1. Health Insurance Exchange Plans and the 2014 Tax Filing Season HEALTH INSURANCE MARKETPLACE STATEMENTS

2. What is it? Form 1095-A is used by the Health Insurance Exchanges (kynect) to report information to the Internal Revenue Service (IRS) on individuals who enroll in a Qualified Health Plan (QHP).

3. Who gets one?  Any taxpayer who obtained their health insurance through a federal or State Health Insurance Exchange will receive Form 1095-A in the mail by January 31, 2015.  If an individual enrolled in more than one Qualified Health Plan policy, they will receive a Form 1095- A for each policy.

4. Example of 1095-A Form - http://www.irs.gov/pub/irs-pdf/f1095a.pdf http://www.irs.gov/pub/irs-pdf/f1095a.pdf

5. What about those who are still uninsured?  Individuals without coverage and those who don’t maintain coverage throughout the year must have an exemption or make an individual shared responsibility payment when they file their 2014 tax return in 2015.

6. What information is on the form?  Form 1095-A includes total monthly premiums for the recipient and family members, monthly advance premium tax credits, and premiums for the second-lowest-cost silver benchmark plan.  Form 1095-A also contains information for use by individuals in completing IRS Form 8962 (Premium Tax Credit), including:  To Claim the Premium Tax Credit  Reconcile the credit with advance payments of the credit  kynect will report information like Premium Paid, Payment Assistance used, and Policy details to the IRS and to individuals who enroll in QHP/HIP through kynect.

7. What does this mean?  Taxpayers who received or were eligible to receive Payment Assistance will have to:  Use IRS Form 1095-A, Health Insurance Marketplace Statement to complete IRS Form 8962, Premium Tax Credit (PTC) to reconcile the APTC amount. Form 1095-A will be sent out by kynect to anyone who had a qualified health plan during 2014.  It must be sent out by January 31.

8. About PTC (Premium Tax Credit)  Refundable credit for only eligible individuals  Get it Now (advance credit payments) OR  Get it Later (without advance credit payments)  Use form 1095A, Form 8962 and Form 1040

9. Reconciliation of APTC (Advance Premium Tax Credit)  Individuals that chose to use their PTC up front to help lower their monthly premium received APTC  If the APTC was less than the actual premium tax credit, the individual will receive an additional tax credit. Please note: It is possible that an individual could get an additional tax credit from the reconciliation and still not be eligible for a refund.  If the APTC was greater than the actual tax credit, the individual will owe the excess as an additional tax liability.

10. Reconciliation Example  Advance Payments$4,000 Calculation of PTC -$3,000 Difference$1,000  Repayment Amount$1,000* *Amount from Form 8962 that would be entered on Form 1040  Note: A tax return MUST be filed to reconcile advance credit payments regardless of any other filing requirement.

11. Example of Form 8962 - http://www.irs.gov/pub/irs-pdf/f8962.pdf http://www.irs.gov/pub/irs-pdf/f8962.pdf

12. More Information  Many people can get free help to fill out their taxes.  Visit http://www.irs.gov/Individuals/Free-Tax-Return- Preparation-for-You-by-Volunteers to learn more about getting help.http://www.irs.gov/Individuals/Free-Tax-Return- Preparation-for-You-by-Volunteers  If you need more information, visit https://www.healthcare.gov/taxes/ https://www.healthcare.gov/taxes/  Or call the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325)