Marketplace Coverage and the 1095-A Form ALICE POLLARD NC COMMUNITY HEALTH CENTER ASSOCIATION FEBRUARY 6, 2015

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1 Marketplace Coverage and the 1095-A Form ALICE POLLARD NC COMMUNITY HEALTH CENTER ASSOCIATION FEBRUARY 6, 2015

2 Health Coverage and Federal Tax Return Coverage through the Marketplace in 2014 Other Health Coverage Didn t Have Coverage for All or Part of 2014

3 Premium Tax Credit CBPP: Health Reform Beyond the Basics

4 CBPP: Health Reform Beyond the Basics

5 Reconciling APTC APTC Joe received based on the income he es5mated when he applied for Marketplace coverage vs. Actual amount of PTC Joe is eligible for based on his actual income reported on his 2014 tax return

6 Reconciling APTC If a consumer TOOK LESS advance payments of PTC than the actual credit they re eligible for Consumer will get difference as credit on their tax return If the consumer TOOK MORE advance payments of the premium tax credit than the actual credit they re eligible for Consumer will need to pay either the full difference or a porhon of the difference depending on their income; this amount will be added to their tax bill with their tax return or it will be subtracted from their refund.

7 Repayment Limits for APTC

8 Process for People Who Enrolled in Coverage Through Marketplace 1. The Marketplace will send consumers who enrolled through the Marketplace a new form, the A, which they will need to file their taxes. 2. Consumers should wait to receive the A before filing their taxes. Get A form from Marketplace. Check form A for errors. File taxes and complete necessary forms to reconcile PTC. 3. Once they receive the A form, consumers should check the form for errors. 4. If they note any errors, they should report that to the Marketplace to get a correct form. 5. Once they are sahsfied their form is correct, they can file their taxes. 6. With the informahon of A form, consumer should complete IRS Form 8962: Premium Tax Credit along with other tax return forms. This form will calculate the actual PTC a consumer was eligible for in They may need to take other steps to indicate they are eligible for an exemphon for any months not covered or calculate their shared responsibility payment for months they were uncovered and not exempt.

11 When & how will consumers receive the 1095-A? Marketplace began mailing forms on January 10. All forms will be postmarked by February 2. Through HealthCare.gov Account. Messages or New Tax Forms Sec1on of Account

12 What if consumers don t receive the form? Consumers should be able to access their A form in their online account. If they don t have an online account, they can create one and use the find my applicahon funchon. If consumers haven t received a Form A by early February, they should call the Marketplace Call Center A can be re- printed and mailed to consumers. Consumers should check what address the Marketplace sent original form to.

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15 Monthly Premium Amount Total monthly premium for the policy. This may NOT be the amount that a consumer paid for the plan. Does not include any applied APTC. Does not reflect tobacco surcharge. Increased for premiums for a stand- alone dental plan allocated to pediatric dental benefits.

16 Second Lowest Cost Silver Plan The SLCSP is the silver plan with the second lowest premium in the consumer s county. This is not necessarily the plan the consumer enrolled in. Check accuracy of this premium by using tool on HealthCare.gov heps://

21 Monthly Advance Payment of Premium Tax Credit Amount of APTC on behalf of consumers This is not the same as the consumer paid out of pocket

22 What if there are errors on 1095-A? Marketplace Call Center

23 Additional Resources For consumers: heps:// taxes/ For assisters: heps://marketplace.cms.gov/technical- assistance- resources/tax- informahon.html

Getting Ready for Tax Season. January 2016

Getting Ready for Tax Season. January 2016 Getting Ready for Tax Season Health Insurance Coverage Affects Consumer Taxes Health coverage impacts a consumer s taxes CMS is coordinating with the Internal Revenue Service (IRS), tax preparers, tax