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Posts: 1
Registered: ‎04-13-2017

Wrong 1096-A / CoveredCA

Question on incorrect 1096-A from CoveredCA / BlueShield and impact on tax return


Sorry for the long explanation, and hope it makes sense.


- Enrolled in BlueShield through Covered CA on 1/1/2016

- I called and canceled my health plans with BlueShield on 8/17/2016 (outside the US since Aug, and for the next 365 days)

- I received from BlueShield a document confirming end of Coverage on 9/1/2016


Problem 1: BlueShield coverage period

- Long story short, BlueShield now says my coverage ended 10/1/2016 due to lack of payment of the premiums - though I had canceled on my end and had confirmation from them for 9/1/2016. I called, emailed them several times, filed a complaint - no change yet. Am not sure how to proceed from there (this is not a tax question, more to give background)


Problem 2: CoveredCA Credits Paid statement / 1096-A

- the 1096-A from CoveredCA incorrectly shows I would have been covered, paid premiums and received credit until 12/31/2016

- when I called BlueShield and CoveredCA together, I was told I should have informed CoveredCA about the cancellation (I thought that canceling from BlueShield was enough, had asked BlueShield about what else to do and was told - nothing, and I thought calling CoveredCA was only for a change of life events - birth of baby, change of revenue, etc - no for canceling - my bad)

- On the phone with both CoveredCA and BlueShield, the lady from CoveredCA said that she did not have a record of BlueShield informing CoveredCA that the policy had been canceled by BlueShield on 10/1/2016 due to "non-payment". So bottom line, neither I nor BlueShield informed CoveredCA

- The same lady from CoveredCA said to file an appeal to CoveredCA, explaining what happened and send the proof of my end of coverage from BS with date of 9/1/2016

- I filed the appeal, which has been rejected - causes listed: 

   1. Your health plan carrier confirmed the information provided in Form 1095-A (Health Insurance Marketplace Statement) is correct. (NOTE: which is not correct since I did not pay for Sept to Dec 2016


   2.    Your health plan carrier has no record of payment for the period of coverage that you have disputed. (NOTE: which is true but this is the way around, they claim I paid when I did not)


   3.    You did not notify Covered California in a timely manner of a life event or change of circumstances. (NOTE: true, but neither did BlueShield)


   4.    You have not provided sufficient documentation to demonstrate your disputed members' enrollment, policy start and end dates, premiums paid, or APTC applied.  (NOTE: I gave them a document from BlueShield showing the correct enrollment dates)


Problem 3: Unpaid Credits to reduce our tax refund

So while I understand there might be penalties for not informing CoveredCA, I think the penalties should be on both BlueShield and myself. Since I did not get the credit, the amount of premium amount for 2016 is incorrect. I have since got married in 2016 and am filing jointly with my husband, so it is important for the correct credit amounts to be listed, otherwise, our refund will be lessened by too much (for money I did not receive). 



- when we file the 1096-A, shall I fill only the part I know I paid and received credits for? 

- or shall I file based on the received 1096-A even if I know this is incorrect? 

- Side question: who actually get the credits from CoveredCA? On my end, I get to pay less premiums, but who gets the credits? Is that BlueShield?


Thank you,