Tax forms 1095-A, 1095-B, and 1095-C are used to report various aspects of health coverage to enrollees and the IRS. These forms include, among other things, information about Marketplace premium tax credits and individuals who are covered by or offered employer-sponsored health insurance. Whether you receive any type of Form 1095 – and if so, which one you receive – will depend on the type of coverage you have.
If you have questions about your own tax forms or circumstances, consult a tax advisor or the Volunteer Income Tax Assistance Program.
Form 1095-A: From the health insurance Marketplace
If you had coverage through the health insurance Marketplace (exchange) at any time during the prior year, you and the IRS will receive Form 1095-A from the Marketplace in January or February. The form will come from HealthCare.gov or a state-based Marketplace, depending on the state. You can also access it electronically, via your Marketplace account. Form 1095-A will show:
- Which members of your household were covered, and for which months of the year,
- The premium of your Marketplace plan,
- The premium of the second-lowest-cost Silver plan (benchmark plan) in your area,
- If applicable, the amount of premium subsidy (advance premium tax credit, APTC) that was paid to your insurer on your behalf
If you notice any errors on the Form 1095-A that you receive, you should contact the health insurance Marketplace and ask for a corrected form.
If any APTC was paid on your behalf – or if you want to claim the premium tax credit on your tax return – you cannot file your tax return without Form 1095-A.[0] (Most Marketplace enrollees – 93% in 2024[1] – receive advance premium tax credits, and thus need Form 1095-A to file their tax return.)
You will use Form 8962 to reconcile your advance premium tax credit or claim the full premium tax credit. You will need the information on Form 1095-A to complete Form 8962. But only Form 8962 will be attached to your tax return; you’ll keep Form 1095-A with your tax records.
Form 1095-B: From small employers, off-exchange plans, Medicaid, Medicare
If you bought individual coverage outside the exchange, were enrolled in a small employer’s health plan, or had Medicaid or Medicare coverage, you might receive Form 1095-B, showing the months you were covered and the entity that provided the coverage.
Form 1095-B served as proof of coverage between 2014 and 2018, when there was a federal penalty for not having minimum essential coverage. But that penalty was eliminated as of 2019, so Form 1095-B is no longer necessary the way it once was – unless you’re in California, New Jersey, Rhode Island, Massachusetts, or DC, where penalties for not having health coverage are still assessed on state tax returns.
Because there is no longer a federal penalty for being without coverage and because most people in the U.S. no longer need to prove that they have health coverage, some entities no longer send Form 1095-B to enrollees unless they request it.[2]
Form 1095-C: From large employers
If you worked full-time (30+ hours per week) for a large employer – meaning 50 or more full-time equivalent employees[3] – you and the IRS will receive Form 1095-C from the employer in January or February.[4]
Form 1095-C shows whether the employer offered health coverage (via a plan the employer purchased from an insurance company, a self-insured plan, or an ICHRA) that was considered affordable and that provided minimum value, and also whether the employee enrolled in that coverage or declined the offer.
In most cases, Form 1095-C is used by the IRS to ensure that large employers are complying with the Affordable Care Act’s employer mandate, which requires large employers to offer health coverage or pay a penalty. If you enrolled in your employer’s health plan – or if you declined the coverage and didn’t obtain subsidized Marketplace coverage – you generally don’t need Form 1095-C to file your taxes.
But if you declined your employer’s coverage offer and enrolled in a plan with APTC through the Health Insurance Marketplace, you’ll need both Form 1095-A and Form 1095-C to file your taxes. To be allowed to keep APTC that was paid on your behalf (meaning you don’t have to repay it to the IRS when you file your tax return), you’ll need to show the IRS that your employer’s coverage offer was unaffordable and/or didn’t provide minimum value.
Which Form 1095 will I receive?
This will depend on the type of coverage you had during the prior year. And as noted above, you may not receive any Form 1095 if you weren’t a full-time employee of a large employer or covered by a Marketplace plan.
It’s also possible that you could receive more than one form. For example, if you worked full-time for a large employer for the first six months of the year but then quit your job and switched to a Marketplace plan for the second half of the year, you’ll receive Form 1095-C and Form 1095-A early the following year.
As noted above, you would also receive both Form 1095-A and Form 1095-C if you were offered coverage from a large employer but declined it and enrolled in a Marketplace plan instead. If you receive both of these forms applicable to the same months of the year and the Form 1095-A shows that you received APTC, you should consult with a tax advisor to make sure that your APTC is reconciled correctly.
Any Forms 1095 that you receive are also sent to the IRS, so they have the same information that you have.
IHC Specialty Benefits, Inc. is not a tax professional. This article has been prepared for general informational purposes only. You should consult a tax advisor for assistance with your own circumstances, including tax-related issues.
