Form 1095-A is a form mailed from the Marketplace because you or a family member enrolled in health insurance through the Marketplace during the tax year.
The form should be sent by January 31, 2020 from where you enrolled. Use this form to complete Form 8962, Premium Tax Credit.
A copy of this information was also sent to the IRS. You must file a return if you received any advance payments of the premium tax credit.
Part I - Recipient Information - contains the recipient, insurance company, and Marketplace information.
Part II - Covered Individuals - contains coverage information for each individual covered on your policy. If you have more than 5 individuals on your policy, you will receive one or more additional 1095-A Forms that contain Part II information. At the time of enrollment, if you indicated that a family member will not be a dependent on your taxable year return, that person will receive their own 1095-A.
Part III - Coverage Information - contains information about your insurance coverage needed to complete Form 8962, Premium Tax Credit, if applicable.
For a complete list of instructions, please visit the IRS website.
Receive more than one 1095-A? Click here for instructions.