Individual Reporting Requirements

Q. What happens if I did not file a 2014 federal tax return to reconcile my advance payment of the premium tax credit, or APTC. What do I need to do?
A. To keep their APTC and/or cost-sharing subsidy (CSR) for 2016, if you received APTC in 2014 you are required to file a 2014 federal tax return with Form 8962, Premium Tax Credit. If you don’t do this, you lose your subsidy and will have to pay the full cost of their monthly health insurance premiums for the 2016 plan year. Also, the IRS may contact you to pay back some or all of their 2014 APTC.

What you need to do if you received APTC in 2014:

  • Electronically file your 2014 tax return with Form 8962 as soon as possible, even if you don’t normally have to file. To avoid a gap in APTC, you should file by the end of August.
  • Use the Form 1095-A that you received from the Marketplace to complete Form 8962.
  • If one nees a copy of Form 1095-A, they can log into their HealthCare.gov or state Marketplace account or call their Marketplace call center. (For FFM/HealthCare.gov number is 1-800-318-2596. For list of state marketplace contact numbers, see http://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/The-Health-Insurance-Marketplace.)

Q. Where can I go if I need help filing their tax returns?
A. For more information on filing a 2014 tax return with Form 8962, you may visit IRS.gov/aca , call the IRS at 1-800-829-0922 or can contact your tax advisor.

Q. What happens if you received advance payments of the Premium Tax Credit in 2014 and don’t file a 2014 tax return or Form 8962?
A. You will not be eligible for advance payments of the premium tax credit (APTC) or cost-sharing reductions (CSRs) to help pay for their Marketplace health insurance coverage in 2016. This means you will be responsible for the full cost of the monthly premiums and all covered services. In addition, the IRS may contact you to pay back some or all of the APTC received for the 2014 plan year.

Q. How do I update and make changes to income, household or coverage to the Marketplace?
A. Keep in mind that once you have Marketplace health insurance, federal rules require you to report changes to your income, household, address and health coverage eligibility to the Federal Marketplace as soon as possible. These updates may change the coverage or savings you are eligible for in the Marketplace. To update your income, family and other information, go to https://www.healthcare.gov/reporting-changes or call the Federal Marketplace 1-800-318-2596