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What are IRS Forms 1095-A and 8962, and the California Form FTB 3895?
IRS Form 1095-A
The 1095-A form, also known as the Health Insurance Marketplace Statement, reports certain information to the IRS about individuals who enroll in health plans through Covered California. It is a federal tax document that serves as proof of coverage for individuals to claim the premium tax credit.
If you bought your health plan through Covered California, you should receive a 1095-A form from Covered California, whether or not you received state or federal premium assistance. If you’re enrolled in the Blue Shield Minimum Coverage PPO plan, you will not receive a 1095-A form.
The 1095-A form issued by Covered California may be used:
- As proof of Minimum Essential Coverage (MEC)
- To complete the IRS Form 8962
- To confirm eligibility for a lump sum premium tax credit (PTC)
- To validate the amount of Advanced Premium Tax Credit (APTC) received in 2022
For more details about 1095-A forms, visit the IRS and Covered California websites.
Note: If you enrolled in a minimum coverage medical plan specifically, you will not receive a 1095-A form from Covered California. For more details, view our information on minimum essential coverage.
*We are not tax professionals and cannot provide tax advice. Please consult a tax or financial professional if you have questions regarding your individual taxes.
IRS Form 8962
IRS Form 8962, or the IRS Premium Tax Credit form, is the federal tax form that individuals are required to file if they:
- Purchased their 2022 health plan through Covered California, and
- Received or want to claim federal financial assistance.
The IRS Form 8962 may be used to:
- Claim your premium tax credit (PTC)
- Report any Advanced Premium Tax Credit (APTC) you received in 2022
- Prove you enrolled in a minimum essential coverage health plan
For instructions on filling out IRS Form 8962, download the IRS Instruction Manual for Form 8962.
*We are not tax professionals and cannot provide tax advice. Please consult a tax or financial professional if you have questions regarding your individual taxes.
California Form FTB 3895
Please note that you will not receive Form FTB 3895 for the 2022 tax year.
See the next section for information on IRS forms 1095-A and 8962.
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What do I do with forms 1095-A and 8962?
Form 1095-A
When you receive the 1095-A form:
- First, review IRS form 1095-A to ensure all your information is correct.
- Report to Covered California any discrepancies regarding your health plan premium or Advanced Premium Tax Credit amounts using the Covered California consumer 1095-A dispute form.
- Report any discrepancies with name, date of birth, Social Security number, and address to the Covered California Service Center.
- Contact Covered California if you have not received a 1095-A form by early February.
- Second, the information from the 1095-A form may be used to file your federal income taxes.
*We are not tax professionals and cannot provide tax advice. Please consult a tax or financial professional if you have questions regarding your individual taxes.
Form 8962
The IRS form 8962 may be used to:
- Calculate the amount of premium tax credit based on your actual household size and income for the 2022 calendar year.
- Reconcile any advance payments of the premium tax credit received during the 2022 calendar year.
*We are not tax professionals and cannot provide tax advice. Please consult a tax or financial professional if you have questions regarding your individual taxes.
- First, review IRS form 1095-A to ensure all your information is correct.
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What if I got more than one Form 1095-A?
Covered California may send more than one 1095-A form if:
- You or members in your household were enrolled in more than one Covered California health plan in 2022.
- You changed your health plan benefit level. For example, you kept the same health insurance carrier plan, but you changed your health plan level metal tier from Silver to Gold.
- Members of your household were enrolled in different health insurance carrier plans.
- Your family has more than five members. You will receive multiple 1095-A forms that have the same information. Only Part II will list different family members.
If you reported an issue with your original 1095-A form, or if you made a change to your coverage, you may receive a corrected version of your 1095-A form. The corrected version of the 1095-A form should be used when filing your taxes.
*We are not tax professionals and cannot provide tax advice. Please consult a tax or financial professional if you have questions regarding your individual taxes.
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How do I make or report changes to Covered California?
To correct your information on your 1095-A form, you must fill out a request to correct or dispute tax forms, which can also be found on Covered California's website. You can call Covered California's Service Center at (800) 300-1506 to report changes to names, dates of birth, Social Security numbers or addresses.
What to expect: Covered California will review your information within 60 days of receiving your dispute, and send you corrected forms, if necessary.
Important note: The corrected Form 1095-A information must be used when filing federal taxes or when amending a tax filing that has already been submitted.
*We are not tax professionals and cannot provide tax advice. Please consult a tax or financial professional if you have questions regarding your individual taxes.
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Who do I contact if I did not get a form and I got state or federal financial assistance to pay for my Covered California health plan?
If you do not receive an IRS 1095-A notice and you received state or federal financial assistance to pay for your Covered California health plan, please sign into your CoveredCA.com account to go to your secured mailbox to see if the forms are available for you to download. If not, call Covered California's Service Center at (800) 300-1506.
*We are not tax professionals and cannot provide tax advice. Please consult a tax or financial professional if you have questions regarding your individual taxes.
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I received government financial assistance to help pay for my health coverage in 2022. What do I need to know about filing my 2022 state tax return?
The passage of the 2021 American Rescue Plan Act may have increased the amount of federal financial help you received in 2022.
By receiving additional federal financial help, many taxpayers who received California Premium Assistance Subsidy (state financial help) for health coverage in 2022 may have to pay back some or all of the amount, up to the repayment limits to the California Franchise Tax Board (FTB) when filing their 2022 tax return.
For more information about the subsidy reconciliation, including resources for taxpayers who need assistance repaying California subsidies, visit the State of California FTB Subsidy Reconciliation page.**
*We are not tax professionals and cannot provide tax advice. Please consult a tax or financial professional if you have questions regarding your individual taxes.
**Source: California Franchise Tax Board. The website contains information from 2021.