The three items to confirm are the people listed, the months of coverage, and the second lowest cost Silver plan premium, according to HealthCare.gov.
Key takeaways
- Before completing Form 8962, Premium Tax Credit, verify that the data on the client’s Form 1095-A matches the return.
- The HealthCare.gov page titled "How to Use Form 1095-A, Health Insurance Marketplace® Statement | HealthCare.gov" instructs you to confirm the people listed, the months you had coverage, and the second lowest cost Silver plan (SLCSP) premium HealthCare.gov.
- These three specific data points are the items you must check against the client’s records.
- The Internal Revenue Service states that you use the information on Form 1095-A to claim the credit or reconcile advance credit payments on Form 8962, Premium Tax Credit Internal Revenue Service.
- The statute defines the credit amount as the premium assistance credit amount for the taxable year for an applicable taxpayer Government Publishing Office.
The short answer on the 3 Form 1095-A items
They are not IRS form line numbers. They are the three things named in the HealthCare.gov sentence.
Set the form next to your workpapers. Verify the names of all individuals covered. Verify the monthly premium amount for the SLCSP. This focus keeps your review efficient. It targets the data that drives the credit calculation. It avoids unnecessary scrutiny of unrelated fields.
What the IRS says to file with the premium tax credit
The premium tax credit, also known as PTC, is a refundable credit that helps eligible individuals and families cover the premiums for their health insurance purchased through the Health Insurance Marketplace, according to Internal Revenue Service. To get this credit, you must meet certain requirements and file a tax return with Form 8962, Premium Tax Credit (PTC), according to Internal Revenue Service.
Use the information on Form 1095-A to claim the credit or reconcile advance credit payments on Form 8962, Premium Tax Credit, according to Internal Revenue Service. You claim the premium tax credit and reconcile the credit with the amount of your advance credit payments for the year on Form 8962, according to Internal Revenue Service.
For tax years other than 2020, if you get the benefit of advance credit payments in any amount – or if you plan to claim the premium tax credit – you must file a federal income tax return and attach Form 8962, Premium Tax Credit (PTC), to your return, according to Internal Revenue Service. This requirement applies specifically to tax years other than 2020. Do not apply this exception to any other year.
When you prepare the return for a client, verify that Form 8962 is included if the client received advance credit payments. See Form 8879 signature rules: 3 checks before you e-file.
The 3 items HealthCare.gov tells you to confirm
The page clarifies that the form comes from the Marketplace, not the Internal Revenue Service (IRS), according to HealthCare.gov. This distinction is important for your intake process because it identifies the origin of the document your client received. See Accounting Client Intake Checklist for a Clear Handoff. You can find the SLCSP on Form 1095-A, sent by the Marketplace annually, or use the HealthCare.gov tax tool, according to HealthCare.gov.
When reviewing the document, pay attention to the status of the plan during the tax year. A voided form means your Marketplace plan was canceled after your 1095-A was already sent to you, according to HealthCare.gov. If this situation applies to your client, the document may not reflect the final state of their coverage. This partial month treatment affects the premium figures listed on the form. You should verify whether any months show partial coverage rather than full monthly premiums.
Check the months of coverage to see if any are marked as partial. Keep these details alongside the return to support the accuracy of the figures you enter.
What the statute says the credit and family size are
The statute defines the credit amount and the family size used in the calculation. In the case of an applicable taxpayer, there shall be allowed as a credit against the tax imposed by this subtitle for any taxable year an amount equal to the premium assistance credit amount of the taxpayer for the taxable year, according to Government Publishing Office.
Family size is defined separately. The family size involved with respect to any taxpayer shall be equal to the number of individuals for whom the taxpayer is allowed a deduction under section 151 (relating to allowance of deduction for personal exemptions) for the taxable year, according to Legal Information Institute. This definition ties family size to the personal exemption deduction count for the year.
The statute also specifies how the total premium is treated. The total premium for the coverage is determined without regard to the credit under this section or cost-sharing reductions under section 1402 of such Act, according to Legal Information Institute. This means the premium figure used in the calculation excludes the credit itself and any cost-sharing reductions.
For married taxpayers, the statute sets a filing requirement. If the taxpayer is married (within the meaning of section 7703) at the close of the taxable year, the taxpayer shall be treated as an applicable taxpayer only if the taxpayer and the taxpayer's spouse file a joint return for the taxable year, according to Government Publishing Office. This joint return requirement is part of the definition of an applicable taxpayer.
The statute also requires information to determine whether a taxpayer has received excess advance payments, according to Legal Information Institute. This information requirement supports the reconciliation process on Form 8962.
Confirm that the family size count matches the number of individuals for whom the taxpayer is allowed a deduction under section 151. Ensure that the total premium figure excludes the credit and cost-sharing reductions. If the client is married, confirm that they filed a joint return. These checks align the return with the statute's definitions.
Filled reference table from the IRS, HealthCare.gov, and the statute text
The table below maps the core requirement from each publisher to the specific text that defines it. Use this reference to verify that your workpapers align with the source language before you finalize the return.
| Publisher | Key Fact | Source Quote |
|---|---|---|
| Internal Revenue Service | You must meet certain requirements and file a tax return with Form 8962, Premium Tax Credit (PTC). | "To get this credit, you must meet certain requirements and file a tax return with Form 8962, Premium Tax Credit (PTC)." |
| HealthCare.gov | Confirm the people listed, the months you had coverage, and the second lowest cost Silver plan (SLCSP) premium. | "Confirm the people listed, the months you had coverage, and the second lowest cost Silver plan (SLCSP) premium:" |
| Government Publishing Office | An amount equal to the premium assistance credit amount of the taxpayer for the taxable year is allowed as a credit. | "In the case of an applicable taxpayer, there shall be allowed as a credit against the tax imposed by this subtitle for any taxable year an amount equal to the premium assistance credit amount of the taxpayer for the taxable year." |
According to Internal Revenue Service, the requirement to file Form 8962 is tied to meeting certain requirements for the credit. The IRS sentence names the form explicitly as the Premium Tax Credit (PTC) form. This citation anchors the filing obligation to the specific document your client must submit.
According to HealthCare.gov, the three items to confirm are the people listed, the months of coverage, and the second lowest cost Silver plan premium. This sentence provides the exact list of data points you must match against the client’s Form 1095-A.
According to Government Publishing Office, the statute allows a credit against the tax imposed by the subtitle. The amount allowed is equal to the premium assistance credit amount of the taxpayer for the taxable year. This legal text defines the nature of the credit as a subtraction from the tax liability for the specific year in question.
A Form 1095-A match note for this client
Use this note to record the specific details from the client’s Health Insurance Marketplace® Statement.
| Item | What you compare | What you keep |
|---|---|---|
| Example | People, months, and premium | Note kept with the workpapers |
This note serves as your internal check before you move to Form 8962.
Keep this note with the client’s workpapers. See Workpaper recovery: 4 checks for a prior version. If any value is missing or unclear, request a corrected Form 1095-A from the client before proceeding. Do not estimate the premium or assume the months of coverage; the form must show the exact figures. This simple check ensures the data you enter into Form 8962 matches the source document.
Illustrative example of the three checks
One illustrative household has 2 people listed, coverage shown for 10 months, and an illustrative second lowest cost Silver plan premium of 350. Month 4 is the partial month, so the statement shows premium for only part of that month. You match the 2 people, the 10 months, and 350 to the return. You do not replace a missing month with a guess. These figures are illustrative only.
Next step before Form 8962
Compare the people, months, and SLCSP premium on the client's Form 1095-A against the information you have for the return.
Form 1095-A and Form 8962 FAQ
What are the 3 items to confirm on Form 1095-A?
The three items are the people listed, the months you had coverage, and the second lowest cost Silver plan (SLCSP) premium. HealthCare.gov instructs you to confirm these specific details. These items are not IRS form line numbers but rather the data points named in that guidance.
What is Form 8962 used for?
You must file a tax return with Form 8962, Premium Tax Credit (PTC), to get the credit. The Internal Revenue Service states that you must meet certain requirements to receive this benefit. Filing this form is the mechanism for claiming the premium tax credit.
What does a voided form mean on the HealthCare.gov page?
A voided form means your Marketplace plan was canceled after your 1095-A was already sent to you. HealthCare.gov defines this status specifically in relation to the timing of the cancellation and the mailing of the form.
What does a partial month do to the premium on the form?
In this case, your Form 1095-A will show only the premium for the parts of the month you had coverage. HealthCare.gov explains that the form adjusts the premium amount based on the specific portion of the month covered. This ensures the reported amount matches the actual period of active insurance.
What does the statute's family-size sentence count?
The family size involved with respect to any taxpayer shall be equal to the number of individuals for whom the taxpayer is allowed a deduction under section 151. This section relates to the allowance of deduction for personal exemptions for the taxable year. Legal Information Institute provides this definition within the context of the refundable credit for coverage under a qualified health plan.