Preparing for IRS Form 1095-A, The Health Insurance Marketplace Statement

Starting this month, many consumers that signed up for a health insurance plan under the Affordable Care Act (ACA) will begin to receive Form 1095-A, the Health Insurance Marketplace Statement. This form, which will be needed for filing Federal taxes, reflects the total monthly premium paid and tax credits received when enrolling in a Qualified Health Plan on or a state marketplace in 2014.

While everyone that enrolled was notified that they would receive a statement to file with their taxes, many consumers may have forgotten or do not completely understand what this form actually means to them. To help clarify some of the confusion, the IRS will be providing key insight on the purpose of the forms, who needs to file them and when they need to be filed. A tax professional can also help individuals understand the tax implications and complete the filing process; it's likely, however, that many consumers will have additional questions, such as how to correct information, how to reconcile tax credits received or how to claim premium tax credits on their returns.

Preparing for Volume

For many citizens, the quickest and easiest way to get information about their Form 1095-A is through a state or Federal marketplace customer contact center. Just as the contact centers are ready to help consumers during open enrollment periods, contact center staff must be prepared to field these additional tax queries as well. They will need to answer questions and provide citizens with the necessary information and direction to help resolve any issues that arise when they receive their Health Insurance Marketplace Statement.

Many people will need some assistance with understanding this topic because some are unclear about the ACA premium tax credit process and its effect on their upcoming tax filing. One of the ways that states can ready themselves for this influx of inquiries is to provide information resources and direct referral instructions on all consumer-facing channels, including websites and contact centers. By setting up resource pages and providing automated information over the phone using their integrated voice response systems, marketplaces can help consumers find answers to many common questions. It is imperative that states are clear with the information they provide and their referral process, because unclear communication could drive consumers to the incorrect place and delay their ability to submit necessary forms with hard deadlines.

Education and Training

Another best practice for the marketplaces is to attach a cover letter to the Form 1095-A when it's mailed. This cover letter should contain important information on the form's purpose and where consumers should go with questions. By providing upfront answers to basic questions and details on additional resources available, these cover letters will provide consumers better service and contact centers can avoid spikes in call volume -- and thus longer wait times -- for those with more in-depth questions or needing assistance unrelated to Form 1095-A. Marketplaces should also ensure that their information and cover letter are written in plain and clear language to help address consumers' inquiries. It is also important to consider publishing these documents in multiple languages to assist consumers who do not speak English as their primary language.

Finally, marketplaces should consider training their in-person assisters on tax credits and the Form 1095-A. This additional education can help assisters become well-versed on the forms and arm them with the insight to answer potential questions and direct citizens to the appropriate resources. While assisters are not expected to be tax experts, consumers will undoubtedly reach out to many of them requesting information on where to go and what to do. Ensuring that assisters are knowledgeable about the effects premium tax credits have on 2014 tax filings will help streamline the overall tax process.

The Next Frontier

The ACA remains a work in progress as the Federal government and states work to ensure positive outcomes and health coverage for millions of Americans. With the U.S. Department of Health and Human Services reporting that almost 2.5 million people selected a plan through during the first four weeks of the current open enrollment, and with state marketplaces enrolling millions more, marked progress has been insuring the previously uninsured. Although Form 1095-A is another new frontier in the ACA consumer experience, using effective tools and implementing robust processes can help ensure that the impact is not a negative one.

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