New Reporting for Health Plans? Form 1095-A

published September, 2015

If you’ve done your personal tax return for 2014, you know you need to report that you had health insurance, or pay a penalty. If you haven’t done your personal tax return for 2014, tick tock….

There are several ways to get health insurance: you can buy it individually, the employer can provide it, or you can use the marketplace where there may or may not be a subsidy available to pay for your health insurance.

If you use the marketplace, you receive a Form 1095-A from them showing who was covered and amounts paid, including any subsidy, and then we reconcile a subsidy on the tax return to see if you get more subsidy, or if you have to repay a subsidy.

But let’s say your company provides health insurance. How can the IRS verify you’re covered? Starting in 2016, insurance companies will be required to provide a Form 1095-B for each person covered (for tax year 2015), and a transmittal 1094-B (similar to the 1099 – 1096 set we already know about). There’s a penalty if they don’t do this, or don’t do it on time.

You can find more information at

If you have a “self insured” plan, you have to file forms yourself; there’s a different set of forms for you. I don’t know of any of my clients who fall into this category. Possibly, if you are an employer of household employees, and you pay for their health insurance, you’ll be required to file these forms.

If you have fifty or more full time employees (or FTEs) and are “self insured,” you’ll need to file Forms 1094-C and 1095-C starting in 2016. If you don’t have fifty, ignore this. If you think you might be close to fifty, we need to set up a procedure to calculate this.