Understanding the Exclusion of Form 1095-A for Small Group Health Insurance Coverage

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As taxpayers begin gathering documents for tax season, it is essential to comprehend why some people who are covered by small group health insurance plans do not receive a Form 1095-A. Unlike those enrolled in Marketplace plans, individuals covered under small group coverage do not receive this form. Let’s explore the reasons why.

  1. Employer-Sponsored Health Coverage - Small group health insurance plans are typically provided by employers to their employees. These plans fall under the category of employer-sponsored coverage, which is different from Marketplace coverage. Unlike Marketplace plans, small group plans are not facilitated through the Health Insurance Marketplace.

  2. IRS Exemption - the IRS does not require issuers of small group health insurance plans to furnish Form 1095-A to covered individuals. This exemption is due to the different reporting requirements for employer-sponsored coverage compared to Marketplace coverage.

  3. Alternative Forms - Employers offering small group health insurance coverage may issue alternative forms to employees for tax reporting purposes. Form 1095-B (typically provided by insurance companies) and 1095-C (typically used by large employers) may be issued. These forms serve similar purposes to Form 1095-A but cater to the specifics of employer-sponsored coverage. These forms may not be required when filing taxes but it is good practice to keep a copy with your tax records.

In summary, individuals covered by small group health insurance plans do not receive Form 1095-A due to the distinct nature of employer-sponsored coverage and its separate reporting requirements compared to individuals who obtain coverage through the Marketplace.

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