If anyone in a client’s household had a Marketplace plan in 2025, the client should receive Form 1095-A, Health Insurance Marketplace® Statement, by mail no later than mid-February.
This form comes from the Marketplace, not the Internal Revenue Service (IRS). It may be available in the client’s Marketplace account anytime from mid-January to February 1.
Agents should ensure clients have their Form 1095-A before they file. Advise clients to keep their 1095-A forms with their important tax information, like W-2 forms and other records.
Agents should advise clients not to file their taxes until they have an accurate 1095-A.
What’s on Form 1095-A and why it’s needed
The 1095-A includes information about Marketplace plans any member of the client’s household had in 2025, including:
Premiums paid
Premium tax credits used
A figure called “second lowest cost Silver plan” (SLCSP)
If a client had Marketplace coverage but didn’t use the premium tax credit, the form will still reflect enrollment details.
Clients (or their tax preparers) will use information from the 1095-A to fill out tax Form 8962, Premium Tax Credit. This is how they “reconcile” — determine whether there is any difference between the premium tax credit used and the amount they qualify for.
Check that the 1095-A is correct
Agents should remind clients to carefully read the instructions on the back.
Advise clients to make sure the form is correct. If anything about coverage or household information is wrong, instruct them to contact the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325).
Agents should also remind clients to verify that the information about the second lowest cost Silver plan (SLCSP) is correct.
If a client believes their “monthly enrollment premium” is wrong, they should contact the Marketplace.
How to know if the second lowest cost Silver plan information is correct
Review Part III, Column B of the 1095-A, titled “Monthly second lowest cost silver plan (SLCSP) premium.” It should show figures for each month any household member had a Marketplace plan.
The SLCSP premium is incorrect if:
Part III, Column B has a “0” or is blank for any month someone in the household had a Marketplace plan
The client had household changes that were not reported to the Marketplace — such as having a baby, moving, getting married or divorced, or losing a dependent
If either situation applies, advise the client to use the Marketplace tax tool to obtain the correct SLCSP premium.
How agents can guide clients to find the 1095-A online
Instruct clients to:
Log into their Marketplace account and select their 2025 application (not their 2026 application)
Select “Tax Forms” from the menu
Under “Your Form 1095-A,” select “Download PDF”
If a form has a “Corrected” status, download and use the corrected version instead of any previous version
Clients will use the information from the 1095-A to reconcile on Form 8962, Premium Tax Credit.
FAQs
Will I receive any health care tax forms every year to help me complete my tax return?
By early February, you may receive one or more forms providing information about the health care coverage that you had or were offered during the previous year. Much like Form W-2 and Form 1099, which include information about the income you received, these health care forms provide information that you may need when you file your individual income tax return. Like Forms W-2 and 1099, these forms will be provided to the IRS by the entity that provides the form to you.
The forms are:
Form 1095-A: Health Insurance Marketplace Statement (For those who purchased health insurance through the online Marketplace)
The Health Insurance Marketplace (Marketplace) sends this form to individuals who enrolled in coverage there, with information about the coverage, who was covered, and when.
Form 1095-B: Health Coverage. Health insurance providers (Provided by insurers to report that you had minimum essential coverage, ) send this form to individuals they cover, with information about who was covered and when.
Form 1095-C: Employer-Provided Health Insurance Offer and Coverage. Certain employers send this form to certain employees, with information about what coverage the employer offered. Employers that offer health coverage referred to as “self-insured coverage” send this form to individuals they cover, with information about who was covered and when.
Why would a client receive more than one 1095-A?
This may occur if:
The client changed Marketplace plans during the year
The client updated their application (adding/removing a family member or moving), resulting in a new enrollment
Different household members had different plans
There were more than 5 members on the same plan
If a client believes they are missing a 1095-A or notice incorrect information, advise them to contact the Marketplace Call Center.
What if a client paid full price for a Marketplace plan?
They will still receive a 1095-A. Part III, Column C should be blank or show “0.”
If the client wants to determine eligibility for a premium tax credit based on final income, they should complete Form 8962. If they do not qualify, they are not required to include Form 8962 when filing taxes.
What if a client had a Marketplace plan for part of the year?
The 1095-A should include information only for the months the client had Marketplace coverage. If information appears incorrect, advise the client to contact the Marketplace Call Center.
What if a client receives a corrected 1095-A after filing?
They may need to file an amended tax return using the corrected information.
How can a client find a 1095-A for a previous year?
Instruct the client to select the application for the year needed, then select “Tax Forms” to retrieve that year’s 1095-A.
Why would my client not receive a 1095-A?
Clients will not receive Form 1095-A unless they or someone in their household had Marketplace coverage for all or part of 2025.
Who will receive a Form 1095-B or 1095-C?
IRS Form 1095-C is used by employers with at least 50 full-time workers to report employer health plan coverage. IRS Form 1095-B, on the other hand, is mailed by the NC Department of Health and Human Services to report Medicaid or Health Choice health insurance coverage.