ABCs of Form 1095 for health insurance coverage and tax credits.
All individuals and households who had health insurance during 2015 will receive a Form 1095-x. How you received your health insurance will determine who sends the 1095-x to you. You may receive different 1095s based on whether you had Medicaid, private health insurance purchased through a Marketplace exchange like Covered California, or through employer based health insurance plan. Each of the 1095s will be appended with a different letter ( -A, -B, -C) depending on the issuer of the form.
| Form | Sent To | Sent By | Use |
| 1095-A | Individuals and families who enrolled in health plans through a Marketplace Exchange such as Covered California | Marketplace: Covered California. Healthcare.gov | Complete Form 8962 Premium Tax Credit Reconciliation |
| 1095-B | Individuals and families who enrolled in health plans off-exchange directly with the insurance company. Employees enrolled in an employer sponsored small group plan, less than 50 employees. Individuals enrolled in Medicaid (Medi-Cal) or Medicare. | Insurance companies or government agencies | To verify health insurance coverage to avoid the Shared Responsibility Provision (Individual Mandate) penalty |
| 1095-C | Employees of companies with 50 or more employees who may or may not have enrolled in the group health plan. | Insurance companies or the employer | To verify health insurance coverage to avoid the Shared Responsibility Provision (Individual Mandate) penalty. For some employees who declined employer coverage, to verify the cost of the employer sponsored health insurance premium cost. |
1095-A individuals, families through Marketplace
If you enrolled in health insurance through the Marketplace Exchange which includes Healthcare.gov, Federally Facilitated Marketplaces run by Healthcare.gov, or a state based exchange like Covered California you will receive a 1095-A. You need the 1095-A to fill out Form 8962 to either reconcile the premium tax credit subsidy with your final Modified Adjusted Gross Income or to apply for the Premium Tax Credit on your 2015 tax return if you did not receive any Advance Premium Tax Credits to lower you monthly health insurance premium during the year.
For individuals and families who enrolled with Covered California the 1095-A will be in your secure mail box and can also be found under the Documents and Correspondence section of the Summary page of the Covered California account. For Californian’s who need to dispute the information on the issued 1095-A, and need a corrected form, you can file an online dispute at Covered California 1095-A Dispute Form. For question regarding 1095-A from Healthcare.gov visit Healthcare.gov 1095-A Support. Additional resources are posted below.
1095-B Individuals, families, small groups
A 1095-B will be issued to individuals and families who enrolled in health plans outside of the Marketplace exchanges. This would include people who enrolled an individual and family health insurance policy
- Directly from an insurance company
- Medicaid or Medi-Cal Coverage 1095-B
- Original Medicare or Medicare Advantage plan
- Veterans Administration
- Student health plans
- State High Risk Health Insurance
- COBRA
Individuals and families who received their health insurance through a small group employer plan will receive a 1095-B from the insurance company. A small group plan is any employer sponsored plan where the company has fewer than fifty employees. In California, Covered California for Small Business will actually be issuing 1095-Bs to employees of small group plans purchased through the Small Business Health Insurance Options Program of Covered California. (As of this posting, Covered California didn’t know who employees should contact to get a corrected 1095-B and if those 1095-Bs would indicate the health plan was only offered to employees and not to the spouse or dependents.)
1095-C Large employers and self-funded plans
IRS Form 1095-C will be sent to certain employees of companies with fifty or more full time employees. You may receive this form even if you were not enrolled in the company’s health plan. In certain situations, the 1095-C will contain information to verify that you or members of your household were eligible for the Advance Premium Tax Credits through a Marketplace exchange. For example, a 1B code would indicate minimum essential coverage providing minimum value offered to the employee only. If health insurance is only offered to the employee, and not the employee’s spouse or dependent, then those household members are eligible for premium assistance.
Where is the 1095-B or -C
The IRS granted an extension to the January due date for providers of the 1095-B and 1095-C Forms. The due date for furnishing the 2015 Form 1095-B, Health Coverage, was changed from January 31, 2016, to March 31, 2016. The due date for furnishing the 2015 Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, was changed from January 31, 2016, to March 31, 2016.
New Due Dates for Filing Forms 1095-B, 1094-B, 1095-C and 1094-C
EXTENSION OF THE DUE DATES FOR 2015 INFORMATION REPORTING UNDER I.R.C. §§ 6055 AND 6056
According to the IRS, none of the 1095-xs need to be filed with a tax payer’s income tax return. However, the 1095-A is essential for completing Form 8962 Premium Tax Credit reconciliation and 1095-B and –C may be necessary for completing Form 8965 Health Coverage Exemptions or the Shared Responsibility Payment penalty.
IRS information on all of the above types of 1095-x can be found at
IRS Forms and Instruction for Download
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Covered California Support Documents for 1095-As
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