reconciliation of APTC

[TP29]

Our family of 4 was enrolled in a marketplace plan for the whole year. Starting November, my wife became eligible for an employer sponsored plan, but we did not enroll into it. We also missed reporting this to healthcare.gov.

Now she has received form 1095-A from the marketplace, and will most probably be getting a 1095-C from the employer. How do we reconcile the two, since 1095-A now has the incorrect figures for November and December.

Thank You!

[MarilynG1]

If you didn't enroll into your wife's employer healthcare plan, then enter your 1095-A into TurboTax as it is shown, since it is correct.  You don't need to report to healthcare.gov until you actually enroll in the employer plan. 

Just because you were eligible to participate in the employer plan, does not mean you were required to do so.  If the cost of the employer plan is considered 'excessive' or doesn't provide adequate coverage, you can stay in your Marketplace plan.

You don't enter a 1099-C into TurboTax; it is for your records.  

Here's more info on Marketplace vs. Employer Plans. 

[TP29]

Thank You @MarilynG1 

I was concerned about the statement 

"If you have a Marketplace plan and then get an offer of health insurance through a job, you may no longer qualify for savings on your Marketplace plan. As long as the job-based plan is considered affordable and meets minimum standards, you won’t qualify for savings. This is true even if you don’t accept the job-based coverage offer". 

In our case, we did not accept the offer, but it could be considered 'affordable' and meeting the minimum standards. How do we handle the amounts reported on 1095-A in such case? does the SLCSP need to be adjusted for November and December to just the other 3 (except my wife)?

Thank You!

[MarilynG1]

Don't change any numbers on your 1095-A, as you did receive the PTC for those months.  You may hear from the IRS if you do so, since they have a copy. 

You may have to repay some PTC for November and December, if you indicate that you had eligible employer insurance for those months. 

@TP29

[TP29]

Thanks a lot, @MarilynG1 this is really helpful !

Just one more question, where do I specify in turbotax that we had eligible employer coverage for the last 2 months?

[GeorgeM777]

To follow-up on the comments from @MarilynG1, you don't enter into TurboTax that you were eligible for employer coverage for the last two months of 2022.  Continue to enter the amounts on your Form 1095-A.  

Reconciliation for the premium tax credit is done on a month-by month basis.  If you still qualify to receive a subsidy based on your total income for the year, then you may not have to pay back any of the subsidy you received.  However, if your total income for the year is higher than you had previously indicated, you may have to pay back some of the premium subsidy.  The higher your total income for the year, the more premium subsidy you may have to pay back.   

@TP29

[AmeliesUncle · Accepted solution]

Assuming your employer insurance was "affordable", then you need to enter $0 for the Second Lowest Cost Silver Plan (SLCSP; column B of the 1095-A) for the months you qualified for employer insurance.

[TP29]

Thats what I thought too. Just that turbotax doesn't allow to put $0 for the SLCSP 🙂

[AmeliesUncle]

Oh yeah, I forgot about that.  You may need to file by mail.   Or if you are willing to have your tax return be 'off' by a couple of dollars, you could enter $1.