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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.

Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.

If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

We protect your documents and personal data by following strict security and privacy standards.
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Covered California will send IRS Form 1095-A Health Insurance Marketplace Statement to all enrolled members.
Links and Resources Type of ReportingAffected EmployersRequired InformationCode §6055?Health coverage reporting by health insurance issuers and sponsors of self-insured plansEmployers with self-insured health plansInformation on each individual provided with coverage1 more row
Notice: IMPORTANT: You must have your 1095-A before you file. Don't file your taxes until you have an accurate 1095-A.
If someone else enrolled an individual in your tax family in coverage, and APTC was paid for that individual's coverage, you must file Form 8962 to reconcile the APTC. You need to obtain a copy of the Form 1095-A from the person who enrolled the individual.
What happens if you don't file your 1095-A? You will not be able to file your taxes without Form 1095-A. You can wait on your form to arrive in the mail or log into your HealthCare.gov account to find your form. If you filed your taxes before reviewing Form 1095-A, you may need to submit an amended tax return.