Health Care Reform: Health Insurance Marketplace Statement

Health Care Reform: Health Insurance Marketplace Statement

by Posted on: February 12, 2015Categories: HR & Compliance   

When you buy health insurance coverage in the Marketplace, you may be able to get a premium tax credit (also called a subsidy) that lowers the amount you pay in monthly premiums. Under the Affordable Care Act (ACA), individuals enrolled in Marketplace coverage may be eligible for health premium subsidies if their income falls within a specific range for the number of people in their household. In general, the lower your income is within these ranges, the bigger your credit will be.

If you receive any subsidies, you’ll have to report them to the IRS when you file your federal income taxes. To do this, you’ll have to fill out Form 1095-A, also known as a Health Insurance Marketplace Statement.

Completing a Health Insurance Marketplace Statement is a prerequisite for another form that actually gets filed along with your tax return to claim the premium tax credit.

Getting a Health Insurance Marketplace Statement

If you have Marketplace coverage, you do not need to worry about obtaining a Health Insurance Marketplace Statement by yourself. Both your insurance company and the Marketplace have reported your information on this form to the IRS. You will be sent a Health Insurance Marketplace Statement for each qualified health plan or policy you or your family members are enrolled in. Instructions on how and where to file the form will also be sent.

Filling Out a Health Insurance Marketplace Statement

A Health Insurance Marketplace Statement is a one-page form that consists of three parts: plan information, household information and dollar amounts for your health insurance premium and tax credit.

The first part consists of 15 boxes and includes information about:

  • The specific Marketplace you enrolled through
  • The company that issued your policy
  • Your Marketplace-assigned policy number
  • The start and end date of your policy
  • Personal information for you and your spouse

The second part includes boxes for you to list additional dependents covered under your insurance policy. If you have more than five dependents covered under a policy, you will receive an additional Health Insurance Marketplace Statement.

However, if your Marketplace policy covers individuals who are not your dependents—such as an adult child—you do not need to list them on your Health Insurance Marketplace Statement; they would have to submit their own statement.

The final part of the Health Insurance Marketplace Statement consists of three columns of financial information related to your monthly premiums and tax credits.

  • Column A is the monthly premium cost of the policy in which you are enrolled.
  • Column B is the monthly premium cost of a generic Marketplace plan that will be used as a baseline to determine any tax credits you are eligible for.
  • Column C is the monthly amount of advance credit payments that were made to your insurance company on your behalf.

Some of this section may already be completed for you, depending on whether you have received tax credits in advance.

After completing the Health Insurance Marketplace Statement, follow the instructions on how to file it. Be sure to keep a copy on hand, as you’ll need information from your Health Insurance Marketplace Statement when completing your tax return.


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