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

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Feb 19, 2025

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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.

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.
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.
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.

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How does an ICHRA work?

ICHRA stands for Individual Coverage Health Reimbursement Arrangement (ICHRA). This health arrangement allows you to pick your own health insurance plan using your employer’s monthly tax-free allowance. These funds can be used to cover insurance premiums, including dental and vision, as well as qualified medical expenses.

What are the benefits of an ICHRA?

Your health plan belongs to you, and you can keep your health insurance if you leave your company.
You get to choose from any qualified health plan on the market. Venteur can help you select a plan where your preferred doctors, providers, and prescriptions are covered.
If you choose a health plan that costs less than your employer contribution, the extra funds are added to Venteur’s Health Wallet, an account used to pay for qualified medical expenses.

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What's the difference between an ICHRA and a Group Plan?

Group health insurance plans are purchased by companies and offered to their employees. Traditional group plans take a one-size-fits-all approach to healthcare, giving employees limited choice when it comes to their coverage options. Employer-sponsored ICHRAs give employees a tax-free allowance to pick any plan on the public exchange that meets their unique needs.

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What is the Health Wallet and how can I use it?

1. What Your Health Wallet Balance Represents:

Your Health Wallet balance could be thought of as a measure of the medical expense reimbursements you're entitled to under your health insurance plan. It's essential to note that it isn't quite like a bank account with a set amount of accessible cash. Rather, consider it as a marker of what you're eligible to get reimbursed for as part of your ICHRA plan.

When you shop for insurance through the app, you will see a dollar amount that is available for out-of-pocket expenses. This amount is what gets contributed to your Health Wallet account for your use in reimbursements. However, depending on how your employer has setup the account, it may be available immediately or it may be available after every monthly invoice.

2. Your Health Wallet Account:

When your account is setup, there is a predetermined way on how your Health Wallet functions for your reimbursement funds. The first scenario is that there is money that has been set aside at the start of the period which can be used for your reimbursements. You may see the entire amount entitled to you is immediately available for medical expense reimbursements. It's like having a store of health benefits ready to be used when you need them.

3. Simplifying the Health Wallet Experience:

We're always striving to enhance your experience and are currently working on making the Health Wallet balance operate more like a pre-paid debit card. This shift aims to streamline the funding process further and allow you quicker and more direct access to your health reimbursements, leading to an even smoother journey for you.

Remember, whether your account shows the funds immediately or after every invoice, it doesn't affect the overall sum you're entitled to under your ICHRA plan; it merely affects the timing of when you will receive the reimbursements.

Your trust is important to us, and we're continually striving to make our services better for you. If you ever have questions about your Health Wallet or anything that would help make for a more understandable benefits experience with us, don't hesitate to reach out to our customer service team.

Do ICHRAs meet the Affordable Care Act's employer mandate?

The Affordable Care Act (ACA) requires that employers with more than 50 full-time equivalent employees provide health insurance to their employees. This is known as the 'employer mandate'.

ICHRAs can meet the mandate as long as they are considered 'affordable.' According to IRS, 'an ICHRA is affordable if the remaining amount an employee has to pay for a self-only silver plan on the exchange is less than 8.39% of the employee’s household income.'

To simplify, this means that the ICHRA contribution an employee receives cannot be less than the lowest-cost silver plan available to the employee - (9.02% of the employee's household income).

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