Health Insurance Forms: 1095-A vs. 1095-B

Introduction
Navigating health insurance forms can be confusing, especially when you receive a request from the IRS for a form that doesn’t seem to apply to your situation. This blog aims to provide clarity on the differences between Form 1095-A and Form 1095-B, and guide you on what to do if you have received a request for a form that you don’t have.

Understanding Health Insurance Forms
Form 1095-A is used by health insurance Marketplaces to report health insurance coverage and premiums paid by individuals and families. It is typically used for those who have purchased coverage through the Affordable Care Act (ACA) Marketplace.

Form 1095-B is used by employers to report health insurance coverage and premiums paid by employers for their employees. It is typically used for those who have employer-sponsored health insurance.

What to Do if You Receive a Request for a Form You Don’t Have
If you receive a request from the IRS for a Form 1095-A, but you only have a Form 1095-B, it’s important to understand why you received the request.

– You may have been covered by both Marketplace and employer insurance during the year. In this case, you need to provide both forms to the IRS.
– Someone may have fraudulently claimed a Premium Tax Credit on your behalf. If you suspect fraud, report it to the IRS and your health insurance Marketplace.

How to Respond to an IRS Request
If you are unable to provide the requested form, you should send a letter to the IRS explaining your situation. Include a copy of the Form 1095-B that you have and any other relevant documentation.

Important Note: The IRS is unlikely to contact you by phone. If you receive a call claiming to be from the IRS, be cautious and do not provide any personal or financial information.

Seeking Professional Help
If you are unsure about how to respond to an IRS request or have any concerns about your health insurance coverage, it’s advisable to consult with a licensed insurance agent. They can assist you with understanding your coverage options, filing forms, and resolving any issues with the IRS.