FORM 1095-C FREQUENTLY ASKED QUESTIONS

 

Q-1: How does the government know if I’ve complied with the Individual Mandate?

A-1: Individuals will indicate on their Form 1040, 1040A, or 1040EZ if they have complied with the individual shared responsibility mandate by checking box 61 of Form 1040 (line 38 of Form 1040A or line 11 of Form 1040EZ).. Individuals who qualify for exemptions or exceptions from the individual shared responsibility mandate will need to complete and file Form 8965.

 

Q-2: What is the Form 1095-C?

A-2: The Form 1095-C provides information about the health coverage offered by your employer. The coverage the employer offered to you meets employer’s obligations is not necessarily the same coverage in which you actually enrolled. Information regarding the coverage that employer made available to you will be found in the Form 1095-C. The Form 1095-C will be distributed by March 31, 2016.

 

Q-3: I thought I would receive proof of coverage from my employer before I filed my tax return this year. What changed?

A-3: The IRS extended the distribution deadline. Your employer does not need to provide a Form 1095-C to you until March 31, 2016.

 

Q-4: Should I wait to file my individual tax return until I receive a Form 1095-C from my employer?

A-4: It is up to you. You do not have to wait until you receive your Form 1095-C. While the information on these forms may assist in preparing your tax return, the Form 1095-C is not required. Individual taxpayers will generally not be affected by the extension and should file their returns as they normally would.

You can prepare and file your return using other information about your health insurance.

 

Q-5: What other information can I use to prepare my return?

A-5: The IRS has stated that you do not have to wait for a Form 1095-C from your employer to file your individual income tax return. You can use other forms of documentation instead of the Form 1095 information returns to prepare your tax return. Other forms of documentation that would provide proof of your insurance coverage include:

  • insurance cards,
  • explanation of benefits
  • statements from your insurer,
  • W-2 or payroll statements reflecting health insurance deductions,
  • records of advance payments of the premium tax credit and
  • other statements indicating that you, or a member of your family, had health care coverage.

If you and your entire family were covered for the entire year, you may check the full-year coverage box on your return. If you or your family members did not have coverage for one or more months of the calendar year, you may claim an exemption or make an individual shared responsibility payment.

You will not need to send the IRS proof of your health coverage. However, you should keep any documentation with your other tax records. This includes records of your family’s employer-provided coverage, premiums paid, and type of coverage.

 

Q-6: Should I wait to file my individual tax return until I receive a Form 1095-A?

A-6: Yes. If you are covered under a governmental Marketplace plan, the Marketplace must provide you with a Form 1095-A by February 1, 2016. You will only receive this form directly from the government Marketplace. Your employer will not and cannot supply you with this form.

 

Q-7: After I receive the Form 1095-A do I need to wait for more information from my employer?

A-7: You may wish to ask for more information from your employer. You may be eligible for a tax credit if you did not receive an advance determination from the federal/state exchange. For this reason, you will need the Form 1095-C from employer (or other communication) to determine if you are eligible for a premium tax credit.

 

Q-8: Will I receive some type of Form if I am covered by Medicare, Medicaid, CHIP, TRICARE, or other government-based plan?

A-8: Yes. If you are covered under a governmental plan, you will receive a Form 1095-B. However, you do not need to wait for it to file your tax return. You will only receive the form directly from the governmental agency. Your employer will not and cannot supply you with the form.

 

Q-9: Where can I find more information about the individual shared responsibility provision?

A-9: The IRS has several helpful publications:

Q&As: www.irs.gov/Affordable-Care-Act/Individuals-and-Families

Q&As: www.irs.gov/Affordable-Care-Act/Questions-and-Answers-about-Health-Care-Information-Forms-for-Individuals

Form 8965, Health Coverage Exemptions: www.irs.gov/pub/irs-pdf/f8965.pdf

Form 1040 Instructions (2015): www.irs.gov/instructions/i1040gi/