27 January 2016

Form 1095 has started to show up in people's mailboxes and judging from the questions I am fielding (and the colorful choice of words unexpected tax documents inspire) some people are confused about what the form means and what they should do with it. Somehow the confusion and trepidation I am observing reminded me of Boromir from Lord of the Rings. But then again, I am a huge nerd. Back to the taxes...

The short answer from me is to hang onto that form 1095 (A/B/C) because you might need it to prove to the IRS you don't owe a penalty tax! You probably don't need it to file your taxes (although some people will), but it might just save you a heap of trouble one day if the IRS comes knocking.

Now I'm going to try to explain this beast in single blog post. No small feat given the complexity. 

The 1095 series (A/B/C) are new tax forms this year. (Actually, the 1095-A debuted last year.) The 1095 series is related to the Affordable Care Act (ACA) (you know...that government policy people either love or hate... sometimes known as "ObamaCare").

It's a little misleading that the 1095 gets sent to you, because it's not really for YOU. It's for the IRS. As you are (hopefully) aware, the ACA requires all Americans to have health care insurance or pay a penalty tax. The form 1095 is sent by employers or insurers to the IRS, and tells the IRS who had health care insurance in 2015. The copy sent to you is mostly for information purposes, although those with a 1095-A will probably need it to prepare their tax return.

The flavor of 1095 you receive (A, B, or C) depends on how you acquired your health care insurance.

1095-A: If you received your health care insurance via the online marketplace/exchange, then you get a 1095-A. If you are eligible for the Premium Tax Credit, then you will need your 1095-A in order to correctly calculate your taxes. (In reality, it would be possible to get health care insurance through the exchange and calculate your taxes without the 1095-A, but if you can do that you should be writing a tax blog, not reading one!) The Premium Tax Credit is government assistance to purchase health care insurance. Eligibility for the Premium Tax Credit is based on income and family size. I could write paragraphs on this topic, but I won't because the immediate issue isn't the 1095-A. That came out last year. This year the new and concerning issue is the 1095-Bs and Cs.

1095-B: You get a 1095-B if you get your health care insurance through the government or directly from an insurance company (meaning you bought a policy directly from an insurer without going through your employer or the exchange). Military personnel and their families covered by TriCare should receive a form 1095-B. Veteran's receiving their health care insurance through the Veteran's Administration should also receive a form 1095-B.

1095-C: If you work for an employer with 50 or more full-time employees, the employer is now required to provide an affordable health care insurance plan to their employees or pay a penalty tax. There have been lots of news stories of late about what constitutes an employer with 50 employees, and what constitutes full-time employment. I could also write paragraphs about that, but lets assume you work for one of the majority of Applicable Large Employers who will simply comply with the law. You will receive a form 1095-C.

Taxpayers receiving a form 1095-A should receive their forms by 1 FEB.

Those of us receiving a form 1095-B or C might not get it until 31 March. This is the first year employers have to provide this form, so the government gave them an extension this year to get the forms out to employees. Many people are getting them now (my 1095-Bs from the VA and DoD are already received), but employers have the extension this year so they will probably continue to trickle out for most of tax season. In the future employers have until 1 FEB to send the forms to taxpayers (and the IRS).

You don't need to wait until you have your 1095-B or C to file your tax return. You might want to, but you don't need to. The only reason I can think to wait for your 1095-B or C is because you can't remember which months you had insurance due to non-continuous employment or coverage. In that case you may want to wait to make sure your tax return information matches the information provided to the IRS on form 1095-B or C. You really want that to match. The IRS will likely have questions for you if it doesn't.

Remember - the purpose of this form is to have employers and insurers tell the government who had (or was at least offered) health care insurance in 2015. The government is essentially using employers and insurers to help them police individual compliance with the mandate to have health care insurance. Any month that you or your dependents were not insured generates a tax penalty. Last year you could just say you had health care insurance. This year you have to prove it.

You do not send a copy of the form 1095 as part of your income tax return. However, I would verify the form 1095-B/C you received is correct, and keep a copy for 7 years. You want to have your documentation in order if the IRS comes knocking. The ACA penalty tax is large and growing. You want to be able to prove you don't owe it, and that 1095-B/C stating you had coverage all year is your ticket to  prove you were covered. Keep track of it.

There are still ways to get exempted from the requirement to have health care insurance. If you think you might qualify for an exemption or you have additional questions, please contact me.