Reconciling your advance payments of the Premium Tax Credit

 

We sent you Letter 12C because:

  • the Health Insurance Marketplace notified us that they made advance payments of the premium tax credit to your or your family's health insurance company to reduce your premium costs for the tax year the letter references and
  • you didn’t include the Form 8962, Premium Tax Credit, to reconcile the advance payments that were paid on your behalf when you filed your individual tax return for the tax year the letter references.

When the Health Insurance Marketplace pays advance payments of the premium tax credit on your behalf, you must file Form 8962 to reconcile the advance payments to the actual amount of the Premium Tax Credit that you are eligible for based on your actual household income and family size. You must use the Form 1095-A, Health Insurance Marketplace Statement, sent to you from your Health Insurance Marketplace to complete Form 8962.

If you don't reconcile:

If you don’t reconcile, you won’t be eligible for advance payments of the premium tax credit or cost-sharing reductions to help pay for your Marketplace health insurance coverage for the following calendar year.

What you need to do

  • Read your letter carefully and respond timely.
  • You must respond to the letter, even if you disagree with the information in the letter. If you disagree, send us a letter explaining what information you think is in error. If you didn’t purchase a health insurance policy from the Marketplace, you must let us know.
  • Provide the information requested in the letter. This includes:
    • a copy of your Form 1095-A provided by your Marketplace
    • a completed Form 8962

NOTE: If you originally filed a Form 1040EZ tax return, you must transfer the information from your Form 1040EZ to a Form 1040 and include it with your response. Form 1040EZ does not have the designated lines needed to carryforward amounts from a Form 8962.

  • The Marketplace is required to send Forms 1095-A to you no later than January 31 for the applicable tax year. If you didn’t receive your Form 1095-A, log in to your HealthCare.gov or state Marketplace account or contact your Marketplace directly. The IRS cannot answer questions about the information on your Form 1095-A, reissue missing/lost forms, or issue a corrected form.
  • Do not file a Form 1040X, Amended U.S. Individual Income Tax Return. After we receive the requested information, we’ll use it to process your original tax return. If you’re entitled to a refund after reconciling your advance payments, we’ll send your refund about 6-8 weeks after we receive all of the necessary information.

How to respond

Your Letter 0012C provides a fax number, if you want to send the information by fax. Fax your information to the fax number in the notice using either a fax machine or an online fax service. Protect yourself when sending digital data by  understanding the fax service’s privacy and security policies.

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Answers to common questions

Qualifying taxpayers who enroll in health insurance through a Marketplace can receive advance payments of the premium tax credit. The Marketplace makes advance credit payments directly to the health insurance company to reduce the out-of-pocket cost of the taxpayer’s premiums. The Marketplace determines eligibility for advance credit payments when the taxpayer enrolls or enrolls a family member in Marketplace health insurance. The Marketplace estimates the amount of premium tax credit a taxpayer will qualify for using the taxpayer’s estimated household income and family size. The estimated premium tax credit is the maximum amount of advance credit payments for which the taxpayer is eligible. The taxpayer then chooses to have all, some, or none of the advance credit payments paid to the insurance provider.

Taxpayers who receive advance credit payments must compare and reconcile their advance credit payments to the actual premium tax credit they are allowed for the year. They do this reconciliation on Form 8962.

If a taxpayer’s advance credit payments are more than his or her premium tax credit, the taxpayer must repay the excess advance credit payments (the amount of the repayment may be limited for taxpayers with household income of less than 400 percent of the federal poverty line for their family size).

If the taxpayer’s advance credit payments are less than his or her premium tax credit, the taxpayer will get the benefit of the increased tax credit.

You’ll receive a Form 1095-A when you or a family member enroll in health insurance coverage through the Health Insurance Marketplace. Form 1095-A provides the information you need to complete Form 8962. If you or your family members enrolled in the Marketplace in more than one qualified health plan policy, you’ll receive a Form 1095-A for each policy. Check the information on your Form 1095-A carefully. Please contact your Marketplace if you have questions about its accuracy.