How do 1095 tax forms relate to your health coverage?

In California, the Affordable Care Act (ACA) requires all residents to have minimum essential coverage, sometimes called qualifying health coverage. If you don’t have health coverage, then you will be charged a state tax penalty when filing your taxes.

As a result, the state introduced three tax forms relevant to individuals, employers and health insurance providers. They are forms 1095-A, 1095-B and 1095-C. These forms help determine if you had the minimum level of benefits required under the ACA.

“Although you are not required to submit your 1095 forms to the IRS when you file your taxes, it’s a good idea to keep them as part of your tax records,” explains Jason Smith, director of operations at Sharp Health Plan.

The 1095 forms you get depend on how you enrolled in your plan. If you were insured through more than one health plan or employer during the year, you should expect to receive multiple 1095 forms. Each form will include slightly different information.

If you enrolled in benefits in 2024 through:

• Covered California™, you'll receive form 1095-A from Covered California.

• An insurance provider, you'll receive form 1095-B from your insurance provider.*

• Your employer (with 100 or fewer employees), you'll receive form 1095-B from your employer's insurance provider.

• Your employer (with over 100 employees), you'll receive form 1095-B and 1095-C from your employer's insurance provider and your employer.

*If you were enrolled in a government-sponsored plan, like Medicare or Medicaid, you will receive Form 1095-B from the Centers for Medicare & Medicaid Services.

Form 1095-A

If you were enrolled in benefits through Covered California, you will receive Form 1095-A. This form will include the amount of coverage you had, any tax credits you were entitled to and if you used them to pay for your health insurance, and the amount you paid for coverage. You can use this information to adjust any tax credit payments and claim any premium tax credits that may be due.

Forms 1095-B and 1095-C

If you purchased insurance directly through an insurance provider, or if you were enrolled in benefits through an employer, then you will receive Form 1095-B. This form includes the type of coverage you had, what dependents were covered under your plan (if applicable), and the period of your coverage.

If you were enrolled in benefits through an employer with 101 or more employees, then you will also receive Form 1095-C from your employer. This form will provide information on the coverage your employer offered, and whether or not you enrolled in that coverage.

“If you have questions about the forms you receive, you should contact the issuer of the form,” advises Smith. For more information, you can check out these 1095 tips. The IRS also has helpful information on its website.

"If you aren't currently enrolled in coverage, you may qualify for a special enrollment period that would allow you to get coverage," advises Smith. "Sharp Health Plan offers financial help with Covered California plans as low as $0 a month, based on eligibility."

For more information on essential health coverage, visit CoveredCA.com.