[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-301517-105":53,"doc-detail-301517-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","form-1095-a-corrected-cover-sheet-health-insurance-marketplace","Form 1095-A Corrected Cover Sheet - Health Insurance Marketplace","","Health Insurance Marketplace sends a corrected Form 1095-A cover sheet to each tax filer or responsible adult by January 31. The notice explains why the corrected form matters, what information it contains about household enrollment, Marketplace premiums, and advance payments of the premium tax credit. It instructs recipients to use the corrected 1095-A to complete Form 8962 and file a federal return, including guidance on zero monthly premium amounts, possible amended returns, and using the online tax tool with required ZIP, age, and enrollment details.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/form-1095-a-corrected-cover-sheet-health-insurance-marketplace/301517/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/form-1095-a-corrected-cover-sheet-health-insurance-marketplace/301517.png","ImageObject",442,249,{"name":88,"@type":89},"Rowan","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-23","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":47},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"Who receives the corrected Form 1095-A cover sheet and when is it sent?","Question",{"text":108,"@type":109},"Each tax filer (or responsible adult on a policy) receives the corrected Form 1095-A cover sheet by January 31 each year.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What information does Form 1095-A provide for completing taxes?",{"text":113,"@type":109},"It lists household members enrolled in a Marketplace plan, the Marketplace plan premium details, and any advance payments of the premium tax credit made on the recipient’s behalf.",{"name":115,"@type":106,"acceptedAnswer":116},"What should you do if your corrected Form 1095-A includes zeroes in Part III columns B and C?",{"text":117,"@type":109},"You may need to file an amended return and use the online tax tool to find the correct monthly premium for your applicable second lowest-cost Silver plan, then enter it on Form 8962 or provide it to your tax preparer.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},301517,1790096803,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":47,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":79,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":73},1099514067415,"https://ap-avatar.wpscdn.com/avatar/100002539d78ffe74a7?x-image-process=image/resize,m_fixed,w_180,h_180&k=1779092875211072502","Background: The Health Insurance Marketplace will send Form 1095-A to each tax filer (as defined under 45 CFR 155. 300), or responsible adult on a policy, on or before January 31st of each year. The following document represents a cover sheet that the Marketplace will include with the completed 1095-A that will be sent to each tax filer or responsible adult. Individuals will receive a completed Form 1095-A if they or a member of their household were enrolled in a qualified health plan (QHP) through the Marketplace for any months in the coverage year, with or without receiving advance payment of the premium tax credit (APTC) . Form 1095-A lists the individuals who were enrolled in a QHP, the QHP premium, and any APTC that was paid on the enrollee’s behalf to the issuer. This cover sheet will go to individuals who are receiving a corrected 1095-A form.  \nDepartment of Health and Human Services  \n465 Industrial Boulevard London, Kentucky 40750-0001  \n[Name of tax filer or responsible adult] [Date]  \n[address]  \nApplication ID: [number] Plan Name:  \nDear [Name of tax filer or responsible adult] :  \nSince you had Health Insurance Marketplace coverage for all or some part of [insert applicable coverage year], we’re required to provide you with important information you’ll need to correctly fill out your federal income tax return for that year. You’ve already received a Form 1095-A (Health Insurance Marketplace Statement) . We’re sending you this corrected Form 1095-A because it includes changes we made to your original Form 1095-A. A copy of this information also has been given to the IRS. Please use this form when you complete Tax Form 8962 (Premium Tax Credit) and file your federal income tax return, and keep it for your records.  \nYou must file a tax return  \nYou must file a federal income tax return if you or another member of your household received any advance payments of the premium tax credit in [insert applicable coverage year] to lower premium costs, even if you don't normally file a return. When you file your tax return electronically or by mail, you must complete and file Form 8962. Use the information on this corrected Form 1095-A to complete Form 8962. Also, when you complete your federal income tax return, you'll need to indicate that you had Health Insurance Marketplace coverage for some or all of [insert applicable coverage year] . If you want more information about Form 1095-A, read the \"Instructions for Recipient\" section on the back of the enclosed form. If you need Form 8962, visit [irs.gov](irs.gov).  \nChanges to your Form 1095-A information  \nIf you think information on the attached corrected Form 1095-A is incorrect, call the Marketplace Call Center at the number below to find out how to get a new corrected Form 1095-A.  \nIf you already filed your federal income tax return using information from a previous Form 1095-A, and you didn’t resolve the incorrect information with the IRS, you may need to file an amended return. Visit [irs.gov](irs.gov)[ ](irs.gov)[and enter the keywords](and enter the keywords) “amended return” for more information on when to file an amended return.  \nWhy Form 1095-A is important  \nForm 1095-A includes:  \n• information about you and any other members of your household who were enrolled in a Marketplace plan during [insert applicable coverage year]  \n• information about your Marketplace plan premium and other information you may need to fill out your federal income tax return  \n• the amount of any advance payments of the premium tax credit that we paid in [insert applicable coverage year] to a health plan on your behalf or on behalf of other members of your household.  \nIf there are zeroes printed in Part III, Column B and C during the months you had coverage  \nThe attached form might include zeroes for the monthly premium amount for the second lowestcost Silver plan (SLCSP) available to you. If your corrected Form 1095-A has zeroes in Part III column B and column C for the months you","cbCairtRKnTngPa5","https://ap.wps.com/l/cbCairtRKnTngPa5","pdf",598040,"English","# Background\n# Changes to your Form 1095-A information\n# Why Form 1095-A is important\n## Zeroes in Part III columns B and C\n## Using the online tax tool to help complete your taxes\n# You may get more than one Form 1095-A","[{\"question\":\"Who receives the corrected Form 1095-A cover sheet and when is it sent?\",\"answer\":\"Each tax filer (or responsible adult on a policy) receives the corrected Form 1095-A cover sheet by January 31 each year.\"},{\"question\":\"What information does Form 1095-A provide for completing taxes?\",\"answer\":\"It lists household members enrolled in a Marketplace plan, the Marketplace plan premium details, and any advance payments of the premium tax credit made on the recipient’s behalf.\"},{\"question\":\"What should you do if your corrected Form 1095-A includes zeroes in Part III columns B and C?\",\"answer\":\"You may need to file an amended return and use the online tax tool to find the correct monthly premium for your applicable second lowest-cost Silver plan, then enter it on Form 8962 or provide it to your tax preparer.\"}]","Form 1095-A Corrected Cover Sheet - Health Insurance Marketplace | PDF",1789783216]