Your total (or gross) income for the tax year, minus certain adjustments youre allowed to take. Add the amounts on lines 2a and 2b. One qualified health plan covers Bret, his spouse Paulette, and their daughter Sophia from January through August, and APTC is paid for the coverage of all three. Your SLCSP premium is reported in Part III, column B, lines 21 through 32, of Form 1095-A. You should round the amounts on Form 1095-A to the nearest whole dollar and enter dollars only on Form 8962. See the instructions for Line 1 and Line 9, earlier, to determine whether you need to complete Part IV. Enter the smaller of line 27 or line 28. For help determining which of these forms to file, see the Instructions for Form 1040 or the Instructions for Form 1040-NR. Follow the rules in Column (f), earlier, to report this APTC. APTC was paid for you or another individual in your tax family. Stephanie and Keith both enter 01 in column (c) and 07 in column (d). Individual you enrolled who is not included in a tax family. You must repay the amount shown on line 27. For a single person, the 2022 federal poverty level is $13,590 in the continental U.S. For each additional person in the household, the federal poverty level increased by $4,720 (so for a household of three, for example, the 2022 federal poverty level is $23,030). You must repay the APTC allocated to you subject to the limit on line 28 because you are not an applicable taxpayer. *If your family size was more than 8 people, add $4,540 for each additional person. If you file a paper return and. However, if you became eligible for APTC because of a successful eligibility appeal and you retroactively enrolled in the plan, the portion of the enrollment premium for which you are responsible must be paid on or before the 120th day following the date of the appeals decision. If you or a member of your tax family was enrolled in a stand-alone dental plan that provided pediatric benefits, the portion of the dental plan premiums for the pediatric benefits will be included in the amount in column A on the Form 1095-A that reports the coverage in your primary health plan. Exception 1Certain married persons living apart. 974 for more information. 974 for instructions on how to figure the amounts to enter in column (e). You and your spouse must equally allocate (50% to each spouse) certain policy amounts if all of the following conditions are met. See Missing or incorrect SLCSP premium on Form 1095-A under Line 10, earlier, to determine your correct applicable SLCSP premium. Henry purchased different health insurance for himself through a Marketplace for July through December. *If your family size was more than 8, add $5,220 for each additional person. The poverty rate for married-couple families increased from 4.0 percent in 2019 to 4.7 percent in 2020. However, in order to rely on a Marketplace's determination that you or a family member was ineligible for Medicaid, CHIP, or a similar program, you must provide accurate information to the Marketplace when you enroll in a qualified health plan. Thus, 33% of the policy amounts are allocated to Jane's coverage. John leaves columns (e) and (f) blank because he is not an applicable taxpayer and cannot take the PTC. If you need health coverage, visit HealthCare.gov to learn about health insurance options that are available for you and your family, how to purchase health insurance, and how you might qualify to get financial assistance with the cost of insurance. You can take the PTC for 2022 if you meet the conditions under (1), (2), and (3) below. Melissa must add this amount to her APTC of $3,200 for her single coverage. Also see How To Avoid Common Mistakes in Completing Form 8962 at the end of these instructions. If you were covered under an individual coverage HRA for 2022, you are not allowed a PTC for your 2022 Marketplace health insurance. Poverty in the United States Single people in the United States making less than 12,880 U.S. dollars a year. Adjusted gross income appears on IRS Form 1040, line 11. Therefore, you and the other tax family must allocate the enrollment premiums, the APTC, and the applicable SLCSP premium so that each family is able to compute their PTC and reconcile their PTC with the APTC paid for their coverage. Your credit amount for each month is the lesser of: The enrollment premiums (described next) for the month for one or more qualified health plans in which you or any individual in your tax family enrolled, or. Then check the Yes box on line 9 and follow the instructions for Line 9 and Part IV. Ryan enters the amount from line 29 on the applicable line of his tax return. If you have concerns about your safety, please consider contacting the confidential 24-hour National Domestic Violence Hotline at 1-800-799-SAFE (7233), or 1-800-787-3224 (TTY), or 1-855-812-1001 (video phone, only for deaf callers). See Pub. Form 1095-A shows the months of coverage purchased through the Marketplace and any APTC paid to your insurance company to help cover your monthly premium. If you are required to use lines 12 through 23 of Form 8962, enter the amounts from lines 1 through 12 of this worksheet in the lines for the corresponding months and columns on Form 8962. Advance payment of the premium tax credit (APTC). However, if you got married in December of 2022 and you and your spouse, or individuals in your and your spouse's tax family, were enrolled in separate qualified health plans, add the amounts from Form 1095-A, column B, for each plan (or plans) and enter the total. Adjusting your APTC when you re-enroll in coverage and during the year can help you avoid owing tax when you file your tax return. If individuals in your coverage family enrolled in separate policies in the same state, you will receive a Form 1095-A for each policy. If you did not complete Part VAlternative Calculation for Year of Marriage, enter on lines 12 through 23, column (c), your monthly contribution amount from line 8b. IRS Lowers Employer Health Plans' 2020 Affordability Threshold The annual limit on the percentage of income that employees can be required to pay for health plan premiums will fall slightly. In the case of household income (expressed as a percent of poverty line) within the following income tier: The initial premium percentage is The final premium percentage is Up to 150.0 percent. If you must make more than four allocations of policy amounts shown on Forms 1095-A, check the No box on line 34 and attach a statement to your return providing the information shown on lines 30 through 33, columns (a) through (g), for each additional allocation. Once you complete line 11, skip to line 24. Generally, there are two situations where your SLCSP premium may not be accurately reflected on your Form 1095-A. Depending on the facts and circumstances, abuse of an individuals child or other family member living in the household may constitute abuse of the individual. In 2018, the national middle-income range was about $48,500 to $145,500 annually for a household of three. This amount is the total of your enrollment premiums for the year, including the portion paid by APTC. Other health coverage the Department of Health and Human Services designates as MEC. Multiply line 3 by line 7 and enter the result on line 8a, rounded to the nearest whole dollar amount. According to Table 3, Henry and Cara will allocate the amounts from the policy for January through June on line 30 using the rules under Allocation Situation 1. 974 for guidance on determining whether an individual coverage HRA is affordable. The children become eligible for and enroll in government-sponsored health coverage and disenroll from the qualified health plan, effective August 1. See. MAGI is adjusted gross income (AGI) plus these, if any: untaxed foreign income, non-taxable Social Security benefits, and tax-exempt interest. Catastrophic health plans and stand-alone dental plans purchased through the Marketplace, and all plans purchased through the Small Business Health Options Program (SHOP), are not qualified health plans for purposes of the PTC. See, If 100% of the policy amounts are allocated to you, check, If you are not an applicable taxpayer because you are using filing status married filing separately and, In all other situations, leave column (f) blank because you do not allocate the applicable SLCSP premium reported in those situations. On his Form 8962, Part IV, line 30, John enters Carols SSN in column (b) and enters 0.50 in column (g). If line 24 is equal to line 25, enter -0- on line 26 and skip lines 27 through 29. However, column B reports $650 for December on line 32 because an individual included in Lee's coverage family was eligible for MEC (other than coverage in the individual market) for the entire month of December and Lee reported the change to the Marketplace. Enter for each month the lesser of the amount in column (a) or the amount in column (d) for that month. If you have concerns about your safety, please consider contacting the confidential 24-hour National Domestic Violence Hotline at 1-800-799-SAFE (7233), or 1-800-787-3224 (TTY), or 1-855-812-1001 (video phone, only for deaf callers). Check the box to indicate your state of residence in 2022. Beginning in 2020, employers can offer individual coverage health reimbursement arrangements (individual coverage HRAs) to help employees and their families with their medical expenses. Therefore, 20% of the enrollment premiums, APTC, and the applicable SLCSP premium are allocated to Alice and 80% are allocated to Joe. This dataset contains a selection of six socioeconomic indicators of public health significance and a "hardship index," by Chicago community area, for the years 2007 - 2011. If this information changed during 2022 and you did not promptly report it to the Marketplace, the amount of APTC paid may be substantially different from the amount of PTC you can take on your tax return. According to Table 3, John and Carol follow the rules under Allocation Situation 2. If you file a paper return and do not round amounts to whole dollars, be sure to enter the decimal point to separate dollars and cents. If your household income is less than 100% of the federal poverty line, and you do not meet the requirements under Estimated household income at least 100% of the federal poverty line or Alien lawfully present in the United States, earlier, you are not an applicable taxpayer and you are not eligible to take the PTC. Complete line 36, columns (a) through (d), as indicated in Pub. If you entered an ITIN on your tax return, enter this number on Form 8962. 974. See Pub. You must be an applicable taxpayer to take the PTC. For more information, see, Qualified Small Employer Health Reimbursement Arrangement, Other changes affecting the composition of your, For more information on how to report a change in circumstances to the Marketplace, see, For additional information about the tax provisions of the Affordable Care Act (ACA), see, The PTC is a tax credit for certain people who enroll, or whose family member enrolls, in a, APTC is a payment during the year to your insurance provider that pays for part or all of the premiums for a qualified health plan covering you or an individual in your tax family. Keith and Stephanie agree to allocate the policy amounts 33% to Stephanie and 67% to Keith. For purposes of the PTC, your tax family consists of the following individuals. Enter 0.50 in column (g) of the appropriate line in Part IV to allocate the APTC. Joe must reconcile $5,716 of APTC ($7,145 x 0.80). If you file as married filing separately and are not a victim of domestic abuse or spousal abandonment (see Exception 2Victim of domestic abuse or spousal abandonment under Married taxpayers above), then you are not an applicable taxpayer and you cannot take the PTC. Enter the lesser of the amount in column (a) or the amount in column (d). According to Table 3, they follow the rules under Allocation Situation 2. See Missing or incorrect SLCSP premium on Form 1095-A, later. The Marketplace estimated at the time of enrollment that your household income would be at least 100% of the federal poverty line for your family size for 2022. Paulette files a tax return using a filing status of single. FPL is used to determine eligibility for: Medicaid, Marketplace Tax Subsidies, SNAP, energy assistance, and other subsidies. Enter 401 here and on line 5 of Form 8962. Enter on line 4 the amount from Table 1-1, 1-2, or 1-3 that represents the federal poverty line for your state of residence for the family size you entered on line 1 of Form 8962. Enter the annual enrollment premiums from Form 1095-A, line 33, column A. Do not include the modified AGI of dependents who are filing a tax return only to claim a refund of tax withheld or estimated tax. For purposes of the PTC, household income is the modified adjusted gross income (modified AGI) of you and your spouse (if filing a joint return) (see Line 2a, later) plus the modified AGI of each individual whom you claim as a dependent and who is required to file an income tax return because his or her income meets the income tax return filing threshold (see Line 2b, later). If you got married during 2022 and APTC was paid for an individual in your tax family, you may want to use the alternative calculation for year of marriage, an optional calculation that may allow you to repay less excess APTC than you would under the general rules. Alternative calculation for year of marriage. See Form 1095-C, line 14, and the Instructions for Recipient included with that form, for information about whether you and other members of your tax family were offered coverage. Column (f) is left blank. You allocated the policy amounts under Allocation Situation 4. 974 under Alternative Calculation for Year of Marriage. Mike and Susan check the No box on Form 8962, line 10, and complete lines 12 through 23. Was anyone in your tax family enrolled in a qualified health plan before your first full month of marriage? Today, 73 percent of extremely low-income renters defined as households whose incomes are at or below the poverty line or 30 percent of their area's median income pay more than half of . At 194% of the federal poverty guidelines this income could qualify for a premium tax credit and a cost-sharing reduction via a Marketplace Silver plan. Carols federal poverty line percentage is determined using only her and Mark's modified AGI. Enter the appropriate amount from Table 5 on line 28. If you were covered under a QSEHRA, your employer should have reported the annual permitted benefit in box 12 of your Form W-2 with code FF. 974 because amounts on Form 1095-A must be allocated among three tax families (Brets, Paulettes, and Mikes). If you were married at the end of 2022, generally you must file a joint return. The termination is generally effective no sooner than the second month of nonpayment. Finally, if your employer offered coverage for you but not your family, you may be able to take the PTC for your family members. The recipient of the Form 1095-A should provide a copy to the nonrecipient. They cannot take the PTC for their own coverage and are not eligible for the repayment limitations in Table 5 for APTC paid for their own coverage. Carol must then reconcile $4,250 ($8,500 x 0.50) of the APTC for her coverage. If your correct applicable SLCSP premium is not the same for all 12 months, check the No box and continue to lines 12 through 23. It is an economic measure used by government agencies to determine if an individual or family's income is eligible for certain federal subsidies and benefits. In that case, you must use a different applicable SLCSP premium to calculate your credit than the amount reported on Form 1095-A, Part III, column B. If APTC was paid on your behalf, or if APTC was not paid on your behalf but you wish to take the PTC, you must file Form 8962 and attach it to your tax return (Form 1040, 1040-SR, or 1040-NR). For individuals with household income below 100% of the federal poverty line, see Household income below 100% of the federal poverty line under Line 5, later. Need to determine correct applicable SLCSP premium. Household income below 100% of the federal poverty line. Henry claims Heidi as a dependent on his tax return. For additional information about the tax provisions of the Affordable Care Act (ACA), see IRS.gov/Affordable-Care-Act/Individuals-and-Families or call the IRS Healthcare Hotline for ACA questions (800-919-0452). In February 2024, when John files his 2023 tax return, John's federal tax is $1,500. The allocation percentage you use and that you put on line 30 of Form 8962 is the percentage of the policy amounts for the coverage that you will use to compute your PTC and reconcile APTC. If you have more than one Form 1095-A affecting a particular month, add the amounts together for that month and enter the total on the appropriate line on Form 8962, column (a). The annual enrollment premium for the plan is $13,000. Net income, which is the household's income minus deductions, must be at or below the poverty line (100%). Melissa and Ryan lived apart for most of 2022 and each filed a separate return for 2022. Joes tax family for 2022 includes only Joe and Chris, and Joes household income of $66,196 is 380% of the federal poverty line for a family size of two. Enter the amount from column B of only one Form 1095-Ado not add the amounts from each form. work on poverty-and efforts to reduce . If no APTC was paid for your or your family members coverage, the SLCSP premium reported in Part III, column B, lines 21 through 32, of Form 1095-A may be wrong, left blank, or reported as -0-. Gender, . Generally, if coverage in a qualified health plan began after the first day of the month, you are not allowed a monthly credit amount for the coverage for that month. Enter the result of $72,890 on Form 8962, line 4. (For reference, it was $42,660 for a family of 3 in 2019.) Barbara's household income in 2021 is 150% of the federal poverty line, and she purchased health insurance coverage through an ACA marketplace whose premium does not exceed the premium for a benchmark plan. Lee receives a Form 1095-A, which reports in column A $1,000 on lines 21 through 32 for January through December and in column B $900 on lines 21 through 31 for January through November. If someone else enrolled an individual in your tax family in coverage, and APTC was paid for that individuals coverage, you must file Form 8962 to reconcile the APTC. When this happens, the taxpayer receiving the Form 1095-A should provide a copy to the other taxpayers. Change in circumstances affecting SLCSP. Michael and Colleen are not applicable taxpayers and cannot take the PTC. For additional information and resources, see Pub. For purposes of the PTC, modified AGI is the AGI on your tax return plus certain income that is not subject to tax (foreign earned income, tax-exempt interest, and the portion of social security benefits that is not taxable). Nancy files her return using the filing status married filing separately and checks the box on the front of Form 8962. If individuals in your coverage family enrolled in qualified health plans in different states, add together the amounts from column B of Forms 1095-A from each state and enter the total on Form 8962, lines 12 through 23, column (b). Adjustments include deductions for conventional IRA contributions, student loan interest, and more. 2.25 If you have an amount on line 29, be sure to enter that amount on Schedule 2 (Form 1040), line 2. If you are self-employed and are claiming the self-employed health insurance deduction, see Self-Employed Health Insurance Deduction and PTC in Pub. Form 1095-A, Part III, column A, reports the enrollment premiums. If line 24 is greater than line 25, subtract line 25 from line 24 and enter the result on line 26. Therefore, 33% of the enrollment premium, the applicable SLCSP premiums, and APTC are allocated to Stephanie and 67% of these amounts are allocated to Keith. She reports all of the APTC on line 11 or lines 12 through 23, whichever applies. Enter the amount from line 11(e) or add lines 12(e) through 23(e) and enter the total. Also enter the amount from Form 8962, line 29, on Schedule 2 (Form 1040), line 2. Complete Part IV using the rules in this section if you need to allocate policy amounts and Allocation Situations 1 through 3 do not apply. Enter your modified AGI on line 2a. Generally, people can qualify for the credit if their income is more than 100% of the federal poverty guideline but less than 400% (1 to 4 times the federal poverty level). If APTC was paid for the coverage in a qualified health plan of an individual who was not lawfully present, the repayment limitation does not apply to APTC paid for individuals who are not lawfully present. Whether Don is considered eligible for employer-sponsored coverage and ineligible for the PTC for the months September through December of 2022 is determined under the eligibility rules described under, If you cannot get benefits under an employer-sponsored plan until after a waiting period has expired, you are not treated as eligible for that coverage during the waiting period. Melissa and Ryan have been married since 2020 and have no dependents. Your SLCSP premium is the same for every month of 2022. For coverage in 2022, the Marketplace is required to provide or send Form 1095-A to the individual(s) identified in the Marketplace enrollment application by January 31, 2023. Melissa enters the amount from line 29 on the applicable line of her tax return. Multiply $4,540 by 3 and add the result of $13,620 to $44,660. Therefore, you cannot take the PTC for that individuals coverage for the months that individual is eligible for MEC. If you checked the Someone can claim you as a dependent box, or if you are filing jointly and you checked the Someone can claim your spouse as a dependent box on your tax return, you or your spouse is not included in the tax family size calculation for purposes of Form 8962, line 1. Michael does not file Form 8962 because he was not enrolled in a qualified health plan. While coverage purchased in the individual market outside the Marketplace is MEC, eligibility for this type of coverage does not prevent you from being eligible for the PTC for Marketplace coverage.