You do not have to include it as income on your tax return as long as you did not take an itemized deduction for the premiums on last year's return. The rebate represents an adjustment of your Marketplace plan premiums. Please see the last question of the IRS Q&A on Medical Loss Ratio rebates.
The Treasury Department and the IRS are considering the issuance of guidance applicable to future tax years that will address whether a taxpayer must increase his or her tax liability for the year of the receipt of the MLR rebate to the extent the taxpayer was allowed a premium tax credit for the portion of the taxpayer’s prior-year premium that was refunded. As of now, however, the rebate does not need to be included unless the premiums were deducted on Schedule A.
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