) but are not required to send Form 1095-C (see below).
• Other coverage providers
This form provides information about your health coverage.
Use Form 1095-B for information on whether you and your family members had health coverage that satisfies the individual shared responsibility provision.
• If Form 1095-B shows coverage for you and everyone in your family for the entire year, check the full-year coverage box on your tax return.
• If there are months when you or your family members did not have coverage, determine if you qualify for an exemption or must make an individual shared responsibility payment.
Do not attach Form 1095-B to your tax return – keep it with your tax records.
Form 1095-C, Employer-Provided Health Insurance Offer and Coverage Certain employees of applicable large employers (See next column). Applicable large employers– generally those with 50 or more full-time employees, including full-time equivalent employees Form 1095-C provides information about the health coverage offered by your employer and, in some cases, about whether you enrolled in this coverage.
Use Form 1095-C to help determine your eligibility for the premium tax credit.
• If you enrolled in a health plan in the Marketplace, you may need the information in Part II of Form 1095-C to help determine your eligibility for the premium tax credit.
• If you did not enroll in a health plan in the Marketplace, the information in Part II of your Form 1095-C is not relevant to you.
Use Form 1095-C for information on whether you or any family members enrolled in certain kinds of coverage offered by your employer (sometimes referred to as “self-insured coverage”).
• If Form 1095-C shows coverage for you and everyone in your family for the entire year, check the full-year coverage box on your tax return.
• If there are months when you or your family members did not have coverage, determine if you qualify for an exemption or must make an individual shared responsibility payment.
Do not attach Form 1095-C to your tax return – keep it with your tax records.
5. How will I receive these forms?
The Marketplace, health coverage providers and applicable large employers will mail (or hand deliver) these forms to you or provide them electronically to you, if you have consented to electronic delivery.
6. Will I get at least one form?
Maybe. If you were enrolled in health coverage for 2015, you should receive a Form 1095-A, 1095-B, or 1095-C. In addition, if you were an employee of an employer that was an applicable large employer in 2015, you may receive a Form 1095-C. If you don’t fall in either of these categories, you won’t receive a form.
7. Will I get more than one form?
Maybe. You are likely to get more than one form if you had coverage from more than one coverage provider or if you worked for more than one employer that offered coverage. You are also likely to get more than one form if you changed coverage or employers during the year or if different members of your family received coverage from different coverage providers.
8. Will I get a Form 1095-C from each of my employers?
Not necessarily. You will only receive a Form 1095-C from your employer if that employer is an applicable large employer, meaning it had 50 or more full-time employees (including full-time equivalent employees) in the year before the year to which the form relates. Most employers have fewer than 50 employees and therefore are not applicable large employers required to provide Form 1095-C to their full-time employees.
Even if your employer is an applicable large employer, you will only receive a Form 1095-C for that employer if you were a full-time employee for that employer for at least one month of the year or if you are enrolled in an applicable large employer’s self-insured health plan, even if you are a part-time employee.
9. How are the forms similar?
• They all provide information about your health coverage during the prior year.
• They are all used to determine if you, your spouse and your dependents had health coverage for the entire year and if not, for which months you did have coverage. (The Form 1095-C includes this information only if your employer is an applicable large employer and the coverage you enrolled in was a certain kind of coverage referred to as “self-insured coverage”).
• None of these forms should be filed with your tax return; they should be kept for your records with your other tax documents.
10. How are the forms different?
• The forms are provided by different entities.
- Form 1095-A, Health Insurance Marketplace Statement, is provided by the Marketplace to individuals who enrolled or who have enrolled a family member in health coverage through the Marketplace.
- Form 1095-B, Health Coverage, is provided by insurance companies and other coverage providers; however, if your coverage was insurance purchased through the Marketplace or was a type of coverage referred to as “self-insured coverage” that was provided by an applicable large employer, you will receive a different form.
- Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, is issued by applicable large employers to their full-time employees and, in some cases, to other employees.
• The forms are provided to different groups of people.
• Form 1095-A – Only individuals who enroll in coverage through the Marketplace will get this form.
• Form 1095-B – Individuals who have health coverage outside of the Marketplace will get this form (except for employees of applicable large employers that provide self-insured coverage, who will receive Form 1095-C instead).
• Form 1095-C – Individuals who work full-time for applicable large employers will get this form. Also, part-time employees also will get this form if they enroll in self-insured coverage provided by an applicable large employer.
• The forms contain some different information. Form 1095-A, Form 1095-B, and some Forms 1095-C show who in your family enrolled in health coverage and for what months.
Form 1095-A also provides premium information and other information you will need to reconcile advance payments of premium tax credit and claim the premium tax credit on Form 8962. And Form 1095-C shows coverage that your employer offered to you even if you chose not to take that coverage.
11. What do I need to do with these forms?
• You will use the information on these forms to verify that you, your spouse and any dependents had coverage for each month during the year.
• Like last year, if you and your family members had minimum essential coverage for every month of the year, you will check a box on your return to report that coverage. If you or any family members did not have coverage for the entire year, a coverage exemption may apply for the months without coverage. If you or any family members did not have coverage or an exemption, you may have to make an individual shared responsibility payment.
• If you or anyone in your family receives a Form 1095-A from the Marketplace, you will use the information on the form to complete a Form 8962 to reconcile any advance payments of the premium tax credit or to claim the premium tax credit.
• Do not file these forms with your tax return. Keep them in your records with your other important tax documents.
How the Forms Relate to Your Tax Return
12. Can I file my tax return if I have not received any or all of these forms?
If you enrolled in coverage through the Marketplace you will need the information on Form 1095-A to complete Form 8962 to reconcile any advance payments of the premium tax credit or claim the premium tax credit, and to file a complete and accurate tax return. If you need a copy of your Form 1095-A, you should go to HealthCare.gov or your state Marketplace website and log into your Marketplace account, or call your Marketplace call center. Although information from the Form 1095-C – information about an offer of employer provided coverage – can assist you in determining eligibility for the premium tax credit, it is not necessary to have Form 1095-C to file your return. See Publication 974 for additional information on claiming the premium tax credit.
You do not have to wait for either Form 1095-B or 1095-C from your coverage provider or employer to file your individual income tax return. You can use other forms of documentation, in lieu of the Form 1095 information returns to prepare your tax return. Other forms of documentation that would provide proof of your insurance coverage include:
- insurance cards,
- explanation of benefits
- statements from your insurer,
- W-2 or payroll statements reflecting health insurance deductions,
- records of advance payments of the premium tax credit and
- other statements indicating that you, or a member of your family, had health care coverage.
If you and your entire family were covered for the entire year, you may check the full-year coverage box on your return. If you or your family members did not have coverage for one or more months of the calendar year, you may claim an exemption or make an individual shared responsibility payment.
You will not need to send the IRS proof of your health coverage. However, you should keep any documentation with your other tax records. This includes records of your family’s employer-provided coverage, premiums paid, and type of coverage.
13. Am I required to file a tax return if I receive one of these forms?
If you receive a Form 1095-A, Health Insurance Marketplace Statement, showing that advance payments of the premium tax credit were paid for coverage for you or your family member, you generally must file an individual income tax return and submit a Form 8962 to reconcile those advance payments, even if you would not otherwise be required to file a tax return. You also must file an individual income tax return and submit a Form 8962 to claim the premium tax credit, even if no advance payments of the premium tax credit were made for your coverage. For more information, see the instructions to Form 8962.
You are not required to file a tax return solely because you received a Form 1095-B or a Form 1095-C. For example, if you are enrolled in Medicaid you will receive a Form 1095-B. If you do not have a tax filing requirement, you do not have to file a tax return solely because you received the Form 1095-B reflecting your Medicaid coverage.
The health care law tax filing requirements are the same as last year.
• If you enrolled in coverage through the Marketplace, you must file a tax return and reconcile any advance payments of the premium tax credit that were paid on your behalf.
• If you have a filing requirement and everyone in your family had coverage for the entire year, you should check the full-year coverage box on your tax return.
• If you or any family members did not have coverage for the entire year, you should claim any applicable coverage exemption or make an individual shared responsibility payment.
14. Should I attach Form 1095-A, 1095-B or 1095-C to my tax return?
No. Although you may use the information on the forms to help complete your tax return, these forms should not be attached to your return or sent to the IRS. The issuers of the forms are required to send the information to the IRS separately. You should keep the forms for your records with your other important tax documents.
Source: IRS
Catherine oversees UBF's daily operations and client retention strategy. She has a background in mathematics, economics, and human resources. In her spare time, she enjoys spending time with her family, taking the dog on long walks, and caring for a small and unfruitful garden.