Master Your Health Benefits: 1095-A Forms and ICHRA Explained (2025 Edition)

POV: You’re an employee who received an Individual Coverage Health Reimbursement Arrangement (ICHRA) from your employer to buy a health insurance plan. Tax season is now approaching, and you've received a form called 1095-A in the mail. You’re wondering what this form means, how it relates to your health benefits, and what to do next. 

We’ve got you covered. This article will break down everything you need to know. 

What is the Form 1095-A?

Form 1095-A, also known as the Health Insurance Marketplace Statement, is a tax document. It’s sent to all individuals who enroll in health insurance coverage through the Health Insurance Marketplace (e.g. Healthcare.gov).

This form does the following:

• Documents your health insurance coverage for the year
• Shows the amount of premiums you paid and the premium tax credit you received
• Helps to determine if you need to reconcile your premium tax credits on your federal tax return

Premium Tax Credits and ICHRA

Most employees receiving ICHRA funding from their employers are ineligible for premium tax credits. This is because your employer is picking up the bill for either all or part of your health insurance costs. In return for providing this benefit, your employer receives tax advantages. The amount of money they provide for your health insurance is tax-deductible.

Premium tax credits, also known as Advanced Premium Tax Credits (APTCs), are specifically designed to help individuals without access to affordable employer-sponsored health insurance. The Affordable Care Act (ACA) implemented this rule to prevent "double-dipping," ensuring that individuals do not receive both employer-sponsored benefits and government subsidies for the same health insurance coverage.

By offering an affordable ICHRA, your employer is responsible for a significant portion of your health insurance costs, making you ineligible for additional government assistance through premium tax credits. This rule helps maintain fairness in the health insurance marketplace and encourages employers to provide affordable health coverage options for their employees.

Your 1095-A should say $0 in Premium Tax Credits

If you received health benefits through a Venteur-administered ICHRA in 2024, your Form 1095-A should report $0 in the Premium Tax Credit (PTC) column. This is because Venteur exclusively supports "affordable" ICHRA plans that meet the IRS's guidelines for minimum coverage requirements.

What if this number isn’t $0? There are a few possible explanations. 

1. Self-employment: If you were self-employed for a portion of the year, you might have been eligible for premium tax credits. This could lead to a non-zero amount on your Form 1095-A.
   
2. Dependents receiving premium tax credits: If your dependent received APTCs for their marketplace coverage, their premium tax credits might be included in your Form 1095-A. This could result in a non-zero amount on your Form 1095-A.
   
3. Marketplace or health insurance company error: There is a slight possibility that the marketplace or the insurance issuer made an error when generating your Form 1095-A. If you believe this is the case, contact the market for clarification and to request a corrected form.

When should I expect to receive my Form 1095-A?

You should receive your Form 1095-A by January 31, 2025, for the 2024 tax year. The IRS sets this deadline, requiring health insurance marketplaces to provide Form 1095-A to individuals who enrolled in a qualified health plan through the Health Insurance Marketplace during the previous calendar year. 

What if I don’t receive my Form 1095-A?

We recommend contacting the Health Insurance Marketplace directly if you don't receive your Form 1095-A by mid-February 2025. You can also double-check with Venteur to confirm your enrollment in an “on-exchange” plan in 2024. Individuals enrolled in an off-exchange plan will not receive a 1095-A.

What should I do with my Form 1095-A when I file my taxes?

When you file your taxes, you will be asked whether you received a Form 1095-A. Click “yes.” You’ll be prompted to fill in the information from your Form 1095-A into your tax return. TurboTax has helpful guidance on Form 1095-A and Premium Tax Credits. 

If you have any questions about your Form 1095-A or ICHRA benefits, Venteur's team is here to help. Don't hesitate to reach out to us for assistance. You can contact Venteur by phone at 415-801-3676 or email us at support@venteur.com.