Get Ca Ftb 3895 2024-2026

The CA FTB 3895 form is essential for reporting health insurance information for individuals enrolled in the California Health Insurance Marketplace. This guide provides step-by-step instructions to help you fill out the form online easily and accurately.

Follow the steps to complete your CA FTB 3895 form online.

1. Press the ‘Get Form’ button to access the CA FTB 3895 document and open it in your preferred editor.
2. Begin by entering the taxable year at the top of the form. Ensure that you select the correct year, which is 2024 for this specific form.
3. Fill in the recipient's name, including their first name, last name, and any suffix. Then input the recipient’s Social Security Number (SSN) and date of birth.
4. If applicable, complete the spouse’s information by entering their first name, last name, suffix, Social Security Number, and date of birth.
5. Provide the recipient's address, including the apartment or suite number, city, state, and ZIP code.
6. Indicate the marketplace identifier and the marketplace-assigned policy number.
7. Document the policy start and termination dates accurately to reflect the duration of coverage.
8. In Part I, enter the details for each covered individual, including their name, SSN, date of birth, coverage start date, and coverage termination date.
9. Move to Part II, where you will list the monthly coverage information. This includes entering enrollment premiums, second lowest cost silver plan premiums, and any advance payments for premium assistance subsidies for each month from January to December.
10. Calculate and list the annual totals for the premiums and any subsidies at the end of Part II.
11. Review all the information you have entered to ensure accuracy before you proceed to save your changes.
12. Once you have verified your data, you can download, print, or share the completed form as needed.

Take the next step by completing your CA FTB 3895 form online today.