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Kaiser Permanente and Tax Form 1095-A

Taxes FAQs — On-Exchange Members

 (Excerpts from a Kaiser Permanente Northern California FAQ released in January 2015)

Includes: Exchange members, both in state and federal exchanges  Note:  If you are not a Kaiser Member, see our related article written for non-Kaiser members who purchased coverage through Covered California.

What is Form 1095-A? What do I do with it?

If you or anyone in your household enrolled in a health plan through the health insurance marketplace in 2014, you’ll get Form 1095-A, Health Insurance Marketplace Statement from the marketplace. You should receive it in the mail by early February. Keep Form 1095-A with other important tax information, like your W-2 forms and other tax records. You’ll use information from the form to fill out your 2014 federal income tax return.

Consumers use the information included on Form 1095-A, Health Insurance Marketplace Statement, to complete Form 8962, Premium Tax Credit (PTC). Consumers file Form 8962 with their 1040 tax returns if they want to claim the premium tax credit or if they received advance payments (APTC) made to their insurance company.

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1.  I’ve heard that my health coverage may impact my taxes. Is that true?

Yes, your 2014 health coverage affects your income taxes in two ways.

1)  Federal tax law requires everyone to have health insurance or to be eligible for an exemption from this requirement in 2014. If you and/or your dependents did not have qualifying health coverage, then you may owe a penalty.

For more information on exemptions for not having health coverage, visit:
https://www.healthcare.gov/fees-exemptions/exemptions-from-the-fee/.

2)  If you received federal financial assistance, you will need to report the amount you received throughout the year to the IRS on your taxes.

a) If the amount of assistance was less than the premium tax credit that you qualified for, then you should receive a credit.

b) If the amount of assistance you received was more than the premium tax credit that you qualified for, then you may need to pay some or all of the advance payment of the premium tax credit back.

c) You may have to complete one or two new tax forms.

d) You may have to get a health coverage exemption or pay a penalty with your tax return if you didn’t have health coverage in 2014. Some exemptions may not be available now. To learn whether you may qualify for an exemption, you should contact your marketplace.

For more information on how health coverage may impact taxes, contact your marketplace, or visit https://www.healthcare.gov/taxes/ or http://www.irs.gov/ACA.

2.  How was my federal financial assistance calculated?

The amount of Advance Premium Tax Credit (APTC — also called federal financial assistance for premium payment) that was paid on your behalf to Kaiser Permanente to lower your premiums in 2014 was based on the income and family size you estimated when you applied for health coverage, as well as the cost of the second lowest priced silver plan offered through your health insurance marketplace.

Based on your actual income and dependent information for 2014, your APTC premium tax credit will be recalculated and will be compared to the amount of the advance payments made to Kaiser Permanente for your premiums now that you’re filing your taxes. Keep in mind that any change to actual income or change in dependents from what you estimated could increase or decrease the actual premium tax credit for which you qualify in 2014.

If, based on your final 2014 information, the amount of assistance was

— less than you were entitled to, you may receive a credit on your taxes, or

 more than you were entitled to, you may need to pay some or all of the advance payment back.

3.  What do I need to file my taxes?

If anyone in your household enrolled in a health plan through the marketplace in 2014, you’ll need to use the 1095-A statement, which you will receive from the marketplace, when you file your federal income taxes. You should receive it in the mail by early February. Keep your 1095-A statement with your W-2 forms and other tax records.

Consumers use the information included on the 1095-A statement to complete Form 8962, Premium Tax Credit (PTC). Consumers file Form 8962 with their 1040 tax returns if they want to claim the premium tax credit or if they received advance payments (APTC) made to their insurance company.

For more information on the 1095-A statement, contact your marketplace, or visit https://www.healthcare.gov/taxes/ or http://www.irs.gov/ACA.

For more information on Form 8962 and Form 1040, visit http://www.irs.gov/ACA. You can also find copies of Form 8962 and Form 1040 on http://www.irs.gov/ACA.

4.  What is Form 1095-A? What do I do with it?

If you or anyone in your household enrolled in a health plan through the health insurance marketplace in 2014, you’ll get Form 1095-A, Health Insurance Marketplace Statement from the marketplace. You should receive it in the mail by early February. Keep Form 1095-A with other important tax information, like your W-2 forms and other tax records. You’ll use information from the form to fill out your 2014 federal income tax return.

Consumers use the information included on Form 1095-A, Health Insurance Marketplace Statement, to complete Form 8962, Premium Tax Credit (PTC). Consumers file Form 8962 with their 1040 tax returns if they want to claim the premium tax credit or if they received advance payments (APTC) made to their insurance company.

For more information on Form 1095-A, contact your marketplace, or visit
https://www.healthcare.gov/taxes/ or http://www.irs.gov/ACA.

5.  If I’m the main household subscriber, will I get one 1095-A statement or multiple 1095-A statements, for each member of the family?

If you are all on the same plan, you’ll get one statement, which has all the members of your household listed. If you are on separate plans, you’ll get separate 1095-A statements.

For more information on Form 1095-A, contact your marketplace, or visit
https://www.healthcare.gov/taxes/ or http://www.irs.gov/ACA.

6.  What if I enrolled in a health plan through the marketplace during a special enrollment period? Will I still get a 1095-A marketplace statement?

Yes, you will receive a 1095-A marketplace statement for the period of enrollment in the health plan through the marketplace.

For more information on Form 1095-A, contact your marketplace, or visit https://www.healthcare.gov/taxes/ or http://www.irs.gov/ACA.
7.  Will I have to pay a penalty if I was covered 10 months in 2014?

For more information, talk to your tax professional if you have one or visit http://www.irs.gov/uac/Am-I-required-to-make-an-Individual-Shared-Responsibility-Payment%3F.

8.  What is Form 8962?

Consumers file Form 8962, Premium Tax Credit (PTC), with their tax return if they want to claim the premium tax credit or if they received advance payments (APTC) made to their health plan. For more information on Form 8962, and to find a copy of Form 8962, visit http://www.irs.gov/ACA.

9.  What does reconciliation mean?

When you file your federal taxes, consumers who received federal financial assistance (also called subsidies) will use the information on Form 1095-A to complete Form 8962, Premium Tax Credit (PTC). You will use Form 8962 to compare how much your health plan received for 2014 premiums that were advance payments of your premium tax credit (based on an estimate of the amount you would be entitled to) to the final premium tax credit you qualify for. For more information, contact your marketplace, or visit https://www.healthcare.gov/taxes/ or http://www.irs.gov/ACA.

10.  How do I get a copy of my Kaiser Tax Form 1095-A? (I lost it or never received it.)

Contact your marketplace for another copy of Form 1095-A.

For Georgia and Virginia members: You can download a copy at HealthCare.gov in a new section of My Account.

For Colorado members: you can download a copy of your form under “my documents” in your Connect for Health Colorado account starting Tuesday, February 3, 2015.

For more information on Form 1095-A, refer to the Form 1095-A instructions, contact your marketplace, or visit https://www.healthcare.gov/taxes/ or http://www.irs.gov/ACA.

11.  Where can I get help filing my taxes?

Consumers may get free assistance with filling out their taxes. This may include free access to tax software programs, or free in-person assistance. For more information, visit http://www.irs.gov/freefile or http://www.irs.gov/VITA.

Consumers can also seek professional tax assistance. For more information about choosing a tax professional, visit http://www.irs.gov/Tax-Professionals.

If you have additional questions about your taxes, visit http://www.irs.gov/ACA.

12.  Why did I get more than one Kaiser Tax Form 1095-A?

Just as some households receive multiple W-2s if individuals have multiple jobs, some households will get multiple Form 1095-As if they were covered under different plans or made changes to their income or dependent information during the year. Be sure to keep all the 1095-As you get and keep them with your important tax documents.

Sometimes a consumer may receive a “Corrected” Form 1095-A. You should use the most recent Form 1095-A that you receive when you complete your taxes. For more information on Form 1095-A, refer to the Form 1095-A instructions, contact your marketplace, or visit https://www.healthcare.gov/taxes/ or http://www.irs.gov/ACA.

13.  What if I think information on my Form 1095-A is incorrect?

For information that you believe is incorrect on Form 1095-A, consumers should contact their marketplace call center for research and resolution.

For more information on Form 1095-A, refer to the Form 1095-A instructions, contact your marketplace, or visit https://www.healthcare.gov/taxes/ or http://www.irs.gov/ACA.

14. What if I already filed my tax return before I got my 1095-A, or before I got a corrected one?

You may have to file an amended federal income tax return. This means you’ll have to file a corrected version of your return with the IRS.

For more information about filing an amended tax return contact your tax professional if you have one, and/or your marketplace or visit https://www.healthcare.gov/taxes/. The IRS also has information about filing an amended return, visit https://www.healthcare.gov/taxes/marketplace-health-plan/.

15.  Will I get a 1095-A if I’m ONLY enrolled in a stand-alone dental plan or a minimum coverage plan (previously called catastrophic plan)?

No, you won’t get a 1095-A statement if you’re enrolled in a minimum coverage plan. These plans don’t qualify for subsidies. However, if you are enrolled in a stand-alone dental plan and a health plan, you may receive a 1095-A statement.

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Covered California Open Enrollment Notices

Covered California Notices

Covered California is shipping envelopes by Mail for Open Enrollment season (see above)

Members will receive Covered California open enrollment instructions over the next two weeks, informing them of the Renewal Process.  If you need assistance understanding the 2015 changes, click here to request help.  Read story, If you want to review details about last year’s open enrollment or just get a free quote at this website.

Due to an online systems limitation from October 13 to November 3, 2014 only, you will be unable to login to your account in order to report changes for the 2014 plan year.  Covered California has developed a work-around during this period and you can receive assistance from Certified Insurance Agents here.

Remember, Open Enrollment begins November 15th:  Changes are coming to certain PPO networks.  If you did not use a Certified Agent last year, now is a good time to find one…they are a free service of Covered California and are here to help.

Website Problems Challenge December Deadline For California Individual Family Enrollment

For January 1st coverage, the December deadline for California Individual Family enrollment is just days away, yet the Covered California website is down for repairs.  Fortunately, you can download an application today, and even request free assistance from a local Certified Insurance Agent.

FREE RESOURCES FROM COVERAGE CALIFORNIA:

Already started an online application, but frustrated with results?  Get free help from a San Francisco bay area Certified Insurance Agent.  How?  Beginning November 26, 2013, simply login to coveredca.com and follow the instructions below:

GETTING HELP IF YOU HAVE ALREADY REGISTERED ON COVERED CA

  1. CLICK “Find Help Near You” in the upper right corner
  2. CLICK “Find An Agent”
  3. CLICK the name search box and type in “DEREN”
  4. CLICK on the search results for “Marc Derendinger”
  5. CLICK the “Continue” button
  6. CHECK the 3 agreement boxes and Accept this person as your designated agent.

Don’t worry, you can change or revoke this designation at any time, but the benefit to you is getting access to a personal advocate with 30 years industry experience…free of charge!

Now that you have completed the designation, call us and we start helping you right away!

408.475.8219

California Marketplace

2014 Health Plan Options For Californians

For rate comparisons of new group health plans, click here.  For non-group e.g. individual family plans click this link.  Have an individual Kaiser plan?  Read this article.

Got questions? Frustrated with the Affordable Care Act?  Life’s too short to waste time with all this:  Request free consumer assistance from Certified Insurance Agents, below:

Request Free Pricing Information