Reform Alert - News from the Blues' Office of National Health Reform

Proposed rule issued on Marketplace information reporting

July 26, 2013

On June 28, 2013, the IRS released a proposed rule on reporting requirements for the Health Insurance Marketplace. Comments are due September 3.

The Affordable Care Act (ACA) allows for a refundable premium tax credit to help individuals and families purchase individual market health insurance coverage through the Marketplace. The Marketplace will make an advance determination of eligibility for individuals based on information provided at enrollment. Payments will be made monthly to the issuer of the product the individual enrolls in, and must be reconciled on the taxpayer’s income tax return.

The Marketplace must report to the IRS and taxpayers the information required to reconcile the premium tax credits with advance credit payments including:

  1. The level of coverage the individual enrolled in;
  2. Identifying information for the primary insured and each enrollee in the coverage;
  3. The amount of premiums and advance credit payments for the coverage;
  4. Information provided to the Marketplace necessary to determine eligibility for and the amount of the advance credit; and
  5. Other information necessary to determine if a taxpayer has received the appropriate advance credit payments.

Where can I find more information?
More information can be found here.


The information in this document is based on preliminary review of the national health care reform legislation and is not intended to impart legal advice. The federal government continues to issue guidance on how the provisions of national health reform should be interpreted and applied. The impact of these reforms on individual situations may vary. This overview is intended as an educational tool only and does not replace a more rigorous review of the law’s applicability to individual circumstances and attendant legal counsel and should not be relied upon as legal or compliance advice. As required by US Treasury Regulations, we also inform you that any tax information contained in this communication is not intended to be used and cannot be used by any taxpayer to avoid penalties under the Internal Revenue Code.

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