Taxes

Filing tax returns

Share the links on this page with your employees to help them access personalized health information, find a personal physician, locate the nearest facility, review information about coverage options or lean about tax forms required as proof of coverage when filing their returns to the IRS.

Share the links on this page with your employees to help them access personalized health information, find a personal physician, locate the nearest facility, review information about coverage options or lean about tax forms required as proof of coverage when filing their returns to the IRS.
Minimum essential coverage and 1095 IRS reporting forms

The Affordable Care Act requires most U.S. citizens to have health coverage that meets a government standard — known as minimum essential coverage — or be subject to a potential tax penalty.

Starting in January 2016, health plan subscribers will get one or more 1095 tax forms depending on their plan. They’ll need this information as proof of coverage when filing their returns to the IRS — or they might have to pay a penalty.*

The forms apply to everyone with health coverage, except those who purchased a catastrophic plan through a health insurance marketplace such as Covered California. The form they’ll receive depends on the type of health plan they have:

 

Type of plan Form

Individual and family through a marketplace

1095-A

Individual and family direct from carrier

1095-B

Small group (50 or fewer employees)

1095-B

Fully insured large group (more than 50 employees)

1095-B and 1095-C

Self-funded large group (more than 50 employees)

1095-C

Filing tax returns


When your employees fill out their tax returns, they should report any federal financial assistance they received toward health coverage. Additional tax forms will determine if the taxpayer receives a credit or owes payment. Subscribers will need to file Form 8962 to claim the premium tax credit or if advance payments were made to Kaiser Permanente.

Subscribers may have to pay a tax penalty if they:

  • had a coverage gap lasting more than 3 months
  • had more than one coverage gap in 2015
  • can’t claim an exemption in 2015

Subscribers may receive corrected forms, so it’s important to use the most current forms to ensure accuracy of information. Also note that not filing a return could affect a subscriber’s eligibility for federal assistance.

Review our fact sheet and Q&A for more information on minimum essential coverage and employer reporting or see below for information on each form.

1095-A, Health Insurance Marketplace Statement
  • For subscribers in plans purchased through a marketplace only.
  • Mailings started January 1, 2016. Subscribers may get a corrected Form 1095-A in February 2016.
  • Reconciles advance premium tax credit to verify income and eligibility for assistance.
  • Needed to complete IRS form 8962.
  • The 1095-A requires the subscriber to file a 1040 tax form rather than a 1040EZ.
  • Lists all dependents along with the subscriber.
  • Subscribers with multiple plans will get separate forms for each plan. Nondependent children may get their own
1095-B Health Coverage
  • For subscribers who purchased individual and family plans directly from Kaiser Permanente, including Charitable Hospital Coverage. Also for fully insured small and large group subscribers.
  • Mailed by Kaiser Permanente between February 26 and March 15, 2016.
  • Form Corrections: Corrected 1095-B forms are being produced and mailed in early-to-mid April. They will continue to be produced and mailed on an ongoing basis, as corrections come in.
  • Medicare, Medi-Cal, or Children’s Health Insurance Program subscribers receive their forms from the respective government agency.
  • Kaiser Permanente subscribers will also get a cover letter that explains:
    • what 1095-B is and why they’re getting it
    • what they need to do
    • contact information for replacement forms
1095-C, Employer-Provided Health Insurance Offer and Coverage

For employees in large group plans who were eligible for benefits at least one month in 2015.

  • Mailed by the end of March 2016 by the employer or plan sponsor.
  • Employers who self-fund must also report which employees and dependents are covered.
  • 1095-C identifies:
    • Employee and employer
    • Months during the year the employee was offered group coverage
    • Cost of the cheapest monthly premium the employee could have paid under the plan
    • Months of coverage in which the employee and/or dependents were enrolled in a self-funded plan
  • If subscribers had benefits-eligible jobs with more than one employer during 2015, they’ll get a separate 1095-C from each employer.
  • If subscribers weren’t eligible for benefits but averaged 30 or more hours per week in at least one calendar month during 2015, they should get a 1095-C.
  • Subscribers and dependents covered through a self-funded plan will need to fill out Part 3 of 1095-C to show months of coverage.
  • Subscribers in fully insured large group coverage will get both 1095-C from their employer and 1095-B from Kaiser Permanente:
    • 1095-C tells subscribers the months of the previous year they were offered coverage by their employer
    • 1095-B tells subscribers the months of the previous year they had coverage in a fully insured plan issued by Kaiser Permanente (including Kaiser Permanente Insurance Company)
  • Subscribers in self-funded large group coverage will only get a 1095-C, sent from their employer.
  • Those who waived coverage will get a 1095-C from their employer showing they were offered coverage.
Contact information
  • For questions about 1095-A, visit Covered California  or call 800-300-1506.
  • For questions about 1095-B, contact Kaiser Permanente Member Services at 844-477-0450.
  • For questions about 1095-C, subscribers should ask the employer.
  • For more info on 1095-B from Kaiser Permanente, visit kp.org/proofofcoverage.
  • For more info on 1095-B from a government agency, visit the appropriate agency website.
  • Registered members can download duplicate or receive electronic forms at kp.org/proofofcoverage.
  • For tax information, visit IRS.Gov/aca  or call the IRS at 800-829-1040.
  • For information on tax exemptions, visit healthcare.gov .

* The information presented here may change. It’s not intended as legal or tax advice.