The ABCs of IRS Tax Form 1095

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The ABCs of IRS Tax Form 1095

February 1, 2016
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The following are some facts about the forms:

Form 1095-A - Health Insurance Marketplace Statement:

  • Received by individuals who purchased coverage from a federal or state healthcare marketplace (e.g., healthcare.gov).
  • Includes information about coverage, the amount paid for the coverage, any applicable tax credits and if the credits were used to pay for health insurance.
  • Insurance companies participating in the public healthcare marketplace send the form to plan participants.
  • The 1095-A must be filed with an individual's personal income tax forms to complete the filing, adjust any tax credit payments and/or claim any premium tax credits that may be due.

1095-B - Health Coverage

  • Received by individuals enrolled in a fully-insured employer-sponsored plan (such as the Engage Aetna health plans).
  • The form is sent from the insurance carrier and lists the type of coverage held, dependents covered and the period of the coverage. The form also indicates whether an individual had a break in health coverage for the tax year and if a penalty may have to be paid by the individual.
  • The 1095-B does not have to be filed with an individual's personal income tax forms. The information is used to verify coverage and costs. The form should be reviewed carefully by the recipient and saved for reference.

1095-C - Employer-Provided Health Insurance Offer and Coverage  

  • Companies with 50 or more full-time or full-time equivalent employees provide Form 1095-C to employees (individuals enrolled in a fully-insured employer-sponsored plan).
  • Similar to Form 1095-B, the information is used to verify coverage and costs. The form includes information about the employer-offered coverage and also indicates whether or not an individual chose to participate in the plans offered.
  • The 1095-C does not have to be filed with an individual's personal income tax forms. It should be reviewed carefully by the recipient and saved for reference.
  • Some individuals will receive a 1095-C from his or her employer and one or more 1095-B from his or her health insurance carrier. (If an individual switched coverage during the calendar year, he or she will receive a 1095-B for each plan). 

Employers should make sure that employees are aware of the new healthcare reporting requirements and Form 1095, to help them prepare for tax season.

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