Screen 1095A - Form 1095-A, Health Insurance Marketplace Statement (1040)

Form 8962, Premium Tax Credit uses the information on this screen and additional information from the PTC screen. Enter dependent modified adjusted gross income (MAGI) included in household income on the Coverage screen in the Health Care folder.
Source data entry
Use the UltraTax CS Source Data Entry utility to enter data on facsimile versions of forms your clients submit for the preparation of their tax returns. After you complete the facsimile forms, you can export the data to UltraTax CS and use the data sharing feature to transfer it to the client data files. For more information, including the available facsimiles, see UltraTax CS Source Data Entry overview.

Form 1095-A, Health Insurance Marketplace Statement

This field is required.
If the policy number exceeds 15 digits, enter only the last 15 digits of the policy number, per Form 1095-A instructions.
For premiums related to self-employment (SE) income, enter the activity's form and unit number. Enter
X
in the SE Health Ins column for the applicable months. Net SE income transfers from the plan's related activity and calculates the SE health insurance deduction for Schedule 1 (Form 1040). This field is mandatory when claiming premiums as a deduction.
If the Form 1095-A represents a policy that is shared with another taxpayer who is not in the same tax family, enter the Social Security number of the taxpayer and enter an allocation percentage. Form 8962, Part 4, Shared Policy Allocation uses this information.
The annual total calculates automatically. If the amount is the same each month for the entire year, complete only the
Annual total
field.
For each applicable month, enter the premiums for the benchmark Second lowest-cost Silver Plan (SLCSP) from Form 1095-A, Column B. If Column B is blank, you need to determine the applicable SLCSP. If the taxpayer's coverage household or state of residence changed during the year and the Marketplace was not notified, you may need to redetermine the SLCSP. Enter the applicable SLCSP if it is different from what is reported on Form 1095-A. If the amount is the same for each month for the entire year, only the
Annual total
field is required.
If the amount is the same for each month for the entire year, complete only the
Annual total
field.
You may need to allocate the health insurance information on Form 1095-A among more than one tax family. If any individual in the tax family was enrolled in a health plan by someone outside the tax family, or if an individual on Form 1095-A is not part of the tax family, or if the taxpayer was divorced during the year, an allocation may be required.
Enter the percent of the policy that applies to the taxpayer. If the amount for each month is the same for the entire year, complete only the
Annual total
field. UltraTax CS produces the Premium Tax Credit Shared Policy Allocation Worksheet as an audit trail when allocating policies. If the taxpayer did not receive a Form 1095-A, you can enter shared policy allocation information on the PTC screen, Part 4, Shared Policy Allocation statement. This allocation completes Form 8962, Part 4, Shared Policy Allocation.
If the health insurance premiums are attributable to self-employment income, enter the form and unit number of the related activity in the
Self-employed activity identification
fields. Also enter
X
in this column for any month the premiums should be attributable to self-employment income, or enter
X
in the Annual total row if all months apply.
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