As Tax Day approaches on April 15th, the 1095 form should already be mailed out to you. Your 1095 form is a medical statement used to show the IRS that you were enrolled in a qualified health insurance plan throughout the calendar year. You should treat your 1095 document as if it were your W-2 or 1099. It is a valuable document that you must provide to your tax accountant for your tax filing.

1095 Form Structure

  • Section I identifies the primary applicant on your health insurance policy
  • Section II identifies the employer that offered you group coverage (if you were on a group plan)
  • Section III identifies the insurance company you were enrolled with
  • Section IV lists each family member enrolled in your health insurance with boxes next to each person with marks indicating each month of coverage

Tax Penalty for 2018 tax year

For those that did not have coverage that met the 10 essential health benefits mandated by the Affordable Care Act, you are most likely going to have to pay a tax penalty for your 2018 tax return. The tax penalty is the greater of $695 per person or 2.5% of your income, capped at the national average bronze metal plan monthly premium (tax penalty prorated for each month without insurance). There are some exemptions to avoid the tax penalty such as income-related exemptions, hardship exemptions, federally recognized tribe members exemptions and more.

Subsidies/Tax Credits

If you received subsidies/premium tax credits from Covered California, the 1095-A document will show how much in tax credits you accepted per month. This is important for the IRS to see if you accepted too little or too much in subsidies which will certainly impact your tax return. It is important to keep your reported income in Covered California up-to-date to avoid owing back premium tax credits at tax time.

If you have any further questions about your 1095 form, please contact your tax preparer for more information.

At Solid Health Insurance Services, our mission is to find for you affordable health insurance, life insurance, long-term care insurance and travel insurance which fits your medical needs and budget for your individual, family and business needs. Please contact us at 310-909-6135 or at