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Form 1095-A for Hollywood Florida: What You Should Know

The ACA requires all health plans in the Marketplace to furnish a copy of the applicant's most recently filed income tax return with a statement on its face that describes the extent and kind of coverage obtained (including coverage offered or purchased in the Marketplace) and the extent of the applicant's financial assistance for health coverage received. Generally, the statement must be issued by a financial institution within three days of submitting a premium tax return. The Marketplace's Electronic Reporting Center (ERIC)-E-services (formerly known as Enroll America and Marketplace E-Services) accepts a variety of paper forms for this purpose, including Form 1095-B, Bona Fide Health Insurance Marketplace Statement, and Form 1095-C, Certificate of Coverage or Certificate of Coverage Affidavit Form. Please refer to the list below. Refer to your healthcare.gov account for the most recent information on how to use this form. Tax Form Description Form 1095-B — Bona Fide Health Insurance Marketplace Statement, for individuals and family households filing separate returns, and for individuals and individual households for whom the IRS determined they are eligible for the Marketplace Tax Credit (if any). Form 1095-C — Certificate of Coverage or Certificate of Coverage Affidavit Form. Form 1095-B is a document filed by all individuals and families that provide information about the extent and kind of health plan coverage purchased. The form must contain a statement that identifies the taxpayer for whom the return was filed, the taxpayer's name, address and form of financial assistance for health plan coverage received. Form 1095-B is a document signed by the applicant attesting to either of the following: The extent and kind of coverage obtained, or The fact that the financial assistance for the coverage provided includes a health savings account (Has) contribution, and the amount of the contribution. An applicant who does not have an HSA contribution is responsible for the federal and state taxes for the Marketplace contribution at the end of the calendar year. Form 1095-C is an affidavit of coverage or certificate of coverage issued by a financial institution for an individual that certifies coverage that the applicant acquired through the Marketplace. The applicant must obtain a certificate of coverage issued by a financial institution prior to or within 30 business days of an application's submission.

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