You will need your Form 1095-A when you prepare your taxes for 2015


What is it?

Your 1095-A shows the amount the Internal Revenue Service (IRS) paid to your insurance company in 2015 to help you with the cost of your health coverage. The amount paid was based on the income information and household size you provided. If your income changed during the year, you may have paid too much or too little for your health coverage.

If you enrolled in a health plan through Covered California but did notreceive premium tax credits (also known as advanced premium tax credits [APTC] or a subsidy), you will still receive a Form 1095-A from Covered California to show you what months you had health insurance.

What do I do with Form 1095-A?

Save this form — you will need it when you prepare your taxes for 2015. Similar to a W-2, a Form 1095-A is one of the things that will determine the amount of taxes you will pay or the refund you receive. You’ll use it to fill out IRS Form 8962.

Form 8962 is an IRS form to “reconcile” the tax credits your health insurance company received based on your estimated income with the amount that you qualify for based on your actual income, as reported on your federal tax return. For more information about IRS Form 8962, please visit: www.irs.gov/aca.

For help with your taxes, consult a tax preparer. Most tax preparers are ready to assist you with this form and the tax requirements.

What if I didn’t get a Form 1095-A?

If you did not receive a Form 1095-A in the mail or in your Covered California account, complete the dispute form or contact Covered California at (800) 300-1506.

The dispute form is currently only available in English. For assistance in Spanish or any other language, please contact Covered California at (800) 300-1506. Covered California members who enrolled in a minimum coverage plan (also known as catastrophic coverage) in 2015 will receive a Form 1095-B or 1095-C directly from their health insurance company.

What if my Form 1095-A is incorrect?

If the information below is incorrect on your Form 1095-A, please contact the Covered California Service Center at (800) 300-1506 to provide the right information and receive a corrected Form 1095-A.

  • Your name.

  • Your date of birth.

  • Your Social Security number.

  • Your address.

If the following information is incorrect on your Form 1095-A, complete the dispute form. (The dispute form is currently only available in English. For assistance in Spanish or any other language, please contact Covered California at [800] 300-1506.)

  • Incorrect amount of premium tax credits.

  • Wrong months of coverage listed or not shown for covered individuals.

  • Missing household members or incorrect names.

  • Health coverage was terminated.

When will I receive a corrected Form 1095-A?

Covered California will respond to you within 60 days of the date of submission of the Form 1095-A dispute form and issue a corrected form. If the changes you requested cannot be verified or if supporting documentation is needed, you will be contacted by Covered California.

Supporting documents could include invoices from your health insurance company that show the amount of premium tax credits you received and the monthly premium you paid or Covered California notices that show how much premium tax credit you were eligible for.

If you file your tax return before you receive your corrected Form 1095-A from Covered California, you may have to file an amendment to your tax return. If you do not get a new, corrected Form 1095-A before you are required to file your taxes, you must use the original Form 1095-A that Covered California sent you to complete Form 8962 and file your tax return.

What if I received an incorrect Form 1095-B or 1095-C?

Medi-Cal, Medicare, employers and health insurance companies will issue Form 1095-B and 1095-C. If you have questions about your Form 1095-B or 1095-C, please contact the sender. Covered California will not be able to resolve disputes for forms sent by any other source.

Covered California for Small Business health plan members may receive an IRS Form 1095-B or 1095-C. We encourage you to check with your health insurance company or employer if you have questions about these forms.

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