1095-A vs. 1095-C: which do I get?
Employer coverage = 1095-C. Marketplace = 1095-A.
If you're looking at tax forms and wondering which healthcare form applies to you, here's the simple answer: You get a 1095-C if your employer offered you health coverage. You get a 1095-A if you bought insurance through the Health Insurance Marketplace.
Who sends which form
Your employer sends the 1095-C directly to you (and the IRS) if they're an Applicable Large Employer with 50+ full-time equivalent employees. This includes employers offering Benefi. You'll receive this form whether you enrolled in the employer's plan or not. The key is that coverage was offered.
The Health Insurance Marketplace sends the 1095-A if you enrolled in coverage through Healthcare.gov or your state's marketplace. This form shows which months you had Marketplace coverage and any premium tax credits you received.
What if I switched coverage mid-year?
You might receive both forms for the same tax year. Here's when that happens:
Common scenarios for receiving both forms:
- Started the year on Marketplace coverage, then got a job with benefits. You'll get a 1095-A for January through your start date, and a 1095-C from your new employer.
- Lost employer coverage and enrolled in the Marketplace. Your former employer sends a 1095-C, and the Marketplace sends a 1095-A for your enrolled months.
- Had employer coverage but family members used the Marketplace. You get a 1095-C, and a 1095-A covers your family's Marketplace months.
The forms aren't mutually exclusive. Each one reports the months when that type of coverage applied.
What to do with your forms
Keep both forms with your tax records. You don't need to submit them with your return, but you'll reference them when filing.
The 1095-C helps prove you had qualifying coverage (avoiding any penalties in states that still have individual mandates). If your employer offers Benefi's MEC plan, the 1095-C shows you had an affordable coverage option available.
The 1095-A is essential if you received advance premium tax credits through the Marketplace. You'll need the information to reconcile those credits on Form 8962.
Members enrolled in Benefi MEC plans receive their 1095-C forms by January 31st each year through their employer's standard distribution method.