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Sharp Health News

What are 1095 tax forms?

March 13, 2020

What are 1095 tax forms?

If you file state and federal income taxes, you likely receive many forms in the mail at this time of year. One you might have overlooked is the 1095 form, which is related to health care coverage.

The Affordable Care Act introduced three tax forms relevant to individuals, employers and health insurance providers. They are forms 1095-A, 1095-B and 1095-C. These forms help determine if you had minimum essential coverage (sometimes called qualifying health coverage), which is the minimum level of benefits required under the Affordable Care Act.

“Although you are not required to submit your 1095 forms to the Internal Revenue Service (IRS) when you file your taxes, it’s a good idea to keep them as part of your tax records,” explains Jason Smith, director of operations at Sharp Health Plan.

The 1095 forms you receive depend on how you enrolled in your plan. If you were insured through more than one health plan or employer during the year, you should expect to receive multiple 1095 forms. Each form will include slightly different information.

If you enrolled in benefits in 2019 ...                 You will receive:In your mail from:
Through Covered CaliforniaForm 1095-ACovered California
Directly through an insurance providerForm 1095-BYour insurance provider
Through your employerForm 1095-BYour employer's insurance provider
Through your employer (101+ employees)Forms 1095-B and 1095-CYour employer's insurance provider and your employer

If you were enrolled in a government-sponsored plan, such as Medicare or Medicaid, you will receive Form 1095-B from the Centers for Medicare & Medicaid Services.

Form 1095-A
If you were enrolled in benefits through Covered California, you will receive Form 1095-A. This form will include the amount of coverage you had, any tax credits you were entitled to and if you used them to pay for your health insurance, and the amount you paid for coverage. You can use this information to adjust any tax credit payments and claim any premium tax credits that may be due.

Forms 1095-B and 1095-C
If you purchased insurance directly through an insurance provider, or if you were enrolled in benefits through an employer, then you will receive Form 1095-B. This form includes the type of coverage you had, what dependents were covered under your plan (if applicable), and the period of your coverage. If you were enrolled in benefits through an employer with 101 or more employees, then you will also receive Form 1095-C from your employer. This form will provide information on the coverage your employer offered and whether or not you enrolled in that coverage.

“If you have questions about the forms you receive, you should contact the issuer of the form,” advises Smith. For more information, you can check out these tips from Sharp Health Plan. The IRS also has helpful information on their website.

While there is no longer a federal tax penalty for not having minimum essential coverage, the State of California passed new legislation that went into effect Jan. 1, 2020, that requires all California residents to have health coverage for 2020. If you do not have health coverage in 2020, you will be charged a new state tax penalty when you file your 2020 taxes in early 2021.

“Covered California is currently offering a Special Enrollment period for Californians who didn’t know about the new state tax penalty or the new financial help that’s available to those who qualify,” advises Smith. Consumers who fall into these categories, or who are currently insured off-exchange (directly through an insurer) and want to switch to Covered California to take advantage of the new state subsidies, will have through the end of June to sign up for coverage. For more information, visit CoveredCA.com.

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