Instructions for IRS Form 1095-a - Health Insurance Marketplace Statement 2018

September 18, 2018 "Instructions For Irs Form 1095-a - Health Insurance Marketplace Statement" contain the latest filing requirements for the IRS-issued Form 1095-A. Download your copy of the instructions by clicking the link below.

IRS Form 1095-A is a tax form issued by the United States Internal Revenue Service.

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2018
Department of the Treasury
Internal Revenue Service
Instructions for Form 1095-A
Health Insurance Marketplace Statement
Section references are to the Internal Revenue Code
Statements to Individuals
unless otherwise noted.
Furnishing required information to the individual.
Future Developments
Marketplaces use Form 1095-A to furnish the required
statement to recipients. A separate Form 1095-A must be
For the latest information about developments related to
furnished for each policy and the information on the Form
Form 1095-A and its instructions, such as legislation
1095-A should relate only to that policy. If two or more tax
enacted after they were published, go to
IRS.gov/
filers are enrolled in one policy, each tax filer receives a
Form1095A.
statement reporting coverage of only the members of that
Additional Information
tax filer's tax family (a tax family may include the tax filer,
the tax filer’s spouse if the tax filer is filing a joint return
For information related to the Affordable Care Act, visit
with his or her spouse, and the tax filer’s dependents).
IRS.gov/Affordable-Care-Act.
See the instructions for line 4 for more information about
For additional information related to Form 1095-A, visit
who is a recipient. Don't furnish a Form 1095-A for a
IRS.gov/Affordable-Care-Act/Individuals-And-Families/
catastrophic health plan or a stand-alone dental plan. See
Health-Insurance-Marketplace-Statements.
the instructions for Part III, column A.
On Form 1095-A statements furnished to recipients,
General Instructions
filers of Form 1095-A may truncate the social security
number (SSN) of an individual receiving coverage by
Purpose of Form
showing only the last four digits of the SSN and replacing
the first five digits with asterisks (*) or Xs. Truncation isn't
Form 1095-A is used to report certain information to the
allowed on forms filed with the IRS.
IRS about individuals who enroll in a qualified health plan
through the Health Insurance Marketplace. Form 1095-A
Statements must be furnished to recipients on paper by
also is furnished to individuals to allow them to take the
mail, unless a recipient affirmatively consents to receive
premium tax credit, to reconcile the credit on their returns
the statement in an electronic format. If mailed, the
with advance payments of the premium tax credit
statement must be sent to the recipient’s last known
(advance credit payments), and to file an accurate tax
permanent address, or if no permanent address is known,
return.
to the recipient’s temporary address.
Consent to furnish statement electronically. The
Who Must File
requirement to obtain affirmative consent to furnish a
Health Insurance Marketplaces must file Form 1095-A to
statement electronically ensures that statements are sent
report information on all enrollments in qualified health
electronically only to individuals who are able to access
plans in the individual market through the Marketplace. Do
them. A recipient may provide his or her consent on paper
not file a Form 1095-A for a catastrophic health plan or a
or electronically, such as by e-mail. If consent is provided
separate dental policy (called a “stand-alone dental plan”
on paper, the recipient must confirm the consent
in these instructions).
electronically. An electronic statement may be furnished
by e-mail or by informing the recipient how to access the
When To File
statement on a Marketplace’s website (for example, in the
File the annual report with the IRS and furnish the
recipient's Marketplace account).
statements to individuals on or before January 31, 2019,
for coverage in calendar year 2018.
Specific Instructions
The requirement to furnish a statement to individuals
will be met if the Form 1095-A is properly addressed and
Part I—Recipient Information
mailed or furnished electronically (if the recipient has
consented to electronic receipt) on or before the due date.
Line 1. Enter the Marketplace state name or
If the regular due date falls on a Saturday, Sunday, or
abbreviation.
legal holiday, furnish the statement by the next business
Line 2. Enter the number the Marketplace assigned to
day. A business day is any day that isn't a Saturday,
the policy. If the policy number is greater than 15
Sunday, or legal holiday.
characters, enter only the last 15 characters.
How To File
Line 3. Enter the name of the issuer of the policy.
Electronic filing. You must submit the information to the
Line 4. Enter the name of the recipient of the statement.
IRS electronically. Submit the information through the
This should be the person identified at enrollment as the
Department of Health and Human Services Data Services
tax filer (the person who is expected to file a tax return, to
Hub.
Sep 05, 2018
Cat. No. 63016Q
2018
Department of the Treasury
Internal Revenue Service
Instructions for Form 1095-A
Health Insurance Marketplace Statement
Section references are to the Internal Revenue Code
Statements to Individuals
unless otherwise noted.
Furnishing required information to the individual.
Future Developments
Marketplaces use Form 1095-A to furnish the required
statement to recipients. A separate Form 1095-A must be
For the latest information about developments related to
furnished for each policy and the information on the Form
Form 1095-A and its instructions, such as legislation
1095-A should relate only to that policy. If two or more tax
enacted after they were published, go to
IRS.gov/
filers are enrolled in one policy, each tax filer receives a
Form1095A.
statement reporting coverage of only the members of that
Additional Information
tax filer's tax family (a tax family may include the tax filer,
the tax filer’s spouse if the tax filer is filing a joint return
For information related to the Affordable Care Act, visit
with his or her spouse, and the tax filer’s dependents).
IRS.gov/Affordable-Care-Act.
See the instructions for line 4 for more information about
For additional information related to Form 1095-A, visit
who is a recipient. Don't furnish a Form 1095-A for a
IRS.gov/Affordable-Care-Act/Individuals-And-Families/
catastrophic health plan or a stand-alone dental plan. See
Health-Insurance-Marketplace-Statements.
the instructions for Part III, column A.
On Form 1095-A statements furnished to recipients,
General Instructions
filers of Form 1095-A may truncate the social security
number (SSN) of an individual receiving coverage by
Purpose of Form
showing only the last four digits of the SSN and replacing
the first five digits with asterisks (*) or Xs. Truncation isn't
Form 1095-A is used to report certain information to the
allowed on forms filed with the IRS.
IRS about individuals who enroll in a qualified health plan
through the Health Insurance Marketplace. Form 1095-A
Statements must be furnished to recipients on paper by
also is furnished to individuals to allow them to take the
mail, unless a recipient affirmatively consents to receive
premium tax credit, to reconcile the credit on their returns
the statement in an electronic format. If mailed, the
with advance payments of the premium tax credit
statement must be sent to the recipient’s last known
(advance credit payments), and to file an accurate tax
permanent address, or if no permanent address is known,
return.
to the recipient’s temporary address.
Consent to furnish statement electronically. The
Who Must File
requirement to obtain affirmative consent to furnish a
Health Insurance Marketplaces must file Form 1095-A to
statement electronically ensures that statements are sent
report information on all enrollments in qualified health
electronically only to individuals who are able to access
plans in the individual market through the Marketplace. Do
them. A recipient may provide his or her consent on paper
not file a Form 1095-A for a catastrophic health plan or a
or electronically, such as by e-mail. If consent is provided
separate dental policy (called a “stand-alone dental plan”
on paper, the recipient must confirm the consent
in these instructions).
electronically. An electronic statement may be furnished
by e-mail or by informing the recipient how to access the
When To File
statement on a Marketplace’s website (for example, in the
File the annual report with the IRS and furnish the
recipient's Marketplace account).
statements to individuals on or before January 31, 2019,
for coverage in calendar year 2018.
Specific Instructions
The requirement to furnish a statement to individuals
will be met if the Form 1095-A is properly addressed and
Part I—Recipient Information
mailed or furnished electronically (if the recipient has
consented to electronic receipt) on or before the due date.
Line 1. Enter the Marketplace state name or
If the regular due date falls on a Saturday, Sunday, or
abbreviation.
legal holiday, furnish the statement by the next business
Line 2. Enter the number the Marketplace assigned to
day. A business day is any day that isn't a Saturday,
the policy. If the policy number is greater than 15
Sunday, or legal holiday.
characters, enter only the last 15 characters.
How To File
Line 3. Enter the name of the issuer of the policy.
Electronic filing. You must submit the information to the
Line 4. Enter the name of the recipient of the statement.
IRS electronically. Submit the information through the
This should be the person identified at enrollment as the
Department of Health and Human Services Data Services
tax filer (the person who is expected to file a tax return, to
Hub.
Sep 05, 2018
Cat. No. 63016Q
claim other family members as dependents, and who, if
benefits. If a covered individual is enrolled in a
qualified, would take the premium tax credit for the year of
stand-alone dental plan, include the portion of the
coverage for his or her tax family). If the tax filer can't be
premiums for the stand-alone dental plan that is allocable
identified from the information provided at enrollment (for
to pediatric dental coverage in the total monthly
example, because no financial assistance was
enrollment premiums. If more than one Form 1095-A is
requested), enter the name of the primary applicant for the
filed for coverage of the recipient’s family for the same
coverage.
months, because, for example, a family member enrolled
in a separate policy, include the portion of the premium for
Line 5. Enter the social security number (SSN) for the
pediatric dental coverage in the amount in column A on
recipient shown on line 4.
only one Form 1095-A. If more than one tax filer is
Line 6. Enter the recipient’s date of birth only if line 5 is
enrolled in a policy, report on each tax filer's Form 1095-A
blank.
only those enrollment premiums allocated to that tax filer.
If a policy is terminated by an issuer for nonpayment of
Lines 7, 8, and 9. Enter information about the recipient’s
premiums, enter -0- for a month in which the covered
spouse, if any, if advance credit payments were made for
individuals have coverage but the premiums aren't fully
the coverage. Enter this information even if the advance
paid (generally, the first month of a grace period). If one or
credit payments weren't made for the spouse's coverage.
more covered individuals terminate coverage before the
Enter a date of birth only if line 8 is blank.
last day of a month, the amount reported in this column
Line 10. Enter the date that coverage under the policy
should not include any amount of the monthly enrollment
started. If the policy was in effect at the start of the year,
premium that was refunded.
enter 1/1/2018.
Column B. Enter the premiums for the applicable second
Line 11. Enter the date of termination if the policy was
lowest cost silver plan (SLCSP) that was used as a
terminated during the year. If the policy was in effect at the
benchmark to compute monthly advance credit payments.
end of the year, enter 12/31/2018.
If advance payments were made, the applicable SLCSP
for a month is the SLCSP that applies to individuals in Part
Lines 12–15. Enter the recipient's address.
II who were identified at enrollment as members of the tax
Part II—Covered Individuals
filer's tax family (the tax filer, the tax filer's spouse if the tax
filer is filing a joint return with his or her spouse, and any
Enter on lines 16 through 20 and columns A through E
dependents of the tax filer) and who are enrolled in the
information for each individual covered under the policy,
coverage on the first day of the month and aren't eligible
including the recipient and the recipient's spouse, if
for other health coverage for that month. However, if an
covered. If advance credit payments weren't made for any
individual enrolls in coverage and the enrollment is
coverage under the policy and a tax family can't be
effective on the date of the individual's birth, adoption,
identified, enter in Part II information for all covered
placement in foster care, or on the effective date of a court
individuals. If advance credit payments were made for the
order, the individual should be considered to have
coverage or a tax family can be identified, enter in Part II
enrolled on the first day of the month for purposes of the
information only for covered individuals whom the tax filer
applicable SLCSP premium reported in column B. If all
certified at enrollment would be a part of the tax filer's tax
covered individuals enroll after the first of the month, and
family. Information about individuals enrolled in the same
no individual's coverage is effective on the date of the
policy as the tax filer’s tax family who aren't members of
individual's birth, adoption, placement in foster care, or on
that tax family, including children, must be reported on a
the effective date of a court order, enter -0- in column B
separate Form 1095-A.
for that month. If more than one Form 1095-A is filed for
For each line, enter a date of birth in column C only if
coverage of a tax filer’s family for the same month (for
column B is blank. Enter in column D the date the
example, because members of the family were split
coverage started for the individual. Enter in column E the
among several policies), enter the SLCSP premium that
date of termination if the individual's coverage was
applies to all the family members who were enrolled in any
terminated during the year. If the coverage was in effect at
policy on the first of the month and who were not eligible
the end of the year, enter 12/31/2018.
for other health coverage for that month. Enter this SLCSP
premium in column B on each Form 1095-A.
If there are more than 5 covered individuals,
In some cases, the information provided at enrollment
complete one or more additional Forms 1095-A,
TIP
may not indicate which covered individuals are members
Part II.
of the recipient's family and are not eligible for other health
coverage. (Such information may not be provided, for
Part III—Coverage Information
example, because no financial assistance was
Enter information in Part III, lines 21 through 32, for each
requested.) If this is the case, and if the Marketplace has
month of coverage. This information is determined on a
provided a tool for determining the applicable SLCSP
monthly basis and may change during the year if there is a
premium for the year of coverage at the time of filing the
change in enrollment or other circumstances that affect
tax return, leave column B blank. If the Marketplace has
eligibility for or the amount of the premium tax credit. Total
not provided a tool for determining the applicable SLCSP
the amounts on lines 21 through 32 and enter on line 33.
premium, enter the premiums for the SLCSP that would
apply to all individuals identified in Part II as covered for
Column A. Enter the total monthly enrollment premiums
the month.
for the policy in which the covered individuals enrolled.
Include only the premiums allocable to essential health
-2-
Instructions for Form 1095-A (2018)
If a policy is terminated by an issuer for nonpayment of
Privacy Act and Paperwork Reduction Act Notice.
premiums and advance credit payments are made,
We ask for the information on this form to carry out the
enter -0- for a month in which the covered individuals
Internal Revenue laws of the United States. You are
have coverage but the premiums aren't paid (generally,
required by the Internal Revenue Code to give us the
the first month of a grace period). However, if an individual
information. We need it to ensure that taxpayers are
enrolled on the first day of a month terminates coverage
complying with these laws and to allow us to figure and
before the last day of the month, the individual should be
collect the right amount of tax.
considered to have been enrolled for the entire month for
purposes of the applicable SLCSP premium reported in
You aren't required to provide the information
column B.
requested on a form that is subject to the Paperwork
Reduction Act unless the form displays a valid OMB
Column C. Enter the amount of advance credit payments
control number. Books or records relating to a form or its
for the month. If more than one Form 1095-A is filed for
instructions must be retained as long as their contents
coverage of a tax filer’s family for the same months, enter
may become material in the administration of any Internal
only the advance credit payment amount allocated to the
Revenue law. Generally, tax returns and return
policy reported on this Form 1095-A. If the tax filer’s family
information are confidential, as required by IRC section
also is enrolled in a stand-alone dental plan, any advance
6103.
credit payments allocated to the stand-alone dental plan
should be added to the advance credit payments
The time needed to complete and file this form will vary
allocated to one of the policies reported on a Form
depending on individual circumstances. The estimated
1095-A.
average time is:
Void Statements
Preparing the form
.3 min.
. . . . . . . . . . . .
If a Form 1095-A was sent for a policy that shouldn't be
reported on a Form 1095-A, such as a stand-alone dental
plan or a catastrophic health plan, send a duplicate of that
If you have comments concerning the accuracy of
Form 1095-A and check the void box at the top of the
these time estimates or suggestions for making this form
form. Provide this information to the IRS and to the
simpler, we would be happy to hear from you. You can
recipient of the statement as soon as possible after
send us comments from IRS.gov/FormComments. Or you
discovering that the statement was sent in error.
can write to the Internal Revenue Service, Tax Forms and
Publications Division, 1111 Constitution Ave. NW,
Correction to Information Reported
IR-6526, Washington, DC 20224. Don't send the form to
Report corrected information on the Form 1095-A to the
this office.
IRS and to the recipient as soon as possible after
discovering that information reported is incorrect. Check
the corrected box on the top of the form.
-3-
Instructions for Form 1095-A (2018)

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