Beginning in 2014, the Affordable Care Act required each member of your family to have qualifying health care coverage (known as minimum essential coverage), qualify for an exemption or make an individual shared responsibility payment (sometimes referred to as a “fee”) when you file your federal income tax return.
How will the IRS know who had coverage?
Under IRS rules, health insurance issuers and self-funded health plans must report who had coverage to the IRS. The IRS will match the information we send with the information you include on your income tax return.
What is a 1095-B Form?
The 1095-B form is a tax form health insurers such as United Healthcare Student Resources are required to send to all fully insured members to help them with their 2015 tax return. The 1095-B lets the insured member know which months they and any dependents covered under their plan had coverage in order to avoid the individual shared responsibility penalty. A report is also submitted to the Internal Revenue Service (IRS).
What do I need to do when filling out my 2015 tax return?
If you had minimum essential coverage for every month of 2015, you will simply check a box on your tax return, and avoid having to pay the shared responsibility payment.
Insured Members will receive Form 1095-B from UnitedHealthcare by March 31, 2016. If you enrolled in coverage, these forms will indicate that you had minimum essential coverage.
However, you do not need these forms to file your tax return. Unlike the Form W-2, Form 1095-B is informational— you do NOT need to attach the form(s) to your income tax return. If you or your tax return preparer need additional evidence to confirm your coverage before you receive your 1095 form(s), you can reference any of the following:
- Health insurance card
- Explanation of Benefits
- Receipt showing payment for your coverage
- Records of advance payments of the premium tax credit
- Other statements indicating that you, or a member of your family, had health care coverage
What if I didn’t have minimum essential coverage for the entire year?
If you didn’t have minimum essential coverage for the entire year, you may have to pay the shared responsibility payment when you file your tax return. If you had a gap in coverage for fewer than three months, you may not have to pay this payment. If the gap was longer than three months and you couldn’t afford coverage, you may qualify for an exemption. Get more information on exemptions.
How much is the fee for 2015?
If you didn’t have coverage in 2015, you’ll pay the higher of these two amounts:
Two (2) percent of your yearly household income above a specified threshold. (The threshold is approximately $10,150 for an individual.) The maximum fee is the national average premium for a Bronze plan.
$325 per person for the year ($162.50 per child under 18). The maximum fee per family using this method is $975.
Does everybody need minimum essential coverage?
No. If you qualify for a health coverage exemption, you will not have to pay a fee when you file your tax return. For any month that you do not qualify for a health coverage exemption, you will need to have minimum essential coverage or pay a fee. See if you qualify for a health coverage exemption.
Will dependents older than age 18 get a separate copy of Form 1095-B?
No. Dependents older than age 18 covered under your plan will not get a separate copy of Form 1095-B. You should give a copy to anyone covered under the plan that needs a copy for his or her records.
Do my spouse and dependents have to be covered under the same plan?
No. You, your spouse and your dependents do not have to be covered under the same policy or plan. You, your spouse and each dependent for which you claim a personal exemption on your tax return must have minimum essential coverage or qualify for an exemption. If not, you may owe the fee when you file your tax return.
What if I had minimum essential coverage with another company?
You should receive a Form 1095 from any other entity (employer or insurance carrier) that provided you with minimum essential coverage.
What if I had coverage with more than one United Healthcare StudentResources policy?
Some of our insured members changed policies during 2015. As a result, they would have been covered under two clients (with two different policy numbers) during the year. These members will receive two 1095-B forms, but not in the same envelope or at the same time. Each 1095-B form will indicate the coverage period for the specified policy.
Will this form be sent again next year?
Yes. You will receive a Form 1095 every year from any provider that provided you with minimum essential coverage. If you had more than one insurer or employer during the year, you may receive multiple forms for the year.
Can I get this form electronically?
If the insured member elects to have electronic delivery of Form 1095-B, a notification is emailed to them when the form is ready to view via their MyAccount, with instructions on how to view/print the form.
This communication is not intended, nor should it be construed, as legal or tax advice. Please contact a competent legal or tax professional for legal advice, tax treatment and restrictions. Federal and state laws and regulations are subject to change.
Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Administrative services provided by United HealthCare Services, Inc., or its affiliates.
2/16 ©2016 United HealthCare Services, Inc.