Form 1095-A, or Health Insurance Marketplace Statement, is given to individuals with health plans through the Health Insurance Marketplace, established under the Affordable Care Act.
You must report any premium tax credits you used to reduce the cost of your health plan. Include them on your federal tax return. This helps show you met the health coverage rule to avoid penalties. The Health Insurance Marketplace sends you the form 1095A from the IRS. Use the information from it to fill out IRS Form 8962.
Policy Holder Information. The 1095 A form includes details like your name and address.
Covered Individuals. Information about everyone who had coverage under the policy.
Marketplace Coverage Information. Lists the months you were covered.
Premiums and Credits. Shows the amount of your monthly premiums and any advanced payment of the premium tax credit.