Helping Your Clients With Their Health Care Tax Forms

Your Covered California insureds can now access their health care tax forms by visiting the “Documents and Correspondence” section of their online Covered California web account. All health plan members should also have received a hard copy of Form 1095-A by mail. 

1095-A Form

The form shows the amount paid to the member’s health plan in 2015 by the federal government to help with the costs of health coverage. The amount paid is based on income information and household size reported by the individual. 

If the member’s income changed during the year, the member may have paid too much or too little for health coverage. Checking Form 1095-A against their actual income is important. 

If the member enrolled in L.A. Care through Covered California but did not receive premium tax credits, also known as advanced premium tax credits (APTC) or a “subsidy,” the member will still receive Form 1095-A from Covered California to show what months the individual had health insurance.

Form 1095-A is similar to a W-2 form, which an employer provides to report income. Form 1095-A helps determine taxes owed or refundable. The member uses Form 1095-A to fill out IRS Form 8962. The IRS uses Form 8962 to “reconcile” the tax credits the health plan received based on the individual’s estimated income with the amount of his or her actual income, as reported on their federal tax return. 

Members should not attach the completed Form 1095-A to their tax return. It should be kept with their tax records. For more details about Form 1095-A visit the IRS and Covered California websites.

If your client did not receive Form 1095-A in the mail or through their Covered California account, they can contact Covered California at 800.300.1506.

Tax filing requirements for the health care law are the same as last year. They require all individuals who enrolled in coverage through Covered California to file a tax return and reconcile any advance payments of the premium tax credit that may have been paid on their behalf. 

Medi-Cal members will receive a different form, 1095-B. These individuals, who have low incomes, have different tax filing requirements. If they do not have enough income to require paying income taxes, they do not have to file a return simply because they received Form 1095-B.  

The amount of income earned requiring the filing of a federal income tax return varies according to age and marital status. In general, a single individual under 65 years old must file a tax return if they earned more than $10,300 in wages during 2015.