Premium Tax Credits

Premium Tax Credits (PTCs) are subsidies that lower the cost of health insurance premiums for individuals and families who purchase insurance through the MA Health Connector. PTCs can be received in advance, lowering your monthly insurance premium bill, or as a lump-sum refundable credit at tax time. Premium Tax Credits received in advance are called APTCs. 

If you are requesting that the CHII program pay your Health Connector insurance premium, CHII requires that you receive these PTCs in advance. The amount of APTCs a household receives is based on the expected annual household income you estimate for the upcoming plan year and report on your Health Connector application. 

You can apply for Premium Tax Credits when filling out an application for health insurance through the MA Health Connector. You can apply through the online application (https://www.mahix.org/individual/) or over the phone (877-623-6765).  

When filling out the application, select that you want to see if you can get help paying for health coverage. 

If you received Premium Tax Credits through the MA Health Connector in the past, you will also need to attest to reconciling your past Premium Tax Credits. 

There are multiple ways to see if you received Advance Premium Tax Credits. If you have been on an insurance plan through the MA Health Connector, you can find out if you received APTCs in the following ways: 

1. 1. If you were in a ConnectorCare plan, you received APTCs that helped lower that monthly insurance premium. 
   2. You can look at your old Health Connector premium bills to see if there are APTCs listed (see photo below).
   3.  You can call the Health Connector’s Member Service line at (877)623-6765 and ask a representative to help you determine if you previously received APTCs. 

If you received any amount of APTCs in a given year, then you must file your federal taxes for those years that you received credits.  When you file, you must reconcile their Premium Tax credits using IRS Form 8962.  

You should be sure you have all of the following forms to reconcile your Premium Tax Credits:  

• IRS Form 1040 (both pages) 
  • IRS Schedule 2 (Form 1040) if you have Excess APTCs OR 
  • IRS Schedule 3 (Form 1040) if you have Net Premium Tax Credits. 
• IRS Form 8962: Premium Tax Credit 
• HC Form 1095-A: mailed to client from MA Health Connector. Used to complete IRS Form 8962.

1. Determine if you received APTCs (see Question #3 above). If you did, keep reading! 
2. File your taxes for each year you received any amount of APTCs.  
3. After filing your taxes, CHII enrollees who received APTCs for that tax year must submit copies of the following federal tax forms to Community Resource Initiative’s BRIDGE team: 
   • IRS Form 1040 (both pages) 
     • IRS Schedule 2 (Form 1040) if you have Excess APTCs OR 
     • IRS Schedule 3 (Form 1040) if you have Net Premium Tax Credits. 
   • IRS Form 8962: Premium Tax Credit 
   • HC Form 1095-A: mailed to client from MA Health Connector. Used to complete IRS Form 8962. 
4. Clients who received premium assistance from CHII and received APTCs must sign, date, and return the Client agreement form to the BRIDGE Team along with their tax forms listed above. The client agreement form documents your agreement to the following things:  
   • If you received fewer APTCs than you were eligible for during the year, then the IRS will give you additional PTCs (Net PTCs) as a refundable tax credit so you get the full amount you are eligible for.  You agree to pay Community Resource Initiative the money the IRS gives you as a refundable tax credit for the months that the CHII program paid your insurance premiums 
   • If you received more APTCs during the year than you were eligible for (Excess APTCs), then you will have to pay the IRS for any extra APTCs. You agree to let Community Resource Initiative pay this amount to the IRS on your behalf after you have filed your taxes. The IRS will then refund this amount back to you after receiving and processing payment from Community Resource Initiative. This process can take several months. You can opt out of this.  
     • In order to avoid penalties due to late payment of taxes owed due to Excess APTCs, clients should either pay the amount owed by the deadline, or set up a payment plan with the IRS. 

If you received any amount of APTCs during the year, but you do not reconcile these credits on your taxes, nothing will happen immediately. However, during the following Open Enrollment period:  

1. You will lose access to APTCs through the Health Connector. This means you will be charged the full premium amount for your insurance bill.  
2. You will not be eligible for Connector Care plans.  

Your eligibility for HDAP and CHII support will not be affected if you do not reconcile.  However, we encourage you to reconcile your APTCs from prior years to regain access to this subsidy. The BRIDGE Team is available to assist. 

You should pay the IRS all taxes owed, including those due to Excess APTCs, by the tax filing deadline to avoid any penalties. You may request to set up a payment plan with the IRS if you cannot afford to pay the IRS when you file.  

Community Resource Initiative can only make payment to the IRS on your behalf for Excess APTCs after your taxes have been filed. Community Resource Initiative cannot pay any late payment penalties. 

You should submit your tax forms and signed Client Agreement form to the BRIDGE Team for review only after you have filed your taxes. 

The BRIDGE Team will review your tax forms and determine if Community Resource Initiative can pay the IRS for your Excess APTCs. If this is the case, Community Resource Initiative will make a payment to the IRS on your behalf. The IRS will process that payment and eventually refund you for that amount later that year. 

Yes, contact the BRIDGE Team for assistance. 

• Clients receiving premium assistance from CHII who received APTCs must sign, date, and return the Client agreement form to the BRIDGE Team along with their tax forms.
• Client agrees to send Community Resource Initiative‘s CHII any refund from the IRS related to APTC underpayment.
• If client owes Community Resource Initiative for Net PTCs: Payment of this refund to Community Resource Initiative may be made in the form of check or money order and is expected within 10 days of receipt of the refund from the IRS.
• If client owes IRS for Excess APTCs: Client provides authorization for Community Resource Initiative to make payment to the IRS on their behalf (client can opt out).
  • Client must pay this to IRS when it is due to avoid a penalty or request a payment plan from the IRS if they cannot afford to pay.
  • If Community Resource Initiative makes a payment for the client, the client will be refunded later that year.
• After filing their taxes, CHII enrollees who received premium tax credits for that year must submit copies of the following federal tax forms to Community Resource Initiative‘s HDAP/CHII:
  • IRS Form 1040 (both pages) 
    • IRS Schedule 2 (Form 1040) if you have Excess APTCs OR 
    • IRS Schedule 3 (Form 1040) if you have Net Premium Tax Credits. 
  • IRS Form 8962: Premium Tax Credit 
  • HC Form 1095-A: mailed to client from MA Health Connector

Watch Community Resource Initiative‘s BRIDGE team guide you through the Premium Tax Credit process in the video below.

CRI Client Agreement Regarding Reconciliation of Premium Tax Credit 2023

CRI Acuerdo sobre conciliación de créditos fiscales para primas – Año Fiscal 2023

IRS Form 1040, Individual Income Tax Return (downloadable, fillable form)
IRS Form 1040, Schedule 2: Additional Taxes (downloadable, fillable form)
IRS Form 1040, Schedule 3: Additional Credits and Payments (downloadable, fillable form)
IRS Form 8962, Premium Tax Credit (PTC) (downloadable, fillable form)
IRS Form 8962, Premium Tax Credit (PTC) Instructions
Massachusetts Health Connector, Tax Information: Health coverage and your 2023 taxes