Part IIIRepayment of Excess Advance Payment of the Premium Tax Credit. However, you may be able to take the PTC if you meet either of the following conditions. The Marketplace should have entered the same SLCSP premium, which applies to all members of your coverage family, on each Form 1095-A. This indicator is calculated at the household level, . Taxpayers married at year end but filing separate returns. For example, an. Form 8962 and the IRS electronic filing program provide for entries of dollars only. If you were covered under an individual coverage HRA for 2022, you are not allowed a PTC for your 2022 Marketplace health insurance. 974. The Marketplace estimated your income when enrolling for insurance to be at LEAST 100% of the Federal Poverty Level, but not more than 400%. The Pathway to Income Equity pilot program mirrors similar programs throughout the state that provide guaranteed, relatively unconditional payments to households and families experiencing poverty. See Example 1 and Example 2, later. Listing your dependents by name and social security number (SSN) or individual taxpayer identification number (ITIN) on your tax return is the same as claiming them as a dependent. If you file a paper return and. Michael and Colleen are not applicable taxpayers and cannot take the PTC. Other situations where a policy is shared between two tax families, later.). Bret and Paulette each file a tax return using a filing status of single. If you were married at the end of 2022, generally you must file a joint return. See. A taxpayer who includes the gross income of a dependent child on the taxpayers tax return must include on Worksheet 1-2 the childs tax-exempt interest and the portion of the childs social security benefits that is not taxable. $16,400 a household of two people with a householder 65 years or older with no children. Your enrollment premium is reported in Part III, column A, lines 21 through 32, of Form 1095-A. On her Form 8962, Part IV, line 30, Carol enters Johns SSN in column (b) and enters 0.50 in columns (e) and (g). If Exception 1 or Exception 2 applies, follow the rules in the next paragraph. However, filing a separate return from your spouse will not disqualify you from being an applicable taxpayer if you meet certain requirements described under Married taxpayers, later. Enter the amount from line 8a of Form 8962. If your share of the enrollment premiums is not paid, the issuer may terminate coverage. In most cases, you are considered eligible for MEC if the coverage is available to you, whether or not you enroll in it. That individual was not eligible for minimum essential coverage (MEC) for the month, other than coverage in the individual market. If you are not an applicable taxpayer because you are using filing status married filing separately and Exception 2Victim of domestic abuse or spousal abandonment, earlier, does not apply to you, then you must repay all of the total APTC entered on lines 12 through 23, column (f) (unless the alternative calculation for year of marriage rule applies to you and you are able to reduce your repayment amount, or you are filing married filing separately and a repayment limitation applies). From February to June 2020, the share of non-elderly individuals living with below-poverty family earnings: Rose by 10.8 percentage points among Black individuals, from 26.9 percent to 37.7 percent; Rose by 7.8 percentage points among Latino individuals, from 22.9 percent to 30.6 percent; Don got a new job with employer coverage that Don could have enrolled in as of September 1, 2022, but chose not to. Enter on line 2b the combined modified AGI for your dependents who are required to file an income tax return because their income meets the income tax return filing threshold. 974 under. Thus, 33% of the policy amounts are allocated to Jane's coverage. If you are not an applicable taxpayer because you are using filing status married filing separately and Exception 2Victim of domestic abuse or spousal abandonment, earlier, does not apply to you, you cannot take the PTC. Other situations where a policy is shared between two tax families, earlier. Leave columns (e) and (f) blank. 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. Carols family size is two because John is not in her tax family. A qualified health plan may have covered at least one individual in your tax family and one individual not in your tax family if: You are married but filing a separate return from your spouse, You or an individual in your tax family was enrolled in a qualified health plan by someone who is not part of your tax family (for example, your ex-spouse enrolled a child whom you are claiming as a dependent), or. Married taxpayers Tom and Nicole applied for insurance affordability programs at the Marketplace for themselves and their two children whom they claim as dependents, Kim and Chris. Use the worksheet next to figure your modified AGI using information from your tax return. No one can claim you as a dependent for the year. 722 000 people were affected by income poverty. Estimation of Median Incomes. Allocation Situation 4. You are living apart from your spouse at the time you file your 2022 tax return. 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). Because Mike is eligible for other MEC, their coverage family changed starting in August. State Means-Tested Public Benefits Each state will determine which, if any, of its public benefits are means-tested. If any of the above apply and you did not notify the Marketplace or if you have reason to believe the Marketplace reported the wrong applicable SLCSP premium, determine the correct applicable SLCSP premium for the months affected. You are generally not allowed a monthly credit amount for the month if any part of the enrollment premiums for which you are responsible that month has not been paid by the due date of your tax return (not including extensions). If the QSEHRA was unaffordable for a month and you had to reduce the monthly PTC (but not below -0-) by the monthly permitted benefit amount, enter QSEHRA in the top margin on page 1 of Form 8962 to explain your entry and avoid delay in the processing of your return. If the result is zero or less, enter -0-. See Marriage in 2022, later, if you got married during 2022. Read the following instructions to determine whether you should check the Yes box or No box and then proceed as directed. Kevin and Nancy are married at the end of 2022 and have no dependents. Enter the amount from column B of, Self-Employed Health Insurance Deduction and PTC, If 100% of policy amounts are allocated to you, check , Keith and Stephanie are married at the beginning of 2022 and have three children, Ben, Grace, and Max. If either of these two situations applies to you, or if you have reason to believe the Marketplace reported the wrong applicable SLCSP premium, you must determine the correct applicable SLCSP premium for every month. Enter the result of $67,020 on Form 8962, line 4. Need to determine correct applicable SLCSP premium. The thresholds vary by state. 200% federal poverty line is $24,632 for one person; $32,634 for family of two; $38,146 for family of three. Enter your allocation percentage as a decimal rounded to two places (for example, for 67%, enter 0.67). Other situations where a policy is shared between two tax families, later. If no APTC was paid for your coverage, Form 1095-A, Part III, column B, may be wrong or blank or may report your applicable SLCSP premium as -0-. The Marketplace determination does not apply, however, for the months September through December of 2022 because Don did not provide information to the Marketplace about his new employers offer of coverage. You must be an applicable taxpayer to take the PTC. If you are filing Form 1040-NR, you should include your dependents in your tax family only if you are a U.S. national; a resident of Canada, Mexico, or South Korea; or a resident of India who was a student or business apprentice. For 2014, your household income is at least 100% but no more than 400% of the Federal poverty line for your family size (see Household income below 100% of the Federal poverty line, later, for certain exceptions). Allocation Situation 1. Therefore, 20% of the enrollment premiums, APTC, and the applicable SLCSP premium are allocated to Alice and 80% are allocated to Joe. Both poverty thresholds and poverty guidelines are based on the official poverty measure established by the U.S. Census Bureau. Your Form 1095-A may include amounts in dollars and cents. Often programs limit participant's income to 100% of the FPL, or some percentage of the FPL, such as $138% or 200%. Multiply line 3 by line 7 and enter the result on line 8a, rounded to the nearest whole dollar amount. 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. The law extends eligibility to taxpayers with household income above 400 percent of the federal poverty line by lowering the upper premium contribution limit to 8.5 percent of household income. If you indicated to the Marketplace at enrollment that you would claim an individual in your tax family for the year of coverage but the individual is not included in any tax family for the year of coverage, you must report any APTC paid for that individual's coverage. Because Michael and Colleen are not applicable taxpayers and cannot take the PTC, Colleen does not complete Part IV of her Form 8962. 974 under Alternative Calculation for Year of Marriage. 974 for information on determining the correct premium for the applicable SLCSP or, if you enrolled through the federally facilitated Marketplace, go to HealthCare.gov/Tax-Tool/. If line 25 is greater than line 24, leave line 26 blank and go to Part III. at least one individual in your spouse's tax family. The enrollment premiums are the total amount of the premiums for the month, reduced by any premium amounts for that month that were refunded, for one or more qualified health plans in which any individual in your tax family enrolled. Taxpayers married at year end but filing separate returns to allocate the APTC for the January through April coverage. Complete line 35, columns (a) through (d), as indicated in Pub. Enter the SSN of the taxpayer with whom you are allocating policy amounts. 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. According to, 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. If no APTC was paid for the policy, the Marketplace may not know which enrollees are in which tax family, and therefore may furnish only one Form 1095-A showing the total premium. Your employer may have sent you a Form 1095-C, Employer-Provided Health Insurance Offer and Coverage, with information about the coverage offered to you, if any. Certain federal agencies and programs use percentage multiples of the federal poverty level (FPL) to define income limits and to set eligibility criteria for households. You and your former spouse were married to each other at some point during 2022 but were no longer married to each other at the end of 2022. 974 or, if you enrolled through the federally facilitated Marketplace, go to HealthCare.gov/Tax-Tool/. See the instructions for Line 1, later, for more information on figuring your tax family size. Gary and his 25-year-old nondependent son, Jim, enroll in a qualified health plan. Married filing separately (not in Exception 2Victim of domestic abuse or spousal abandonment). If your plan covered benefits that are not essential health benefits, such as adult dental or vision benefits, the amount in this column will be reduced by the premiums for the nonessential benefits. The poverty guidelines. That includes nearly 50 percent of Americans and almost 60 percent of children. Don is not considered eligible for employer-sponsored coverage for the months January through August of 2022 because he gave accurate information to the Marketplace about the availability of employer coverage, and the Marketplace determined that he was eligible for APTC for coverage in a qualified health plan. The enrolled individual is lawfully present in the United States and is not eligible for Medicaid because of immigration status. For 2022, Michael and Colleen are married with no dependents and are enrolled in a qualified health plan. Check if you qualify for a Special Enrollment Period. Use Tax Form 8962: Premium Tax Credit (PTC) as a stand alone tax form calculator to quickly calculate specific amounts for your 2023 tax return. benefit equally from the combined income of the household. If the correct applicable SLCSP premium is not the same for every month of 2022, check the, If any of the above apply and you did not notify the Marketplace or if you have reason to believe the Marketplace reported the wrong applicable SLCSP premium, determine the correct applicable SLCSP premium for the months affected. For additional information and resources, see Pub. Despite five years of economic recovery, poverty is still stubbornly high in America. 974 for information on determining the correct premium for the applicable SLCSP or, if you enrolled through the federally facilitated Marketplace, go to, Complete line 35, columns (a) through (d), as indicated in Pub. An individual in your tax family was enrolled in your qualified health plan for some but not all of 2022. If you got married in 2022 and you and your spouse (or individuals in your tax family) were enrolled in separate qualified health plans during months prior to your first full month of marriage, add together the amounts from Form 1095-A, column B, for each plan (or plans) and enter the total. If any of the circumstances above apply to you, you must file an income tax return and attach Form 8962 even if you are not otherwise required to file. 974, Premium Tax Credit. 974 for instructions on how to figure the amounts to enter in column (e). A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. For example, if your family size is 11, you have 3 additional people. John enrolls in a silver plan. 974. The 2022 federal poverty level (FPL) income numbers below are used to calculate eligibility for Medicaid and the Children's Health Insurance Program (CHIP). If 100% of the policy amounts are allocated to you, check Yes on line 9 and complete Part IV by entering 100 in the appropriate box(es) for your allocation percentage. If a -0- appears on Form 1095-A, on any of lines 21 through 32, column A, you are not entitled to a monthly credit amount for that month because your enrollment premiums were not paid. For example, if you used this exception to claim the PTC on your tax returns for 2019, 2020, and 2021, you cannot use this exception to claim the PTC on your 2022 return. 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. For the months Henry and Cara were divorced (July through December), they will allocate the amounts from the policy on line 31 using the rules under Allocation Situation 4. 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. 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. The indicators are the percent of occupied housing units with more than one person per room (i.e., crowded housing); the percent of households living below the federal poverty level; the percent of persons in the . If APTC was paid for you or an individual in your, The Marketplace determined your eligibility for and the amount of your 2022 APTC using projections of your income and the number of individuals you certified to the Marketplace would be in your tax family (yourself, your spouse, and your dependents) when you enrolled in a, You will need Form 1095-A to complete Form 8962. 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. For the latest information about developments related to Form 8962 and its instructions, such as legislation enacted after they were published, go to IRS.gov/Form8962. Joe has excess APTC of $1,357 (the excess of the APTC of $5,716 over the PTC of $4,359). Your SLCSP premium is reported in Part III, column B, lines 21 through 32, of Form 1095-A. raised benefits by 23 percent for federal . Don got a new job with employer coverage that Don could have enrolled in as of September 1, 2022, but chose not to. Nancy must determine the correct premium for the applicable SLCSP covering only Nancy. The specific income levels vary with family size and relationships of household members. For additional information on the PTC, see Pub. For purposes of the PTC, your tax family consists of the following individuals. Monthly APTC of $1,000 was paid for them, for a total of $4,000. If Exception 2 applies, you are treated as married but can take the PTC with the filing status of married filing separately. Form 1095-A, Part III, column A, reports the enrollment premiums. See Pub. *If your family size was more than 8, add $5,220 for each additional person. However, having household income below 100% of the federal poverty line will not disqualify you from taking the PTC if you meet certain requirements described under Household income below 100% of the federal poverty line, later. Coverage purchased in the individual market outside the Marketplace does not qualify for the PTC. They were enrolled under the same qualified health plan from January through April 2022. Mike and Susan enter $850 in Form 8962, lines 12 through 18, column (b); and $400 in lines 19 through 23, column (b). If you have more than one Form 1095-A, enter the amount as follows. Under the rules in this section, you and the other taxpayer may agree on any allocation of the policy amounts between the two of you. Use Table 3 to determine which allocation rule to use for each month. She reports all of the APTC on line 11 or lines 12 through 23, whichever applies. Cara also purchased different health insurance through a Marketplace for July through December for herself, Heidi, and Matt. Taxpayers married at year end but filing separate returns. Taxpayers divorced or legally separated in 2022, later. Don is not considered eligible for employer-sponsored coverage for the months January through August of 2022 because he gave accurate information to the Marketplace about the availability of employer coverage, and the Marketplace determined that he was eligible for APTC for coverage in a qualified health plan. Alien lawfully present in the United States. She enters the monthly amounts on lines 12 through 23, column (f) ($500 for January through April and $400 for May through December), and the total of $5,200 on Form 8962, lines 25 and 27. If the QSEHRA is unaffordable for a month, you must reduce the monthly PTC (but not below -0-) by the monthly permitted benefit amount and you must enter QSEHRA in the top margin on page 1 of Form 8962 to explain your entry and avoid delay in the processing of your return. See Form 1095-C, line 14, and the, Don was eligible to enroll in his employers coverage for 2022 but instead applied for coverage in a qualified health plan through the Marketplace for coverage in 2022. For more information about eligibility for Medicaid, CHIP, and other forms of government-sponsored MEC, see Pub. Gaining or losing eligibility for other health care coverage. 200.0 percent up to 250.0 percent. (a) Form(s) 1095-A, lines 2132, column A*, (b) Form(s) 1095-A, lines 2132, column B**, (f) Form(s) 1095-A, lines 2132, column C***. 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). Enter 0.50 in columns (e) and (g) of the appropriate line in Part IV to allocate the enrollment premium and APTC. (The other policy amounts are not allocated because neither spouse is allowed a PTC.) If you received a Form 1095-A with the VOID box checked at the top of the form, that means you previously received a Form 1095-A for the policy shown in Part I that was sent in error. *If your family size was more than 8 people, add $5,680 for each additional person. Monthly APTC of $400 was paid for her, for a total of $3,200. You must repay the APTC allocated to you subject to the limit on line 28 because you are not an applicable taxpayer. Starting in 2020, employers can offer individual coverage HRAs to help employees and their families with their medical expenses. If you cannot agree on an allocation percentage, each taxpayers allocation percentage is equal to the number of individuals enrolled by one taxpayer who are included in the tax family of the other taxpayer for the tax year divided by the total number of individuals enrolled in the same policy as the individual(s). John is eligible for a premium tax credit of $4,083 for the year. Henry purchased different health insurance for himself through a Marketplace for July through December. To be an applicable taxpayer, you must meet the requirements under (a) and (b) below. Alice must compute her contribution amount using the federal poverty line percentage for the household income and family size reported on her Form 8962. Don did not return to the Marketplace to determine if he was eligible for APTC for the months September through December 2022, and remained enrolled in the qualified health plan. If the amount on line 5 is less than 100%, you can take the PTC if you meet the requirements under Estimated household income at least 100% of the federal poverty line next or Alien lawfully present in the United States, later. Don enrolled in the qualified health plan for 2022. Instead of enrolling Kim and Chris in CHIP, the entire tax family enrolled in a qualified health plan (with APTC paid only for Tom and Nicoles coverage). Carol takes into account $7,000 ($14,000 x 0.50) of the premiums of the plan in which she and Mark were enrolled in figuring her PTC. Keith and Stephanie divorce in July. There is also an asset rule but that's not related to the poverty level. Enter 401 here and on line 5 of Form 8962. Enter on lines 12 through 23, column (b), the amount of the monthly applicable SLCSP premium reported on Form 1095-A, lines 21 through 32, column B, for the corresponding month. 974 for the entries to make for your pre-marriage months. Keith and Stephanie divorce in July. 974, Premium Tax Credit. Generally, you are an applicable taxpayer if your household income for 2022 (described earlier) is at least 100% of the federal poverty line for your family size (provided in Tables 1-1, 1-2, and 1-3) and no one can claim you as a dependent for 2022. Gary enters Jims SSN on line 30, column (b), and enters 0.67 in column (e). No APTC was paid for your coverage. Combine them even if one or both of them are negative. 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. The Census Bureau has changed the methodology for computing median income over time. The individuals included in your coverage family may change from month to month. The applicable SLCSP premium is the second lowest cost silver plan premium offered through the Marketplace where you reside that applies to your coverage family (described earlier). For example, if your family size is 11, you have 3 additional people. The line shows that the deep income poverty rate was 7.4% in 2015, and declined to 3.0% in 2020. . You or an individual in your tax family enrolled someone not part of your tax family in a qualified health plan (for example, you enrolled a child whom your ex-spouse is claiming as a dependent). You otherwise qualify as an applicable taxpayer (except for the federal poverty line percentage). For more details on eligibility for MEC, including additional special eligibility rules, see Minimum Essential Coverage in Pub.
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