Help, where can I find a copy of Form 1095-A for my client's Marketplace insurance?

Thanks for the thorough response! I did have them check their marketplace accounts already but nothing showed up there. I think calling the Marketplace Call Center is our next step, though I was hoping to avoid that wait time. Is there any way to determine if they actually had Marketplace coverage versus some other type? They seem pretty certain they were getting a subsidy, which would mean Marketplace, right? Could they have accidentally purchased off-Marketplace insurance thinking it was through Healthcare.gov?

If they were receiving premium tax credits or subsidies, then yes, they definitely had Marketplace coverage and should have a 1095-A. Those subsidies are only available through official Marketplace plans. When they log into their Healthcare.gov account (or state marketplace), they should see their enrollment history. If they see plans listed for 2023 and 2024 but no forms, that confirms they had coverage and there's just an issue with accessing the forms. In that case, the call center is definitely your best option despite the wait. Some state marketplaces also have physical offices you can visit for help.

How exactly does that work? I'm intrigued but confused about how a third-party tool can access marketplace documents that aren't showing up in the actual marketplace account. Do you need the client's login credentials to use it?

I've heard of this but seems sketchy to me. What if the documents genuinely don't exist? Like maybe the client is just wrong about having marketplace coverage and actually had employer insurance? Would this tool just make something up?

The tool works by using advanced document retrieval processes that can access archived or misfiled documents in government systems. They have special API access that can find documents that might not be readily visible in the regular user interface. Yes, you would need the client's permission and credentials. No, the tool doesn't create documents that don't exist. If your client actually had employer insurance instead of marketplace coverage, the system would find their 1095-B or 1095-C instead, or report that no marketplace documents exist. It just has better search capabilities than the standard public-facing interfaces.

How does this actually work? Do they just have some special way to skip the line or something? I've spent literally hours on hold with the Marketplace and would pay almost anything to avoid that again.

This sounds like absolute nonsense. Why would a third party be able to get you through faster than calling directly? The hold queue is the hold queue. Seems like they're just charging people for something that doesn't actually work. Has anyone else actually verified this isn't a scam?

They don't skip the line - they use an automated system that holds the place in line for you. Their system waits on hold so you don't have to. When a representative answers, their system calls you and connects you directly to that rep. It's basically like having someone else sit on hold for you. I was skeptical at first too. But after wasting hours trying to get through myself, I was desperate enough to try it. I can only share my experience, which is that it worked exactly as advertised. I got connected to a Marketplace rep within 20 minutes of using the service, after I had previously tried calling for days with no success. Not a scam in my experience, just a useful service for those of us who don't have hours to waste on hold.

This! I had a client swear up and down they had "Obamacare" last year but after investigating, turns out they had a short-term plan they bought through an insurance broker that wasn't even ACA compliant. No wonder they couldn't find their 1095-A!

That's a really good point. I'll ask them specifically about premium tax credits on their previous returns and whether they remember applying through Healthcare.gov or their state exchange. Do you know if it's possible to file without the 1095-A if they truly can't find it? Would the IRS have access to this information already since the Marketplace reports it to them? I'm trying to figure out if there's any way to move forward if we hit a dead end.

Unfortunately, you really need the 1095-A to complete the return accurately if they had Marketplace coverage with premium tax credits. The IRS does receive the information, but they match it against what you report on Form 8962, and discrepancies can cause rejections or delays. If you absolutely cannot obtain the 1095-A, you could file an extension to give yourself more time to track it down. As a last resort, you could try to reconstruct the information if the client has monthly premium statements showing their subsidy amounts, but this is risky and could lead to discrepancies with IRS records. I'd exhaust all options first - call center, state marketplace office visits, or the tools others have mentioned before trying to file without it.

Where do you find this form? I looked on the healthcare.gov site and couldn't locate an EO-001 form.

I tried this route once and the insurance company told me they couldn't help with 1095-A forms since those come directly from the Marketplace. They only deal with 1095-B forms for non-Marketplace coverage they provide. They did suggest contacting my state's Department of Insurance consumer assistance program, which surprisingly was helpful in escalating my case with the Marketplace. Might be worth trying if you're hitting walls with the regular channels.