The Affordable Care Act and Your 1095

2016 was the first year that the IRS made it mandatory for individuals to provide proof that they had health care coverage or they had to apply through the Marketplace for an exemption certificate.  Forms 1095’s were sent out earlier this year which provided the necessary information when you filed your individual tax return indicating that you had health care coverage.  Below is a break down of the three different 1095’s that were sent out.

1095-A (Health Insurance Marketplace Statement): This form came form the Market Place. Indicating that you purchased your coverage through the Market Place.  It provided the details on the coverage, who was covered as well as when.

1095-B: (Health Coverage):  Health Insurance Providers (Insurance Companies) sent this form to individuals that they covered as well as when they were covered.

1095-C (Employer Provided Health Insurance Offer and Coverage): Certain employers sent this form to employees, with information about what coverage the employer offered.  Employers that offer health coverage referred to as “self-insurance coverage” sent this form to invididuals that they covered, with information about who was covered and when.

If you purchased your coverage through the Marketplace you might have found yourself owing back money indicating that you didn’t estimate your income correctly.  This was done by completing form 8862 to reconcile advance payments of the premium tax credit that was received.

It is critical if your insurance is purchased through the Marketplace to estimate your income correctly.   To be eligible for the premium tax credit your income level MUST be at least 100% but no more than 400% of the federal poverty level. Below are the amounts that were for 2015.

  • $11,670 (100%) up to $46,680 (400%) for one individual
  • $15,730 (100%) up to $62,920 (400%) for a family of two
  • $23,850 (100%) up to $95,400 (400%) for a family of four

In addition if you have any changes to your household, income or if you move please make sure to notify the Marketplace as these changes affect your coverage.