Your 1095-A Statement

An Important Tax Return DocumentSteps to take using 1095-A to file federal tax return

Customers enrolled in a Qualified Health Plan through Washington Healthplanfinder at any time during the year will receive a tax document called the 1095-A: Health Insurance Marketplace Statement.

Customers enrolled in Washington Apple Health (Medicaid) will receive a 1095-B from the Washington State Health Care Authority. Learn more about the 1095-B.

How to Use the 1095-A Form

If you got a 1095-A, you must use it to complete IRS Form 8962: Premium Tax Credit. If you don’t file your taxes correctly and on time, you may not be eligible to get tax credits in future years.

You’ll use Form 8962 to:

  • Figure out the amount of tax credit you’re eligible for, and
  • Reconcile any tax credits you may have used to lower your monthly premium

Get answers to 1095-A frequently asked questions.

What’s on the 1095-A FormBlank 1095-A form?

Your 1095-A has three parts:

  • Part I – Information about you, your family, and your coverage start and end dates.
  • Part II – Information about each household member also covered under the same plan.
  • Part III – Information for every month of the year for three items:
    • The monthly premium amount
    • The premium amount of the second-lowest cost Silver plan available in your area (this is used to calculate your tax credit)
    • The tax credit amount