Understand 1095-A form

[Eucerin]

I just received 1095-A form for 2019, it is my first year in 2019 so I try to understand it.
On the form partIII,
columnA - monthly enrollment premium $1375.29
columnB - monthly second lowest cost silver plan premium $1292.04
columnC - monthly advance payment of premium tax credit $1072.

when I obtained insurance in the beginning of 2019, the monthly premium was 1383.45, the monthly tax credit was 1072, I have paid net monthly premium $311.45 for 12 month in 2019.

Why is the 1095-A form stated different monthly enrollment premium?

What is the purpose of columnB?

THANKS!!

 

[Sue J]

As to Column A, I have seen small differences in this amount some years. Other years it's accurate or very close. I called and asked one time and the explanation is that some insurance plans will include something that is not part of the requirements of an ACA plan. So they can only include the required parts. That may be your $8.16 difference.

The purpose of Column B is that all subsidies are based on the second lowest cost silver plan (SLCSP) for your area and your age. Using your income as a percentage of the Federal Poverty Level and a chart from the IRS determines how much your monthly contribution should be. Deduct that from the SLCSP and you get your subsidy amount. Then you can decide if you want to use that subsidy amount on a lower or higher cost plan.

It's all very confusing until you see how it works out for YOU. Then it will make sense. It's all to reconcile if you got all the subsidy that you are due, or if you got too much and need to pay it back.

I'll see if I can find the info on irs.gov.

The form is 8962 https://www.irs.gov/pub/irs-pdf/f8962.pdf

The instructions for form 8962
https://www.irs.gov/pub/irs-pdf/i8962.pdf The chart is Table 2 on Page 9.

 

[ShokWaveRider]

Just comparisons the second lowest cost plan vs what your actual plan premiums "Should" be, then how much the ACA gave you towards it.

So the premium YOU Paid was Colum A minus Column C. If you did not get a subsidy your Premium would have been all of Column A.

 

[scrabbler1]

The monthly premium shown in Form 1095, Column A, may be lower than what your unsubsidized premium was because your actual premium may have included an amount which paid for items in your policy beyond the federal minimum. This happened with me. Apparently, my state required some items the Feds didn't require.


Column B is the Second Lowest Cost Silver Plan (SLCSP). This is used to help determine the amount of the premium subsidy you are entitled to.


Column A's amount gets copied to tax form 8962, Line 11a. Column B's amount gets copied to tax form 8962, Line 11b. Column C's amount gets copied to tax form 8962, Line 11f.


Tax form 8962 reconciles the amount of the premium subsidy you received with the amount you should have received. If you received too much, you have to pay the difference back (subject to a cap). If you received too little, you can use the difference to offset any taxes due or get a refund.

 

[Eucerin]

THANKS for your responses. Much appreciated!!

 

[NoMoreJob]

We've never had a 1095-A that has exactly matched the real numbers. But it comes close so to save hassle and gain quality of sleep I just report what's on the form.

I learned about the incompetence of the ACA people the year that they couldn't understand my income (retired with investment income only and no W-2) so in their infinite wisdom they cancelled our health insurance. It was the first time in my life I've ever gone without and it wasn't a good feeling. What a mess! I never could even get them to send me a 1095-A for that year (after going through the dispute process and prevailing). But I digress.

Anyway, I suggest just reporting what the form states (as long as it's close).

 

[orchid55]

Reporting what the form says can be okay most of the time. It wasn't for us last year as the SLCSP was reported as $0. We had paid the full premium upfront and were expecting a refund which we couldn't get with the SLCSP reported as $0. It took a long call to the Marketplace to get the correct number. We filed the return with the new number and all went swimmingly despite the misgivings of our accountant.

 

[scrabbler1]

Reporting what the form says can be okay most of the time. It wasn't for us last year as the SLCSP was reported as $0. We had paid the full premium upfront and were expecting a refund which we couldn't get with the SLCSP reported as $0. It took a long call to the Marketplace to get the correct number. We filed the return with the new number and all went swimmingly despite the misgivings of our accountant.

Unlike previous years, the SLCSP on my 1095-A form was zero. I did get a chart from my state's exchange (NY Marketplace) which has the SLCSP for each county in my state. in 2019, unlike in prior years, I did not get any advanced premium subsidy nor did I qualify for any subsidy (i.e. went over the cliff), so I don't have to file any Form 8962 this time and can ignore 1095-A.

 

[kodokan]

Reporting what the form says can be okay most of the time. It wasn't for us last year as the SLCSP was reported as $0. We had paid the full premium upfront and were expecting a refund which we couldn't get with the SLCSP reported as $0. It took a long call to the Marketplace to get the correct number. We filed the return with the new number and all went swimmingly despite the misgivings of our accountant.

My form has zeros in Column B this year; some Googling said it happens when you don’t take a premium up front (this was my first year on an ACA plan, and I have flexible self-employment income, so I figured I’d rather be pleasantly surprised at tax time than have a bill).

The Healthcare marketplace has a tax tool where you can answer a few simple questions, and it give what the actual SLCSP number should be, then tells you to use that for tax filing instead. I’ve printed out the results sheet to keep with my tax records, just in case.

https://www.healthcare.gov/tax-tool/#/premium-tax-credit