Tax Forms Introduced With The Affordable Care Act by Barbara Kempen | Jan 21, 2015 | Affordable Health Insurance, Health Insurance Brentwood, Health Insurance Pacific Palisades, Health Insurance Santa Monica Californians who applied for health insurance through Covered California in 2014 will receive within the next weeks a 1095- A form. This is a health Insurance Medical Statement. In Section 1 it lists the health insurance policy name, the health insurance you were signed up with at the start & end date of coverage. Section 2 list the individuals who were covered in the health plan. In Section 3 it will list the month the premium you paid, the subsidy California paid, and the total amount the insurance company received. Handle the 1095-A like a W-2 form or 1099 and give them to the person who is preparing your taxes. Usingthe 1095-A form, your tax accountant will be able to to fill out the IRS form 8962 (which lists the premium tax credit). It will be then be determined if you will receive a tax credit or if you will have to pay the money back that you received with the subsidy. Please contact your accountant for more details regarding 1095- A and 8962 tax forms.