Get Ca Ftb 3895 2023-2026

The CA FTB 3895 form is an essential document for individuals who obtained health coverage through the California Health Insurance Marketplace. This guide will provide clear and supportive instructions on how to complete this form online efficiently.

Follow the steps to complete the form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Fill in the recipient’s information, including their name, Social Security Number (SSN), and date of birth. Also, provide the spouse's details if applicable.
3. Complete the address fields with the recipient’s complete address, including city, state, and ZIP code.
4. Include the marketplace identifier and the marketplace-assigned policy number. Also, specify the policy start date and termination date.
5. Proceed to Part I for Covered Individuals. For each covered individual, enter their name, SSN, date of birth, coverage start date, and coverage termination date.
6. In Part II, fill out the coverage information for each month, including the monthly enrollment premiums, the monthly second lowest cost silver plan (SLCSP) premium, and the monthly advance payment of premium assistance subsidy.
7. Review the entered information carefully to ensure accuracy. Make any necessary changes before proceeding.
8. Once satisfied with the information, you can save changes, download, print, or share the completed form as needed.

Start completing your CA FTB 3895 online today for a seamless filing experience.