That Form 1095-A was sent in error. You shouldn t have received a Form 1095-A for this policy. Don t use the information on this or the Form 8962. Enrollment the individuals who would be in your tax family for the year of coverage Form 1095-A will list all enrolled individuals in Part II on your Form 1095-A. Cat. No. 60703Q Form 1095-A 2023 Instructions for Recipient You received this Form 1095-A because you or a family member enrolled in health insurance coverage through the Health Insurance...Marketplace. Enrolled individuals aren t individuals who would be in your tax family for the year of coverage your Form 1095-A will include coverage information in Part III that is applicable solely to the individuals listed on your Form 1095-A and separately issued Forms 1095-A will include individuals not in your tax family. CAUTION NOT FOR FILING Form 1095-A is provided here for informational purposes only. Health Insurance Marketplaces use Form 1095-A to report information on enrollments in...a qualified health plan in the individual market through the Marketplace. Don t use the information on the original Form 1095-A you received for this policy. Part I. Recipient Information lines 1 15. VOID box. If the VOID box is checked at the top of the form you previously received a Form 1095-A for the policy described in Part I. If there are more than five individuals covered by a policy you will receive one or more additional Forms 1095-A that continue Part II. Go to www*irs*gov/Form1095A...for instructions and the latest information* OMB No* 1545-2232 CORRECTED Recipient Information 1 Marketplace identifier 2 Marketplace-assigned policy number 3 Policy issuer s name 4 Recipient s name 5 Recipient s SSN 6 Recipient s date of birth 7 Recipient s spouse s name 10 Policy start date 11 Policy termination date 12 Street address including apartment no. 13 City or town 14 State or province 15 Country and ZIP or foreign postal code Covered Individuals A. Covered individual name date of...birth D. Coverage start date E* Coverage termination date Coverage Information Month A. Monthly enrollment premiums B. Monthly second lowest cost silver plan SLCSP premium C. Monthly advance payment of premium tax credit 21 January 22 February 23 March 24 April 25 May 26 June 27 July 28 August 29 September 30 October 31 November 32 December 33 Annual Totals For Privacy Act and Paperwork Reduction Act Notice see separate instructions. Additional information* For additional information about the...tax provisions of the Affordable Care Act ACA including the premium tax credit see www*irs*gov/Affordable-Care-Act/Individuals-and-Families or call the IRS Healthcare Hotline for ACA questions 800-919-0452. Part I reports information about you the insurance company that issued your policy and the Marketplace where you enrolled in the coverage. Line 1. This line identifies the state where you enrolled in coverage through the Marketplace. identify the policy in which you enrolled* If you are...completing Part IV of Form 8962 enter this number on line 30 31 32 or 33 box a* Line 3.
pdfFiller is not affiliated with IRS
Get, Create, Make, and Sign IRS 1095-A
Edit your IRS 1095-A online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share your form instantly
Email, fax, or share your IRS 1095-A via URL. You can also download, print, or export forms to your preferred cloud storage service.
Instructions and Help about IRS 1095-A
How to edit IRS 1095-A
How to fill out IRS 1095-A
Instructions and Help about IRS 1095-A
How to edit IRS 1095-A
To edit an IRS 1095-A form, access the document using pdfFiller's editing tools. Make necessary changes to the information, ensuring accuracy to avoid penalties. After editing, save the document for your records or to prepare for submission.
How to fill out IRS 1095-A
Filling out IRS 1095-A requires the taxpayer to provide specific information regarding health coverage purchased through the Health Insurance Marketplace. Follow these steps:
01
Obtain the form from the Health Insurance Marketplace or download it from the IRS website.
02
Enter personal information such as your name, address, and Social Security number.
03
Report the information about the months of coverage and any premium tax credits received.
04
Double-check all entries for accuracy before submission.
About IRS 1095-A 2023 previous version
What is IRS 1095-A?
What is the purpose of this form?
Who needs the form?
When am I exempt from filling out this form?
Components of the form
What are the penalties for not issuing the form?
What information do you need when you file the form?
Is the form accompanied by other forms?
Where do I send the form?
About IRS 1095-A 2023 previous version
What is IRS 1095-A?
IRS 1095-A is a tax form used to report health insurance coverage obtained through the Health Insurance Marketplace. This form is essential for individuals who have received coverage under the Affordable Care Act (ACA) and need to reconcile their premium tax credits when filing their annual tax return.
What is the purpose of this form?
The primary purpose of IRS 1095-A is to provide information to taxpayers about their health insurance coverage for the year. It also assists the IRS in verifying compliance with the ACA requirements and determining eligibility for premium tax credits based on household size and income.
Who needs the form?
Individuals who purchased health insurance through the Health Insurance Marketplace are required to receive and file IRS 1095-A. This includes those who enrolled in coverage for themselves or their dependents during the tax year.
When am I exempt from filling out this form?
Taxpayers do not need to fill out IRS 1095-A if they had qualifying health coverage through another source, such as through an employer or a government program like Medicare or Medicaid. Additionally, those who did not have any form of health coverage for the year are exempt from this requirement as well.
Components of the form
IRS 1095-A contains several key components, including:
01
Identification information for the taxpayer and covered individuals.
02
Information about the months of coverage indicating when the insurance was active.
03
Details on premium amounts and premium tax credits applied.
What are the penalties for not issuing the form?
Failing to issue IRS 1095-A can result in penalties imposed by the IRS, including fines for the issuer and challenges for the recipient when filing their taxes. It may also lead to the taxpayer owing more taxes if premium tax credits were incorrectly claimed without the form.
What information do you need when you file the form?
When filing IRS 1095-A, you will need to provide the following information:
01
Your personal information including name, Social Security number, and address.
02
Details of coverage such as the Marketplace identifier and monthly premium amounts.
03
Information about any premium tax credits you received or were eligible for during the tax year.
Is the form accompanied by other forms?
IRS 1095-A is often accompanied by IRS form 8962, which is used to report reconciling premium tax credits. Filers must complete both forms to accurately reflect their health coverage and to determine their tax credits related to health insurance purchased through the Marketplace.
Where do I send the form?
The completed IRS 1095-A form should be submitted with your federal tax return to the IRS. While it is not necessary to include a paper copy if you are filing electronically, make sure you have it on hand in case the IRS requests it for verification purposes.
FAQ about IRS 1095-A
What should I do if I realize there is a mistake on my submitted IRS 1095-A?
If you find an error on your submitted IRS 1095-A, you should amend it as soon as possible. To do this, you'll need to obtain a new, corrected form and follow the appropriate amendment procedures outlined by the IRS. Make sure to keep a copy of both the original and the corrected forms for your records.
How can I track the status of my IRS 1095-A filing?
To track the status of your filed IRS 1095-A, you can use the IRS online tools or contact their customer service for assistance. Common e-file rejection codes can help you identify any issues, and knowing how to address these can expedite your filing process. Keeping records and confirmations of your submissions is also essential for verification.
Are e-signatures acceptable for filing IRS 1095-A?
Yes, e-signatures are generally accepted for IRS 1095-A filings, provided they meet certain criteria set by the IRS. Make sure that your e-signature system complies with the IRS guidelines to ensure your filing is valid. Proper documentation of consent and signatures is crucial for legal purposes.
What are the common errors to avoid when filing the IRS 1095-A?
Common errors when filing the IRS 1095-A include incorrect taxpayer information, failing to report all required coverage months, and not matching information with IRS records. Double-checking your entries and understanding the reporting requirements can help minimize these mistakes, ensuring accuracy and compliance.
What steps should I take if I receive an audit notice related to my IRS 1095-A?
If you receive an audit notice concerning your IRS 1095-A, promptly gather all necessary documentation and correspondence related to your filing. Respond to the audit request with clear explanations, and consult a tax professional if needed to understand your rights and obligations. Being proactive can help resolve any issues more efficiently.
See what our users say
Read user feedback and try pdfFiller to explore all its benefits for yourself
I CAN EASILY FILL THE FORMS I NEED AND IT IS CHEAPER THAN OTHER PDF VENDORS.
SALIM K
It is sometimes challenging to fill out forms and have everything in place after printing. But overall - good.
Use this catalog to find any type of IRS forms. We've gathered all of them under this section uncategorized to help you to find a proper form faster. Once you spot it on this list, have a look at the versions and schedules you might need as attachments. All returns are available for 2016 and for previous fiscal years.
