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Your Health

Health coverage tax forms are coming. What do you need to do with them?

Jan 24 2017
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If you had qualifying U.S. health coverage in 2016, a tax Form 1095 will hit your mailbox in 2017. Why are you getting the form, and do you need it to file your taxes?

You’ll get Form 1095-A, B or C from your insurer, your employer or the government, depending on the kind of plan you had. Some people may even get two forms, one from their employer and one from their insurer. And if you switched coverage during the year, you will get one or more forms for each of your plans.f1095b-1

So what is it? Form 1095 tells the government that you had qualifying health coverage, also called minimum essential coverage. This is important, because people who don’t have qualifying coverage for each month or don’t qualify for an exemption could have to make a shared responsibility payment under the Affordable Care Act. Insurers and employers have to report this information to the government for each person covered under their plans. They have to send their plan members — that’s you — a copy of the form as well. The IRS uses information from these forms to confirm who had health coverage.

Note: The form you get will likely have only partial Social Security numbers. That’s not a mistake; it’s to protect your private information. If your Social Security number is missing entirely, contact your health plan and give it to them. They need to give your Social Security number to the government so it’s clear that you had coverage and you don’t have to pay a tax penalty.

Have a health plan from a marketplace? You need these forms

If you bought your health insurance on one of the public exchanges or marketplaces, you’ll need Form 1095-A when you file your taxes. Your form will come from the government by early February. Check to make sure it’s accurate, and keep it safe with the rest of your tax documents. If your plan covered other family members, and they file their taxes separately, give them a copy for their tax returns too.

Read and follow the instructions on Form 1095-A carefully, or check with your tax advisor to understand what you need to do. If your 2016 income is different from what you predicted when you got coverage, and you got a subsidy or premium tax credit for your coverage, it can affect how much you owe in taxes or get in a refund.

Everyone else: just check the forms and file them away.

If you had health insurance in 2016 through an employer, Medicare or Medicaid, or you bought it directly from an insurance company outside the public exchanges, you won’t need the 1095 form to file your taxes. You can just check a box on your tax returns saying you had qualifying health coverage. You’ll just have a copy of the 1095 to keep with your tax documents which serves as proof that you had qualifying health coverage.

So which form will you get? If you are in an insured plan, Form 1095-B will come from your health plan. However, many of the country’s largest employers, and even some smaller ones, offer self-funded plans where the employer pays the claims, with a third party (such as Aetna) administering the plan for them. If your plan comes from one of these employers, the employer will send you Form 1095-C. You’ll also get a Form 1095-C if the employer has 50 or more employees, which means some people will get two forms with the same basic information on them. Employers and insurers will have until March 2, 2017, to send out the 2016 forms to individuals.

For Aetna members, Form 1095-B will be mailed, unless the subscriber consents to receiving it electronically.

Remember to make sure your information is correct

Regardless of whether you need the form to file your taxes, you should still check to make sure the information is right. Did your plan cover the people listed, for the months stated? If it seems like any of the information is wrong, contact the group that sent it. There should be a phone number on the form.

Questions?

Aetna members, call 855-531-6837

For Aetna LEAP members, call 844-241-0208

Coventry members, call 855-531-6839

Innovation Health Leap members for Northern Virginia, call 844-289-4503

Note: this information is not meant as legal or tax advice. Please talk to your legal or tax advisor about any questions.