Here’s the easiest thing you can say about that Form 1095 you’re getting this tax year: Don’t send it in with your tax return, but keep it with your tax records.
After that, it can get a little tricky. There’s uncertainty about the form because it’s new and nearly everyone will get one from now on.
“I think people are slower filing a little bit just because of the confusion,” said Kristi St. Aubin, a tax professional with H&R Block in Omaha. “Some people are holding off. Some of them will come in and say, ‘What am I supposed to do?’ ”
So what is it? It’s like a W-2 form for health insurance, St. Aubin said, listing who had health care coverage and what months they were covered.
For most people, it turns out, using the form is fairly simple.
If you and your family had health coverage all last year, just put an X in the box on your tax return that says “Full-year coverage.” On a standard Form 1040, the box is on Line 61, which asks about your responsibility for health care, along with “other taxes” you may owe.
That’s it, as long as you and your family really did have standard health insurance all last year and you didn’t buy your coverage through the HealthCare.gov marketplace.
But for people in other situations, there are some twists and turns.
You can read the Internal Revenue Service’s overview of the forms by going to www.irs.gov, searching for “1095” and opening up the item titled “Questions and Answers About Health Care Information Forms.”
You also can read about Form 1095s in the website’s “Tax Tips” section and in the instructions for the income tax form you’re using. There are separate articles for Form 1095-A, Form 1095-B and Form 1095-C.
Here’s the scoop:
The Affordable Care Act requires health care coverage for nearly everyone. (People with certain hardships such as home foreclosures, for example, are exempt.)
This year most people will get a Form 1095. Some people get more than one, and the IRS gets copies.
Form 1095-B and Form 1095-C are the most common and pretty similar.
» You’ll get a Form 1095-B if you or your family had coverage through an insurance company or a self-insured employer with fewer than 50 employees.
» You’ll get Form 1095-C from employers who offer insurance through work or are self-insured and who have 50 or more employees.
If you had coverage from more than one provider during the year — say, you changed jobs and switched providers — you should get a form from each one.
If a child is still covered by a parent’s insurance but is not a dependent and is filing a separate tax return, he or she can use the parent’s Form 1095-B or Form 1095-C for the insurance information and should keep a copy.
Look at Part IV, Column (d) on Form 1095-B or Part III, Column (d) on Form 1095-C to see if you and everyone in your family had coverage for the entire year. If so, check that “Full-year coverage” box on your tax return.
If you or someone else in the family didn’t have coverage for the entire year, you must determine if you were exempt during those uncovered months. If not, you must make a “shared responsibility payment,” which is a tax for not having insurance. Instructions with tax forms show how to determine exemptions and payments.
Here’s an important item: If you aren’t required otherwise to file a tax return, you don’t need to file just because you received a Form 1095-B or a Form 1095-C. But hang onto the form, just in case.
The deadline for employers, insurers or others to send out Form 1095-B and Form 1095-C is March 31. But if you don’t have a form and are ready to file your return, go ahead and file, the IRS said. Rely on your own knowledge and financial information, such as pay stubs showing deductions for insurance premiums.
For instance, if you know your entire family had coverage all year, check that box. On the tax return Form 1040, the box is on Line 61, “Health care individual responsibility,” in a group of “Other Taxes.” If you can check the “Full-year coverage” box, you don’t owe any money. The wording is similar on other tax return forms.
If you think you should have a Form 1095-B or Form 1095-C but didn’t get one, talk to your coverage provider or your employer. The IRS won’t know about the forms you should get. If you have questions after getting the form, you can call the contact number on Line 18 of Form 1095-B or Line 10 of Form 1095-C.
If you received Form 1095-B or Form 1095-C but didn’t correctly determine whether you owe a payment, the IRS will process your return in the usual time and later send you a letter if you owe more money, possibly along with interest and a penalty, H&R Block’s St. Aubin said.
“The IRS will get the transcripts of the B’s and C’s sent to them, so they all match up,” she said.
» Now we’ll tackle Form 1095-A, which goes to individuals and families who bought coverage through the health insurance marketplace, HealthCare.gov.
If you’re going to get a Form 1095-A, you should have gotten it already, because the deadline for sending it was Feb. 1. If you think you should get one but haven’t, go to your online HealthCare.gov account, look in the tax documents section and print it out yourself. You can call the marketplace at 800-318-2596 or see the marketplace’s instructions for Form 1095-A.
If you got your coverage from the marketplace, don’t file your taxes until you get a Form 1095-A. If you get a Form 1095-A, you have to file a return, even if you wouldn’t otherwise have to file taxes.
St. Aubin said some people who needed a Form 1095-A filed their tax returns without them and discovered that the IRS is holding up their tax refunds until they supply the required information.
Form 1095-A has the information you need to fill out Form 8962, which you must send in with your taxes if you receive a Form 1095-A.
The information on Form 8962 is intended to verify that subsidies you received when you bought coverage through the marketplace were correct. If you got a bigger subsidy than you should have (because, say, you earned more money than you had predicted), you’ll have to pay some of it back. If your subsidy was too small, you may receive an added tax credit.
If you weren’t covered all year, you also need to determine whether you were exempt from the coverage requirement or if you must make a shared responsibility payment.
If you worked for an employer who offered insurance but you bought your plan on the marketplace anyway, you should receive both a Form 1095-A and a Form 1095-C or Form 1095-B.
This year the individual responsibility payments are larger than last year, and they are scheduled to increase again with 2016 taxes. The payments, either a percentage of your income or a flat amount, are intended to encourage people to get insurance.
If you were covered for at least one day in a month, you can count that month as being insured. The fewer months you are uninsured, the smaller your payment would be.
The family maximums: $285 for 2014 taxes, $975 for 2015 taxes and $2,085 for 2016 taxes.
Because the new forms are required by the controversial Affordable Care Act, they have drawn attention, St. Aubin said.
“It is a hot button now for the presidential candidates,” she said. “People have strong comments about it.” But regardless of your opinion, the new 1095s are official and required by tax law.