If anyone in a client's household had an ACA Marketplace plan during the coverage year, the client should receive Form 1095-A, Health Insurance Marketplace Statement, by mail no later than mid-February of the following year. Form 1095-A comes from the Marketplace, not the IRS. It may also be available in the client's Marketplace account beginning in mid-January.
Agents should confirm that clients have their Form 1095-A before they file taxes. Advise clients not to file until they have an accurate Form 1095-A in hand.
What Is on Form 1095-A
Form 1095-A includes information about every ACA Marketplace plan any member of the client's household had during the coverage year, including:
Premiums paid
Advance Premium Tax Credits (APTC) used
The second lowest cost Silver plan (SLCSP) premium for the client's household
If a client had Marketplace coverage but did not use the Premium Tax Credit, Form 1095-A will still reflect their enrollment details.
Clients, or their tax preparers, will use Form 1095-A to complete IRS Form 8962, Premium Tax Credit. Form 8962 is how clients reconcile the difference between the APTC they received during the year and the Premium Tax Credit they are eligible for based on their actual income.
Verify That the 1095-A Is Correct
Agents should remind clients to review Form 1095-A carefully before filing. If anything about coverage or household information appears incorrect, instruct the client to contact the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325).
Agents should specifically advise clients to verify the second lowest cost Silver plan (SLCSP) information in Part III, Column B of Form 1095-A. The SLCSP premium is incorrect if:
Part III, Column B shows a "0" or is blank for any month a household member had Marketplace coverage
The client had household changes during the year that were not reported to the Marketplace, such as a birth, marriage, divorce, move, or loss of a dependent
If either situation applies, advise the client to use the Marketplace tax tool at HealthCare.gov to obtain the correct SLCSP premium before filing.
How to Find Form 1095-A
Form 1095-A is available through two channels: MyMFG and HealthCare.gov. Both are available by January 31 each year. Clients who do not retrieve the form online should expect to receive it by mail no later than mid-February.
Via MyMFG
Select Other from the top navigation panel.
Select EDE ACA Agent Dashboard.
Type the client's name in the filter field to locate their application, then select View Application.
On the client's EDE eligibility page, locate Eligibility Notices on the left-hand side.
Select Fetch Notice. The client's Form 1095-A will be available to view and download from this section.
Tip: You can also reach the client's EDE eligibility page directly from their client profile by selecting the EDE Eligibility tab and clicking View, then continuing from Eligibility Notices as described above.
Via HealthCare.gov
Log into the client's Marketplace account at HealthCare.gov.
Select the application for the coverage year needed — not the current plan year's application.
Select Tax Forms from the menu.
Under Your Form 1095-A, select Download PDF.
If the form has a Corrected status, download and use the corrected version instead of any earlier version.
Frequently Asked Questions
Why would a client receive more than one Form 1095-A?
A client may receive more than one Form 1095-A if:
The client changed Marketplace plans during the year
The client updated their application, such as adding or removing a household member or reporting a move, which resulted in a new enrollment
Different household members were enrolled in different plans
There were more than five members on the same plan
If a client believes they are missing a Form 1095-A or notices incorrect information, advise them to contact the Marketplace Call Center at 1-800-318-2596.
What if a client paid full price for a Marketplace plan?
The client will still receive a Form 1095-A. Part III, Column C should be blank or show "0" since no APTC was applied. If the client wants to determine whether they qualify for a Premium Tax Credit based on their actual annual income, they should complete Form 8962 when filing.
What if a client had a Marketplace plan for only part of the year?
Form 1095-A will include information only for the months the client had ACA Marketplace coverage. If information for any month appears incorrect, advise the client to contact the Marketplace Call Center.
What if a client receives a corrected Form 1095-A after already filing taxes?
The client may need to file an amended tax return using the corrected Form 1095-A information. Advise the client to consult their tax preparer.
How can a client find a Form 1095-A for a previous coverage year?
Using the MyMFG steps above, select the client's application for the coverage year needed. Via HealthCare.gov, instruct the client to log in, select the application for the year needed, and select Tax Forms to retrieve that year's Form 1095-A.
Why would a client not receive a Form 1095-A?
Clients will not receive Form 1095-A unless they or someone in their household had ACA Marketplace coverage for all or part of the coverage year. Clients who enrolled in coverage outside the Marketplace do not receive Form 1095-A.
Additional Resources
For additional help, please contact Producer Support, which is available by chat directly from your account, by phone at (866) 568-9649, or by email at [email protected].