That Form 1095-A was sent in error. You shouldn t have received a Form 1095-A for this policy. Don t use the information on this or the Form 8962. Enrollment the individuals who would be in your tax family for the year of coverage Form 1095-A will list all enrolled individuals in Part II on your Form 1095-A. Cat. No. 60703Q Form 1095-A 2024 Instructions for Recipient You received this Form 1095-A because you or a family member enrolled in health insurance coverage through the Health Insurance...Marketplace. Enrolled individuals aren t individuals who would be in your tax family for the year of coverage your Form 1095-A will include coverage information in Part III that is applicable solely to the individuals listed on your Form 1095-A and separately issued Forms 1095-A will include individuals not in your tax family. CAUTION NOT FOR FILING Form 1095-A is provided here for informational purposes only. Health Insurance Marketplaces use Form 1095-A to report information on enrollments in...a qualified health plan in the individual market through the Marketplace. Don t use the information on the original Form 1095-A you received for this policy. Part I. Recipient Information lines 1 15. VOID box. If the VOID box is checked at the top of the form you previously received a Form 1095-A for the policy described in Part I. If there are more than five individuals covered by a policy you will receive one or more additional Forms 1095-A that continue Part II. Go to www*irs*gov/Form1095A...for instructions and the latest information* OMB No* 1545-2232 CORRECTED Recipient Information 1 Marketplace identifier 2 Marketplace-assigned policy number 3 Policy issuer s name 4 Recipient s name 5 Recipient s SSN 6 Recipient s date of birth 7 Recipient s spouse s name 10 Policy start date 11 Policy termination date 12 Street address including apartment no. 13 City or town 14 State or province 15 Country and ZIP or foreign postal code Covered Individuals A. Covered individual name date of...birth D. Coverage start date E* Coverage termination date Coverage Information Month A. Monthly enrollment premiums B. Monthly second lowest cost silver plan SLCSP premium C. Monthly advance payment of premium tax credit 21 January 22 February 23 March 24 April 25 May 26 June 27 July 28 August 29 September 30 October 31 November 32 December 33 Annual Totals For Privacy Act and Paperwork Reduction Act Notice see separate instructions. If you purchased insurance through the Federally-facilitated...Marketplace you can find your Call Center information at www. healthcare. gov/contact-us/. If you purchased insurance through a State-based Marketplace you can find your Call Center information on your State-based Marketplace website. You can find a list of Statebased Marketplace websites at www. healthcare. gov/marketplace-inyour-state/. Additional information* For additional information about the tax provisions of the Affordable Care Act ACA including the premium tax credit see...www*irs*gov/Affordable-Care-Act/Individuals-and-Families or call the IRS Healthcare Hotline for ACA questions 800-919-0452.
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Instructions and Help about IRS 1095-A
How to edit IRS 1095-A
How to fill out IRS 1095-A
Instructions and Help about IRS 1095-A
How to edit IRS 1095-A
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How to fill out IRS 1095-A
To fill out IRS 1095-A correctly, start by gathering your health coverage information. The form requires details about the coverage you received through the Health Insurance Marketplace, including policy numbers and names of the individuals covered. Use pdfFiller for a seamless fill-out experience by inputting your data directly into the digital form.
Latest updates to IRS 1095-A
Latest updates to IRS 1095-A
Stay informed about any updates related to IRS 1095-A, especially regarding reporting requirements and deadlines. The IRS routinely publishes updates that may affect how you report your health coverage information.
All You Need to Know About IRS 1095-A
What is IRS 1095-A?
What is the purpose of this form?
Who needs the form?
When am I exempt from filling out this form?
Components of the form
Due date
What payments and purchases are reported?
How many copies of the form should I complete?
What are the penalties for not issuing the form?
What information do you need when you file the form?
Is the form accompanied by other forms?
Where do I send the form?
All You Need to Know About IRS 1095-A
What is IRS 1095-A?
IRS 1095-A is a tax form used to report health insurance coverage purchased through the Health Insurance Marketplace. It provides essential information necessary for individuals to complete their federal income tax returns and claim premium tax credits if eligible.
What is the purpose of this form?
The purpose of IRS 1095-A is to provide the IRS with information about individuals' health coverage. This includes months of coverage and the amount of premium tax credits received. The information helps verify that individuals met their health coverage mandate under the Affordable Care Act.
Who needs the form?
Individuals who obtained health insurance coverage through the Health Insurance Marketplace must receive IRS 1095-A. It is essential for anyone who wants to apply for premium tax credits or reconcile them on their federal tax return.
When am I exempt from filling out this form?
You are exempt from filling out IRS 1095-A if you did not purchase health insurance from the Health Insurance Marketplace or if you were covered by other qualifying plans, such as employer-sponsored health coverage or Medicaid. Always confirm your coverage details before determining your filing obligations.
Components of the form
The IRS 1095-A consists of three main parts: Part I includes details about the issuer of the policy, Part II contains information about the primary insured and their household, and Part III provides coverage details for each month covered under the health plan. Each part is crucial for accurate reporting.
Due date
The due date for filing IRS 1095-A is typically January 31 of the year following the relevant tax year. This form must be issued to the taxpayer and the IRS by this deadline to ensure compliance and enable timely tax filing.
What payments and purchases are reported?
IRS 1095-A reports all payments made towards health insurance premiums within the calendar year. It includes the amount of premium tax credit applied and any related payments made for advance premium tax credits. This information is essential for determining tax obligations and eligibility for credits.
How many copies of the form should I complete?
Typically, you need to complete one IRS 1095-A form for each health insurance policy held through the Marketplace. If your household had multiple policies, you would receive multiple forms, each reflecting their respective coverage information.
What are the penalties for not issuing the form?
If IRS 1095-A is not provided when necessary, penalties may apply. The IRS can impose fines for failing to report accurate coverage information, which could affect your tax return processing and eligibility for tax credits.
What information do you need when you file the form?
When filing IRS 1095-A, collect the following information: your name, Social Security Number, policy information including coverage start and end dates, details about premiums paid, and information on any household members covered under the plan. Ensure that information is accurate to avoid issues with your tax return.
Is the form accompanied by other forms?
IRS 1095-A is often used alongside other tax forms, such as Form 8962, Premium Tax Credit, when claiming premium tax credits on your federal tax return. Ensure you have all necessary forms filled out for complete reporting.
Where do I send the form?
IRS 1095-A is typically not submitted directly to the IRS with your tax return; however, you must retain it for your records and complete Form 8962 based on its information. If required to submit 1095-A, follow the specific instructions provided by the IRS.
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