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Gathering Your Health Coverage Documentation

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The health care law brought some changes to the 2015 federal income tax return that individuals file in 2016. This year marks the first time that taxpayers may receive multiple information forms that they can use to complete their tax return and will keep with their tax records.

The information forms are:

Taxpayers who enrolled in coverage through the Marketplace may qualify for a premium tax credit and must file a tax return to claim the credit and to reconcile any advance payments made on their behalf. These taxpayers will should receive a Form 1095-A.   If you are expecting to receive a Form 1095-A, you should wait to file your income tax return until you receive that form.

The IRS has posted a set of questions and answers that introduce the new Forms 1095-B and 1095-C.  The questions and answers explain who should expect to receive the forms, how they can be used, and how to file with or without the forms.  

Like 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.

Documentation individuals can gather in advance:

Proof of Insurance

Taxpayers are not required to send the IRS information forms or other proof of health care coverage when filing their tax return. However, it’s a good idea to keep these records on hand to verify coverage. This documentation includes 

  • Form 1095 information forms,
  • 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 are expecting to receive a Form 1095-A, Health Insurance Marketplace Statement, you should wait to file your income tax return until you receive that form.

Some taxpayers may not receive a Form 1095-B or Form 1095-C from their coverage providers or employer by the time they are ready to file their tax return. 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.

While your employer may be able to assist you in verifying your coverage, most employers are not required to provide documentation specific to your health care coverage.   

Documents supporting exemptions and hardships

Anyone who qualifies for a health coverage exemption and wishes to be exempt from the individual shared responsibility payment will need to apply through the Marketplace or claim the exemption on his or her tax return. Individuals may need information to support their coverage exemption claim. This includes documentation to support a hardship, income documents, social security information, and household information. If an exemption application is granted by the Marketplace the applicant will receive a notice with a unique Exemption Certificate Number, also known as an ECN. The ECN will be entered in Part I of Form 8965, which must be filed with the tax return. Individuals who do not currently have their ECN, but who have applied for an exemption through the Marketplace, should enter the word “PENDING” in the place of the ECN in Part I of Form 8965. If you are claiming an exemption on your tax return, you do not need an ECN.

Form 1095-A, Health Insurance Marketplace Statement

If you or your family had coverage through a Marketplace the Marketplace will send you information about the coverage on Form 1095-A. The form will show coverage details such as the effective date, amount of the premium, and the advance payments of the premium tax credit or subsidy. If you receive a Form 1095-A, you will use the information on the form to complete Form 8962, Premium Tax Credit (PTC) in order to claim the premium tax credit or to reconcile advance credit payments on the federal tax return.

You may receive more than one Form 1095-A if anyone in your household switched plans or reported life changes (such as getting married or having a baby) after their coverage began, or if they had more than one policy covering people in the same household. Individuals will get a Form 1095-A even if they only had Marketplace coverage for part of the year.

If you receive a Form 1095-A  from the Marketplace, you should check to make sure the information matches your records, including items like the start and end dates of your coverage and the number of people in your household. 

Some taxpayers may receive a corrected or voided Form 1095-A because the information on the initial form was incorrect or incomplete. For more information on what you need to do with a corrected or voided Form 1095-A, see Corrected, Incorrect or Voided Forms 1095-A for Tax Years 2014 and 2015.. This information can help you assess whether you should file an amended tax return.

More information on Form 1095-A, Health Insurance Marketplace Statement, is available on IRS.gov/aca.
 

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. 

You can use Form 1095-B for information on whether you and your family members had health coverage that satisfies the individual shared responsibility provision.
 

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.

You can use Form 1095-C to help determine your eligibility for the premium tax credit. In addition, you can 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”).

Free File and e-file help Simplify Tax Time

All taxpayers who are reporting coverage, claiming a health coverage exemption, making an individual shared responsibility payment, or claiming the premium tax credit should consider filing their tax return electronically. E-filing a tax return is the simplest way to file a complete and accurate tax return as it guides individuals through the process and does all the math for them.

Electronic Filing options include free Volunteer Assistance, IRS Free File, commercial software and professional assistance.

Page Last Reviewed or Updated: 18-Jul-2016