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Form 1095-C for Surprise Arizona: What You Should Know

Form 1095-C is available for those who choose to use it. It can be obtained: by visiting a state government office (including but not limited to the Secretary of State in each area); by mail; by mailing your completed form to the address on the form, along with a check or money order (this will eliminate a possible transaction tax). Note: All forms submitted electronically from the BCB SAZ site will be available at: Arizona Health Insurance Marketplace : Search for information to get an individual account number OR search for plans to get an account number for your plan; or : Search for information to get an individual account number OR search for plans to get an account number for your plan; or by contacting the AZ Health Link. How many people may be covered under my plan? Your account will depend on where you are enrolled on the federal exchange. The federal exchange will have an option for you to select all or part of a “group” plan (for example, if you are a member of a small group plan) to calculate your coverage. If you are enrolled through the state of Arizona, please call the Marketplace and ask for the coverage that applies to you on Form 1095-C and let them know what information is required. Please remember to bring Form 1095-C with you! Does my health plan qualify for subsidies? Yes! It is important that you get coverage that will provide adequate income level (or close to it), unless you qualify for medical assistance, coverage under Medicaid, or certain other health insurance programs.  To qualify for subsidies for medical care, you must be either a family of 4 with an income of 44,520 or less or a qualified individual, as described in the coverage description.  You cannot receive premium tax credits, but premiums may be deducted from income. Do I qualify for tax credits to pay for my coverage? Yes! You must get coverage on the marketplace. You are not eligible for an Obamacare subsidies if your income is: a family of 4 with an income of (44,520 – 62,770 = 22,350 for a family of 4); a qualified individual. The difference between the income of these 2 means that the individual qualifies for the Affordable Care Act's premium tax credits. What information must you provide to the Marketplace? When you go online to compare health plans, you have to answer 5 questions to determine eligibility.

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