Reform Alerts - News from the Blues' Office of Health Reform

IRS Form 1095-A Marketplace coverage reporting

Updated on March 3, 2015 in this alert: Marketplace Form 1095-A may be reissued due to incorrect information

February 10, 2015

On Jan. 12, 2015, the Centers for Medicare and Medicaid Services (CMS) issued a series of FAQs related to IRS Form 1095-A. The Form 1095-A will be sent to individuals enrolled in 2014 health coverage on the Health Insurance Marketplace.

Consumers will use the information included on Form 1095-A to complete Form 8962, Premium Tax Credit (PTC), and to assist them in answering the question on Form 1040, 1040A, or 1040EZ about satisfaction of the Affordable Care Act’s individual shared responsibility provision. Consumers can file Form 8962 with their tax returns if they want to claim the premium tax credit or if they received premium assistance through advance credit payments made to their insurance provider.

The Marketplace will mail Form 1095-A to the policyholder's last known address provided to the Marketplace and upload Form 1095-A to each consumer’s online account.

All enrollees on the Marketplace will receive a Form 1095-A regardless of whether members of the household received financial assistance. Each member of a tax household, who is on the same policy, will be listed together on one Form 1095-A.

The Marketplace will not provide Form 1095-A to consumers who were enrolled in only catastrophic coverage or stand-alone dental plan because they do not qualify for the Premium Tax Credit.

Enrollees are encouraged to check the accuracy of the data on their Form 1095-A such as coverage start and end dates. If a discrepancy is noted, enrollees should contact the Marketplace Call Center at 1-800-318-2596.

Where can I find more information?

More information can be found at

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.