Anyone who enrolled in qualified health plans through the marketplaces in 2014 will .in a few days, begin receiving IRS form 1095-As from the marketplaces, be they the federally facilitated marketplaces (FFMs) or state-operated marketplaces.
The form 1095-A is the form that provides individuals who have enrolled in qualified health plans through the marketplaces the information they need to fill out form 8962, which in turn is the form enrollees will need to reconcile the advance premium tax credits (APTC) they received in 2014 with the premium tax credits they were actually entitled to. The marketplace also reports the information on the 1095-A to the IRS.
On January 12, 2015, HHS released a series of frequently asked questions about the 1095-A at its REGTAP website- some details below!
The 1095-A includes information on anyone in a household who enrolled in a qualified health plan through an exchange, including the monthly premium that they paid for coverage; any APTC the household received; and the cost of the second-lowest-cost silver, or benchmark, plan used to determine the premium tax credits. Marketplaces will mail the 1095-A to any household that enrolled in a QHP, regardless of whether household members received APTC.
If a household was covered by more than one policy, a separate 1095-A will be generated for each policy. If consumers reported a life change in the course of a year and were then granted a special enrollment period, they will receive a 1095-A for the period before reporting the life change and another for the period after. A consumer will also receive more than one 1095-A if there are more than 5 members in the household, as the form only has lines to list five household members.
No 1095-A will be provided to households that only enrolled in catastrophic coverage or stand-alone dental plans. Neither will 1095-As be available to people who were enrolled outside the exchange or in Medicaid or CHIP.
The forms should be mailed by February 2, 2015, and will also be uploaded onto consumer’s online Healthcare.gov accounts. They will be printed only in English, but will contain tag lines in 15 languages with a number to call for information in other languages. A Spanish-language cover letter will be sent with the form to those who have indicated that their preferred language is Spanish.
Account holders can also log onto their account at Healthcare.gov and find the 1095-A either in the “Tax Form” section or in the “Message” section. Consumers who do not have online accounts can create one and view the 1095-A in the “Tax Form” section. This may be particularly important for consumers who do not receive a form in the mail because the address the exchange has for them is invalid, or their address has changed. These individuals can also call the Marketplace call center and have a corrected 1095-A mailed to their new address.
In some circumstances the information on the 1095-A is likely to be inaccurate. This will, for example, be the case if the consumer was terminated from a plan for non-payment after the 90-day grace period, but the 1095-A shows the consumer as having paid the full premium during the grace period.
There will also be other instances where the consumer finds that information reported on the 1095-A is incorrect. For example, the form’s listing of members of the household may be wrong. In these instances, the consumer should contact the marketplace call center. When either an insurer or consumer reports corrected information to the marketplace, the marketplace will generate a “corrected” 1095-A. These forms will be mailed to consumers or posted to their marketplace accounts early in March, 2015.
Further details from: Eric Walters
Email: ewinsurance @gmail.com