1095 FAQs

If I Have Questions about 1095 Tax Forms:

1095-A |1095-B

1095-A (Other health and dental insurance Members)

The 1095-A is similar to other tax documents that customers commonly receive, like the W-2 and 1099 forms. You will need the 1095-A to file your federal income tax return. This form helps to determine whether you received too much or too little financial assistance paying for your monthly premiums.

Will I receive a 1095-A form?

Customers enrolled in a Qualified Health Plan will receive a 1095-A tax form by early February. If you were enrolled in more than one plan during the year, you’ll get a 1095-A for each plan.

Customers enrolled in a catastrophic health plan will not receive a 1095-A form. If you or a household member used tax credits, you must file a federal income tax return.

To get your 1095-A Form:

  • Sign into your account
  • From the dashboard click on “View 1095 Forms”
  • Or go to your Message Center

If you need to request a correction to your 1095-A, fill out a correction request online.

If you are having trouble viewing your Washington Healthplanfinder messages, including your 1095-A, try updating your internet browser or using a different browser (for example, Chrome).

Understand your 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

Correcting information that is incorrect or missing from your 1095-A:

The most common reasons a 1095-A needs to be updated include:

  • Incorrect coverage dates (start date, end date, number of months covered, etc.)
  • Incorrect tax credit amount

If you think there’s an error on your 1095-A, submit a correction request online.

If you need to update household size, such as getting married or having a baby, can be updated using Form 8962. If your household size is the same as last year, make sure to report the change on your application so your eligibility stays up to date.

Why is the premium amount on my 1095-A different from the premium amount on the bill I get from my insurance company every month?

Premium tax credits can only be used for benefits that are considered essential health benefits (or “EHB”) and may not be used for benefits that are not considered EHB (such as acupuncture).

Your 1095-A provides information so you can either claim your tax credits as a lump sum or to reconcile the tax credits you received in advance each month to help pay for your premium. Because of this, the form only includes the premium amount that covers essential health benefits. EHB rates range between 96.55% and 100% of your monthly premium, depending on your plan.

What about Qualified Dental Plans?

  • For Qualified Dental Plans, only the premium for pediatric dental benefits for enrollees under the age of 19 is reported on the 1095-A.
  • If an enrollee turns 19 mid-month, the 1095-A will show their full premium for that month, but will not reflect the premium after that month.
  • The Qualified Dental Plan premium for adults will not be reflected on the 1095-A, because they are not considered Essential Health Benefits according to the guidelines of the IRS for reporting premiums.

1095-B (Free or low-cost Washington Apple Health Members)

The 1095-B is a tax form verifying you or your household member received free or low-cost Apple Health coverage for one or more months of the last tax year. This form will list all those enrolled in Washington Apple Health coverage. You do not need your 1095-B to file your taxes. You do not need to return this form to the Washington State Health Care Authority.

To access your 1095-B tax form, sign in to your Washington Healthplanfinder account. From the dashboard, click “View 1095 Forms” to view or download your 1095-B form. You can find more information on 1095-B at Health Care Authority or call 1-800-562-3022.

To get your 1095-B Form:

  • Sign in to your account
  • From the dashboard click on “View 1095 Forms”

If you do not have an account, you can create an account to view or download your 1095-B tax form.

For individuals who are aged, blind, disabled or in need of long-term services and receiving Apple Health coverage:

  • Request your copy online using the Washington Apple Health web form (click ‘Client’ and select ‘1095-B” from the drop-down menu), or
  • Call the Medical Assistance Customer Service Center at 1-800-562-3022.