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1095-A FAQs

Q: Why did I receive letter 5858 from the IRS requesting information to reconcile advanced payments of the premium tax credit?

You will receive a letter (5858) from the IRS if you received tax credits in 2015 but have not yet filed or reconciled your 2015 federal tax return. If you want to continue getting tax credits in the future, you must correctly file your tax return and attach Form 8962.

Here’s what you need to do if you received this letter:

  • Read the letter carefully.
  • File your 2015 tax return with Form 8962 as soon as possible, even if you don’t normally have to file taxes.
  • Use your 1095-A that you received from Washington Healthplanfinder to complete Form 8962. You can download an electronic copy of your 1095-A from your Washington Healthplanfinder account. If your 1095-A is not available, call our Customer Support Center.
  • If you have already filed your 2015 tax return with Form 8962, disregard the letter.

Read more about what to do if you received letter 5858 from the IRS.

Q: What are Health Insurance Premium Tax Credits (HIPTC), Premium Tax Credits (PTC), or Advanced Premium Tax Credits (APTC)?

Health insurance premium tax credits (or premium tax credits) can be used to lower the health insurance premium costs of Washington Healthplanfinder Qualified Health Plans. If you qualified when you applied through Washington Healthplanfinder, you could either reduce the amount of your monthly health insurance premium (advanced premium tax credits), or get all of the tax credit as a lump sum when you file your annual tax return.

Advanced premium tax credits are paid by the IRS directly to the health insurance company that provides your health coverage.

If you or another member of your household received any advanced payments of premium tax credits, you must file a federal income tax return.

Q: Who will receive a 1095-A from Washington Healthplanfinder?

Only customers enrolled in a Qualified Health Plan will receive a 1095-A. People who were enrolled in more than one plan will get a 1095-A for each plan. Enrollees in catastrophic health plans and those with Washington Apple Health coverage will not receive a 1095-A. Washington Apple Health enrollees will receive a 1095-B from the Washington State Health Care Authority.

Learn more about the 1095-B.

Q: I signed up for a Qualified Health Plan through Washington Healthplanfinder. What forms will I need to submit with my federal tax return?

If you enrolled in a Qualified Health Plan through Washington Healthplanfinder, you will receive an important tax return document called the 1095-A: Health Insurance Marketplace Statement. You will need to use the information from your 1095-A to complete the IRS Form 8962: Premium Tax Credit.

If you want to claim tax credits as a lump sum or if you took advanced premium tax credits, you must file an income tax return and attach Form 8962. You will need to file your federal taxes using the IRS Form 1040, Form 1040A, or Form 1040NR. You cannot file with Form 1040 EZ.

IMPORTANT! If you don’t file your federal taxes correctly, you may not be eligible to get tax credits in future years!

If you have more questions about this process, please contact a tax professional, broker, your local library, or the IRS. More information can also be found at Affordable Care Act Tax Provisions for Individuals and Families.

Q: What is the IRS Form 8962 and what do I need to do with it?

IRS Form 8962: Premium Tax Credit is used to reconcile the premium tax credit you may have received to lower your monthly premium and determine if you received the right amount. You will use the information on your 1095-A to complete Form 8962.

Q: How can I get my 1095-A?

You will receive a paper version of your 1095-A statement from Washington Healthplanfinder. You can also view or print a digital copy of your 1095-A statement by signing in to your Washington Healthplanfinder online account and clicking “My 1095-A Tax Form” under Quick Links.

Q: I forgot to report a change in my income or my family size (such as, getting married or having a baby) that happened in 2015. What should I do?

After December 31, 2015, Washington Healthplanfinder cannot make changes to your 2015 information. Any change that you forgot to make in 2015 that impacts your tax credits will be addressed on Form 8962 and adjusted on your tax return. You will need to work with the IRS or a tax preparer on any tax-related questions you may have. If this change still applies in 2016, update your application online or by calling the Washington Healthplanfinder Customer Support Center at 1-855-923-4633.

Q: Why does the monthly premium amount on my 1095-A not match the premium amount on the bill I receive 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). Because your 1095-A provides information so you can either claim your premium tax credit as a lump sum or to reconcile the advanced premium tax credit you received each month to help pay for your premium, the form only includes the premium amount that covers essential health benefits. EHB rates range between 97.52% and 100% of your regular monthly premium, depending on your plan. You can find more information about essential health benefits on our Health Plans page or at www.healthcare.gov/coverage/what-marketplace-plans-cover.

Q: What if information is incorrect or missing from my 1095-A?

The most common reasons a 1095-A form would be checked and possibly revised include: coverage effective date errors (start date, termination date, and number of months covered) or incorrect advanced premium tax credit information.

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

Q: I also got a 1095-B and/or 1095-C. How are those different from my 1095-A?

If you or members of your household had coverage in 2015 through other programs or plans other than a Washington Healthplanfinder Qualified Health Plan, you may also get a Form 1095-B (Health Coverage) or Form 1095-C (Employer-Provided Health Insurance Offer and Coverage). Customers enrolled in Washington Apple Health will receive a 1095-B from the Washington State Health Care Authority. Every 1095 form is used to help file your federal taxes, indicating your health coverage throughout the tax year. It’s important to follow the instructions on each of the forms so that you fill out your federal tax return correctly. Washington Healthplanfinder is only responsible for providing 1095-As.

Q: How do I know if I was enrolled in a catastrophic health plan?

If you were enrolled in a catastrophic health plan, you will not receive a 1095-A. Instead, you should check a box on your tax return to confirm that you have minimum essential coverage. Below is a list of the 2015 catastrophic health plans:

  • KP WA Catastrophic 6600/0 (Kaiser)
  • BrideSpan Exchange Catastrophic
  • Group Health – Core Basics Plus Catastrophic Plan

Last updated 4/12/16