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Inistrator 3. Name of subscriber 4. Date of birth 5. Subscriber number 6. Street address 7. City/Town 8. State 9. Zip Full-year minimum creditable coverage? If No, indicate months with minimum creditable coverage: Yes No a. Name of dependent Date of birth Subscriber number Full-year minimum creditable coverage? If No, indicate months with minimum creditable coverage: Yes No b. Name of dependent c. Name of dependent Date of birth S.
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Ma 1099 hc form FAQ
You'll need a health insurance coverage tax form for your 2023 taxes. The form you need depends on whether you purchased your plan through Covered California (IRS 1095-A) or directly from Blue Shield of California (IRS 1095-B).
If you purchased coverage through the federally facilitated Marketplace and you set-up a HealthCare.gov account, you can get a copy of Form 1095-A, Health Insurance Marketplace Statement online from your account.
Form 1094-C is used to report to the IRS summary information for each employer and to transmit Forms 1095-C to the IRS. Form 1095-C is used to report information about each employee.
This form is not required when you file your federal or state 2023 tax return. But, we do suggest that you keep this form with your tax information. This is in case you are asked to provide proof of your health care coverage.
If you think you're missing a 1095-A, or if any information looks incorrect, contact the Marketplace Call Center.
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