If ANY person on the tax return (Taxpayer, Spouse or any dependent) was covered by a Marketplace plan, they will receive a Form 1095-A (Health Insurance Marketplace Statement). This Form 1095-A comes directly from the federal Marketplace or a state exchange and should be issued to the Policyholder by January 31. The information contained on a 1095-A is used to reconcile the Net Premium Tax Credit (Form 8962) which is reported on the taxpayer’s 1040. Failure to complete Form 8962 will result in an erroneous return being filed. A Taxpayer who purchased insurance in the marketplace should wait until they receive Form 1095-A to file their return.
The information on Form 1095-A that is needed to complete the Net Premium Tax Credit (Form 8962) includes the following:
Policy number for the policy that the individual on the tax return purchased from the Marketplace or state health care exchange.
Each individual covered under the policy and the months that each person had coverage.
The enrollment premiums, which are the amount of the premiums for the month(s) in which any individual on the tax return was enrolled in one or more qualified health plans. This is found in Part III, column A of Form 1095-A.
The Applicable Second Lowest Cost Silver Plan (‘SLCSP’) that applies to the individual(s) receiving the 1095-A. It’s not necessarily the plan which the individual(s) enrolled in but it is used to determine Net Premium Credit. The SLCSP amounts are found in Part III, column B of Form 1095-A. Certain 1095-A’s issued to policyholders do not have an amount listed for the SLCSP because the taxpayer did not request financial assistance at the time that they purchased the policy. If no SLCSP is contained on the 1095-A, the Marketplace has an applicable premium tool that can be used to ascertain the SLCSP. See: SLCSP Premium Tool
The Advance Payment of the Premium Tax Credit (‘APTC’) which the policyholder received during the year. The APTC amounts are found in Part III, column C of Form 1095-A.
If the policyholder shares this policy with an individual that is not on the same tax return as the policyholder, the 1095-A will be shared with that other individual. This is known as a Shared Policy and a Shared Policy Allocation.
If the policyholder does not share the policy with a person who is not on the tax return, then to enter a 1095-A into the program from the Main Menu of the Tax Return, (Form 1040):
Select ‘Payments, Estimates & EIC’
Select ‘Premium Tax Credit (PTC)’
If the Taxpayer had the policy for the entire year, Select ‘Use Annual Totals,’ you will then answer the question “Do all forms 1095-A for your tax household include coverage for January through December with no change in monthly amounts shown on lines 21-32, columns A and B.” If this statement is correct, select ‘YES.’ If this statement is not correct, select ‘NO.’
Select ‘Enter Form 1095-A Amounts (Form 8962 Part 2 )’ and input the amounts from the 1095-A for the Enrollment Premium, the Second Lowest Cost Silver Plan and the Advance Payment of Premium Tax Credit. If you selected YES to the annual totals inquiry, you will only enter the totals. However, if you answered NO to the annual totals inquiry you will enter the Enrollment Premium, the Second Lowest Cost Silver Plan and the Advance Payment of Premium Tax Credit for each month as reported on the 1095-A.
If there are multiple 1095-A’s, these separate 1095-A amounts should be accounted for on Form 8962. The amount that is found in Column A on the separate 1095-A’s which represents the actual premiums charged by the insurance company and the amount that is found in Column C on the separate 1095-A’s which represents the APTC, should be combined for entry on Form 8962. To determine the amount that is entered on Form 8962 for the SLCSP, the taxpayer should review Monthly Calculation section found in the Instructions for Form 8962. Also see: 1095-A – Health Insurance Marketplace Statement. Once all of the amounts have been entered for each month that the taxpayer had minimum essential coverage as reported on the 1095-A, exit the menu.
If there is a Net Premium Tax Credit, this amount will be reflected as a Payment on Form 1040 and the taxpayer will receive the benefit of that amount. If the Advance Payment of Premium Tax Credit exceeds the amount that the taxpayer was entitled to receive, the Excess Advance Payment of Premium Tax will be reflected in the Taxes section of Form 1040 and the taxpayer will have to repay the excess advance payment on their tax return.
NOTE: This is a guide on entering a 1095-A into the Keystone Tax Solutions program. This is not intended as tax advice.