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1095A - which is amt actually paid


schirallicpa

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The client has provided me an amount for health care insurance costs that (of course) doesn't match any figure on this 1095A.  I'm assuming that column A "monthly enrollment premiums" is the payment they actually made.  But finding it difficult to confirm with my google searches.  And it is a Sunday afternoon, and I should be home doing something creative....

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38 minutes ago, schirallicpa said:

I'm assuming that column A "monthly enrollment premiums" is the payment they actually made. 

Their payment should be column A less any APTC they accepted that would be shown in column C.  However...

Depending on the state and whether a state marketplace or the Fed marketplace was used, I can tell you that sometimes the Jan payment actually billed and paid may be the same as that of the prior year's policy if the application was done near the deadline because the Fed marketplace has to communicate the renewal information to the insurance co, and not all states' insurance companies are linked directly to the marketplace for the applicant to pay the premium at the time of application, so the insurance co may have assumed renewal of the existing policy at the 2019 rate and wouldn't know of any APTC agreed to at that time.  If that is the case, the insurance co will give credit for whatever premium amount was paid and adjust the Feb bill accordingly, but the 1095 will show the Jan premium for the new policy that should have been paid.

Do the yearly totals on the 1095 appear to be what the taxpayer paid on an annual basis?  I've seen 1095s with errors that had to be corrected, but it's been a couple of years since then. 

Edited by jklcpa
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6 minutes ago, schirallicpa said:

So - the amount they actually paid is column A minus column C?

Yes, that should be it.  I did have that one that was totally messed up though.   If you can't reconcile it, maybe you should ask the client for a list of the actual payments made each month, or the bills from the insurance company.

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