Overlapping coverage and the PTC

[BCDONALD12]

I had health insurance through the marketplace for the entire year of 2024 and received a PTC to help pay for that plan. I just received a 1095-C from my employer whom I work for part time stating that I was eligible for but denied medical coverage for months Mat through December. The only medical coverage I received in the mail was from a company called Medi-Share and when I called them they told me they were not an insurance company. My company will not correct my 1095-C. Refusing company health coverage would make intelligible for the PCT. I only made 27,000 last year, but that puts me over the 9.02% above poverty level. I am at a loss as to how I file this on my taxes. If I was intelligible for the tax credit am I still eligible for limitations on form 8962 or do I have to pay all the PCT back ?

[IsabellaG]

It depends. If Medi-Share was the only form of health coverage that you were offered, it would have to offer minimum essential coverage that provides minimum value to its employees in order to be considered a health plan provided by the employer for the purpose of determining if you were eligible for the Premium Tax Credit (PTC).

 See this link: An employer-sponsored plan provides minimum value if it covers at least 60 percent of the total allo... 

If this plan did not offer minimum essential coverage, you would still be eligible for the PTC, regardless of the 1095-C. You don't report a 1095-C on your return, just the 1095-A. However, you should make sure to document what you were offered by your employer, and hold on to the 1095-C and any other evidence that the only coverage you were offered was not insurance, but a health-sharing plan that did not meet the standards of minimum value for the Affordable Care Act. At some point you may need to support your position to the IRS.