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Your 1095-A Statement

An Important Tax Return Document

If you enrolled in a Qualified Health Plan through Washington Healthplanfinder at any time during the year, you’ll receive an important tax return document from Washington Healthplanfinder called the 1095-A: Health Insurance Marketplace Statement.1095-A info-graphic with steps on how to reconcile premium tax credits You can print or save a PDF copy of your 1095-A on your Washington Healthplanfinder account dashboard.

Customers who received minimum essential coverage through Washington Apple Health (Medicaid) will get a 1095-B. Learn more about the 1095-B.

How to Use the 1095-A Form

This form is necessary to file your taxes for the previous year. You’ll use the information from your 1095-A to complete the IRS Form 8962: Premium Tax Credit. Keep your 1095-A form with other important tax information, such as your W-2 forms and other tax records.

You’ll use Form 8962 to compare the amount of tax credit you took in advance during the year to help pay for your monthly premium to your final premium tax credit that you were eligible for. This is called “reconciling.”

Click on the info-graphics below for steps to take once you’ve received your 1095-A:

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What’s on the 1095-A Form?

Your 1095-A statement has three parts:Blank 1095-A statement

  • Part I: Basic information about you, your family, and your health insurance start and end dates.
  • Part II: Information about each member of your “coverage household” – those members of your family also covered under the same health plan.
  • Part III: Information for every month of the year for three items:
    • The monthly premium amount allocated to the 10 Essential Health Benefits of the health plan you selected,
    • The premium amount of the second lowest cost silver plan available through Washington Healthplanfinder (this is used to calculate your premium tax credit), and
    • The advanced premium tax credit paid for you to the health insurance company of your health plan.

Get answers to 1095-A frequently asked questions.