Federal Tax Filing: IRS Form 1095-A
Covered California will send IRS Form 1095-A Health Insurance Marketplace Statement to all enrolled members. It is used to fill out IRS Form 8962 Premium Tax Credit as part of your federal tax return.
1. Get Form IRS Form 1095-A by mail.
Did not receive IRS Form 1095-A by mail? Call us.
2. Make sure your form IRS Form 1095-A is correct. If not, call us.
Verify basic information about your health plan and household members on Parts I and II of the form. See errors? Call us.
Make sure the premium for your second-lowest-cost Silver plan is correct. Use the Shop and Compare Tool to find the second-lowest-cost Silver plan.
3. Fill out IRS Form 8962 to calculate the amount of Premium Tax Credit you received in advance and the amount that you were entitled to.
Use this calculator to find the amount of the second-lowest-cost Silver plan premium where you live.
If you need help, please contact the Covered California Service Center. Representatives cannot provide tax advice.
For information about your state taxes (Form FTB 3895), see State Tax Filing.
For information on limits to what you may need to repay to the Franchise Tax Board or the Internal Revenue Service,, see Financial Help Repayment Limits.
For other information, see: Where to Find Your Forms, Errors on your forms?, and If You Didn’t Receive Your Tax Forms.
Please consult the California Franchise Tax Board, the Internal Revenue Service, or a tax advisor if you have questions about how to use these forms when preparing your taxes, penalty amount, or tax return.
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