Fill out Form 1095-A, Health Insurance Marketplace Statement with Instafill.ai

Form 1095-A, Health Insurance Marketplace Statement, is used to report information about health insurance coverage obtained through the Marketplace. It is important for individuals to accurately complete their tax returns, especially if they received premium assistance.
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Form 1095-A, Health Insurance Marketplace Statement free printable template

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Are you looking to fill out a 1095-A form online quickly and accurately? Instafill.ai offers the #1 AI-powered PDF filling software of 2024, allowing you to complete your 1095-A form in just 37 seconds or less.
Follow these steps to fill out your 1095-A form online using Instafill.ai:
  1. 1 Visit instafill.ai site and select Form 1095-A.
  2. 2 Enter recipient and policy information.
  3. 3 Fill in covered individuals' details.
  4. 4 Complete coverage information for each month.
  5. 5 Sign and date the form electronically.
  6. 6 Check for accuracy and submit the form.

Our AI-powered system ensures each field is filled out correctly, reducing errors and saving you time.

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Frequently Asked Questions About Form Form 1095-A

Form 1095-A is used by Health Insurance Marketplaces to report information on enrollments in a qualified health plan in the individual market through the Marketplace.

Individuals who enrolled in health insurance coverage through the Health Insurance Marketplace or their family members should receive Form 1095-A.

Part I includes recipient information such as Marketplace identifier, policy number, policy issuer's name, recipient's details, and policy dates.

Part II contains information about covered individuals under the policy, including names, SSNs, dates of birth, and coverage dates.

Form 1095-A provides information needed to complete Form 8962, Premium Tax Credit (PTC), and is required for accurate tax return filing.

Instructions for Form 1095-A can be found at www.irs.gov/Form1095A for guidance and the latest information.

If the 'VOID' box is checked, it indicates that a previously received Form 1095-A was sent in error and should not be used for calculating premium tax credit.

Part III provides coverage information necessary for completing Form 8962 to reconcile advance credit payments or claim the premium tax credit during tax filing.

Monthly premiums, second lowest cost silver plan premium, and advance credit payments are reported in columns A, B, and C respectively for each month in Part III of Form 1095-A.

If the 'CORRECTED' box is checked, the information on the corrected Form 1095-A should be used to calculate the premium tax credit and reconcile any advance credit payments.

Compliance Form 1095-A
Validation Checks by Instafill.ai

1
Form Version Accuracy
Ensures the use of the most current version of Form 1095-A, incorporating the latest updates and guidelines from the Department of Health and Human Services (HHS).
2
Complete Field Verification
Automatically detects and alerts if any required fields are left blank, ensuring no essential information is missing from the form.
3
Policy Number Validation
Confirms the correct format and accuracy of the policy number, crucial for linking the form to the correct health insurance policy.
4
Name and Social Security Number (SSN) Consistency
Ensures that the name on the form matches the SSN provided, a critical step for accurate policyholder identification.
5
Coverage Period Checks
Verifies that the coverage start and end dates are accurately reported, reflecting the actual period of insurance coverage.
6
Premium Amount Verification
Confirms that the total amount of premiums reported aligns with the records from the health insurance provider, ensuring accurate financial reporting.
7
Tax Credit Eligibility Confirmation
Validates eligibility and the amount of the advance payment of the premium tax credit, crucial for correct tax benefit claims.
8
Exemption Claims Verification
Verifies valid claims for exemptions based on the type of coverage or other qualifying criteria set by health insurance regulations.
9
Signature and Date Validation
Ensures that the form is signed and dated, validating the filer's acknowledgment and certification of the information provided.
10
Cross-Field Consistency Analysis
Performs logical cross-checks within the form to ensure all related information, such as SSN and premium amounts, are consistent.

Common Mistakes in Completing Form 1095-A

Providing a Social Security Number (SSN) that is incorrectly formatted (e.g., wrong number of digits or structure). Using an SSN that does not match the Social Security Administration records for the name listed on the form, leading to mismatches and processing delays.

Failing to use the legal name as it appears in Social Security Administration records, especially for policyholders or dependents with name changes that have not been updated. For policies covering multiple individuals, not listing the name of the person whose SSN is provided.

Reporting more than one type of coverage or the wrong coverage type for the policyholder’s actual insurance. Misunderstanding coverage periods, leading to incorrect reporting of the start or end dates.

Claiming incorrect premium amounts, often due to misunderstanding the amounts covered by subsidies versus actual out-of-pocket expenses. Incorrectly reporting monthly premiums, which can affect tax credit calculations.

Neglecting to provide details about essential health benefits covered, which is crucial for determining eligibility for certain tax credits. Overlooking required additional documentation for specialized or supplementary coverage, leading to incomplete or non-compliant submissions.

Submitting the form without the necessary signature, which certifies the accuracy of the information and compliance with healthcare reporting requirements. Forgetting to date the signature, which is important for validating the timeliness and relevance of the form’s information.

Providing outdated or incorrect address details, which can cause issues with correspondence and benefit statements. Not updating the form when there are significant changes to contact information or family status.

Misclassifying the type of insurance (e.g., individual vs. family plan) which affects coverage details and premium tax credits. Sole policyholders not properly identifying dependent coverage alongside their own.

Not resubmitting the form when there are changes in coverage, such as a new policy number or insurance provider. Failing to notify the Marketplace of changes in eligibility for premium tax credits, which can lead to incorrect subsidy applications.
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Fill out Form 1095-A, Health Insurance Marketplace Statement with Instafill.ai

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