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1095-C and Premium Tax Credit (PTC) Eligibility?

How can it be that no information is needed from 1095-C when according to the IRS Part II contains information regarding premium tax credit eligibility?  Seems like that would be pretty significant to a persons tax return and refund or amount owed.

Can you clear this up for me?  Thanks

References:

https://ttlc.intuit.com/questions/2941634-what-do-i-do-if-i-have-a-1095c
What do I do if I have a 1095C?

https://ttlc.intuit.com/questions/2920031
Do I need to enter my 1095-C?
No. You don't need your 1095-C to file your tax return. We'll ask you questions about your health coverage but form 1095-C isn't needed for those. Just file the form with your tax records.

https://www.irs.gov/affordable-care-act/individuals-and-families/form-1095-c-what-you-need-to-do-wit...

•If you enrolled in a health plan through the Marketplace, the information in Part II of Form 1095-C could help determine if you’re eligible for the premium tax credit.

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6 Replies

1095-C and Premium Tax Credit (PTC) Eligibility?

Well, this is mostly just for your information.  If your employer provides Employer-Sponsored Affordable Health Coverage, then you are not eligible for the Premium Tax Credit.  So, if you have been covered by your employer, this will make the 1095-C, not at all important when calculating anything on your return as you would not be subject to penalty and not eligible for the Premium Tax Credit.  You will, however, want to keep it for your records as proof of coverage. 

Part 2 will really only matter when the employer is NOT providing affordable coverage.  This again will be for your information and will be useful if you are contacting the marketplace.  You will also be able to use these numbers to calculate whether or not it is affordable when it comes to waiving the penalty ( is what they are offering more than 8.13% of your income for each month).  If it is, then you would be exempt from the penalty.

So, the importance only comes from determining whether or not you were able to get affordable insurance through your job. 

"5. Who is eligible for the premium tax credit?

You are eligible for the premium tax credit if you meet all of the following requirements:

  • Have household income that falls within a certain range (see question 7).
  • Do not file a Married Filing Separately tax return ((unless you qualify for a special rule that allows certain victims of domestic abuse and spousal abandonment to claim the premium tax credit using the Married Filing Separately filing status (see questions 9 and 10));
  • Cannot be claimed as a dependent by another person; and
  • In the same month, you, or a family member:
    • Enroll in coverage (excluding “catastrophic” coverage) through a Marketplace
    • Are not able to get affordable coverage through an eligible employer-sponsored plan that provides minimum value (see questions 11 and 12)
    • Are not eligible for coverage through a government program, like Medicaid, Medicare, CHIP or TRICARE
    • Pay the share of premiums not covered by advance credit payments"

https://www.irs.gov/affordable-care-act/individuals-and-families/questions-and-answers-on-the-premiu...

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1095-C and Premium Tax Credit (PTC) Eligibility?

Thanks Vanessa for the prompt reply.

I understand that.  But where is this handled in TurboTax?  If 1095-C Part II 14 "Offer of Coverage" is relevant to PTC eligibility then seems this would be necessary, even critical, in order to correctly calculate a persons taxes.

1095-C and Premium Tax Credit (PTC) Eligibility?

It's not relevant on your actual return.  The Premium Tax credit is only available if you have a 1095-A from the Marketplace.  So, if you do not have anything from the Marketplace, you won't be able to get the credit.
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1095-C and Premium Tax Credit (PTC) Eligibility?

If you were to call the Marketplace and say I have code such and such on my 1095C, they would then be able to say, you are eligible for insurance through the marketplace or you are not.  If you are, then you would get a 1095-A and if you were eligible for the tax credit then that would be on your return from the 1095-A.
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1095-C and Premium Tax Credit (PTC) Eligibility?

DOES NET WORTH COME INTO PLAY AT ALL ON THE Premium Tax Credit ?. WHAT IF YOUR INCOME DIPPED IN 2019 TO LOW LEVELS BASED ON STOCK LOSSES OR REDUCED DIVIDENDS?

TURBO TAX IS GUIDING FOR A PTC CREDIT IN 2019 VIA FORM 8962.

 

IF YOU HAVE A HIGH NET WORTH,  ARE YOU STILL QUALIFIED FOR THIS CREDIT?

1095-C and Premium Tax Credit (PTC) Eligibility?

Net worth means nothing when figuring the PTC but you must have had insurance thru the Marketplace and get a 1095-A issued to you.  

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