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IRS Tax Form 1095-A
Covered California
You will need your Form 1095-A when you prepare your federal income tax return.
Your Form 1095-A shows the amount the Internal Revenue Service (IRS) paid to your insurance company to lower the cost of your health coverage. The amount paid was based on the most recent household size and income information you provided to Covered California. If that information changed during the year and you did not report the change to Covered California, you may have paid too much or too little for your health coverage. Below, are answers to common questions about IRS Form 1095-A.
What if I didn't get a Form 1095-A?
If you have not received a Form 1095-A in the mail or in your Covered California account, complete the dispute form or contact Covered California at (800) 300-1506. The dispute form is currently only available in English. For assistance in Spanish or any other language, please contact Covered California at (800) 989-2199.
What if my Form 1095-A is incorrect?
If the information below is incorrect on your Form 1095-A, please contact the Covered California Service Center at (800) 989-2199 to provide the right information and receive a corrected Form 1095-A, or receive directions on how to make the necessary changes before filing your taxes.
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Your name. -
Your date of birth. -
Your Social Security number. -
Your address.
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Incorrect amount of premium tax credits. -
Wrong months of coverage listed or not shown for covered individuals. -
Missing household members or incorrect names. -
Health coverage was terminated.
When will I receive a corrected Form 1095-A?
Covered California will respond to you within 60 days of the date of submission of the Form 1095-A dispute form and issue a corrected form.
What do I do with Form 1095-A?
You will need it when you prepare your taxes. Similar to a W-2, a Form 1095-A is one of the things that will determine the amount of taxes you will pay or the refund you receive. You will use it to fill out IRS Form 8962. Form 8962 is an IRS form to “reconcile” the tax credits your health insurance company received based on your estimated income with the amount that you qualify for based on your actual income, as reported on your federal tax return.
What is the difference between Form 1095-A, B and C?
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Form 1095-A, Covered California Statement: Covered California sends this form to individuals who enrolled in coverage with Covered California (except for individuals who enrolled in a minimum coverage/catastrophic plan. These individuals may receive a Form 1095-B or 1095-C directly from their health insurance company). -
Form 1095-B, Health Coverage: Health insurance companies outside of Covered California and programs such as Medi-Cal send this form to individuals they cover, with information about who was covered and when. -
Form 1095-C, Employer-Provided Health Insurance Offer and Coverage: Large employers send this form to their employees. It states the health coverage that was offered (if any) and the months in which it was offered.
What if I received an incorrect Form 1095-B or 1095-C?
Medi-Cal, Medicare, employers and health insurance companies will issue Form 1095-B and 1095-C. If you have questions about your Form 1095-B or 1095-C, please contact the sender. Covered California will not be able to resolve disputes for forms sent by any other source.
Covered California Enrollment Center
As a certified Covered California agency, we can help you access your Covered California account and would be happy to assist you with your 1095-A questions. Please call us at (800) 650-0922.
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