With tax season among us, many individuals will be required to obtain forms verifying health coverage they secured in 2015.  For guidance on these matters, you should always contact your accountant or tax preparer.

Below is a chart explaining some of the forms individuals may receive from different entities.

Form Description
W-2 In box12 of this form, the code DD indicates the cost of the employer sponsored insurance.  An amount in this code indicates an individual had MEC at some point during the year, but it does not verify which months were covered, the employee’s cost of coverage, or which family member was covered.
SSA-1099 This form is used to report any Social Security benefits an individual received during the year and also Medicare Part B or D premiums deducted.
1095-A Sent by the Marketplace to QHP-enrollees to verify months of coverage for each individual in the policy and the amount of APTC received, if any.
1095-B Provided by insurance companies, Medicaid, Medicare, providers of public coverage, and small employers not subject to the employer-responsibility requirement. The form indicates who was covered under the policy and which months each person had coverage.
1095-C Employers that are subject to the employer-responsibility requirement will submit this form to the IRS and to the covered employee.  Form indicates who was offered coverage, how much employee-only coverage cost, and who in the household enrolled.

Individuals who were covered through a Marketplace plan can also access their 1095-A by logging in to their account at www.healthcare.gov.

Some individuals will be eligible for an exemption from the requirement to have health insurance.  Guidelines for the exemptions can be found here:  https://www.healthcare.gov/health-coverage-exemptions/

The penalty for not having health coverage in 2015 is a maximum of $325 or 2% of income for an individual.  That amount increases for 2016.

If you have questions regarding your health coverage and the tax form requirements, please contact your ClaimAid Patient Advocate for further direction or call the ClaimAid Corporate Office at 800.842.4052.