Line 15 on Form 1095-C shows the monthly amount an employee would have been required to pay for the lowest-cost self-only health coverage offered by their employer.
What is Line 15 on Form 1095-C?
Line 15 reports the employee's required monthly contribution for the lowest-cost self-only health coverage available through the employer.
Line 15 is used for Affordable Care Act (ACA) affordability reporting.
Line 15 is not:
The amount deducted from your paycheck
The cost of the plan you selected
The cost of family coverage
The amount you actually paid for health insurance
It represents the cost of the lowest-cost self-only coverage option available to you for that month.
Why is Line 15 reported if I did not enroll?
Line 15 may be reported even if you never enrolled in your employer's health plan.
Applicable Large Employers (ALEs) are required to report information about health coverage offered to eligible employees.
Line 15 helps the IRS determine whether the employer's offer of coverage met ACA affordability requirements.
Line 15 may appear even if:
You declined coverage
You enrolled in a spouse's plan
You purchased Marketplace coverage
You never enrolled in employer coverage
Does Line 15 mean money was taken from my paycheck?
No.
Line 15 does not represent payroll deductions or money withheld from your paycheck.
It is a reporting value used for ACA affordability calculations.
The amount shown on Line 15 may be different from any amount you actually paid for health insurance coverage.
How is Line 15 calculated for an ICHRA?
For an Individual Coverage HRA (ICHRA), Line 15 generally represents the employee's required monthly contribution after accounting for the employer's ICHRA allowance.
The calculation is generally:
Employee Required Contribution = Lowest-Cost Silver Plan (LCSP) Premium − Monthly ICHRA Allowance
The Lowest-Cost Silver Plan premium is based on factors such as:
Employee age
Employee residence or worksite location
Applicable Marketplace rates
Because Marketplace premiums vary by location and age, Line 15 amounts may differ between employees.
How does Line 15 relate to affordability?
The IRS uses Line 15 as part of its affordability analysis under the Affordable Care Act.
Generally:
Lower employee contributions are more likely to be considered affordable.
Higher employee contributions may be considered unaffordable.
Affordability rules may affect eligibility for Marketplace premium tax credits.
The affordability threshold is established by the IRS and may change each year.
Why does the Line 15 amount look incorrect?
Line 15 often causes confusion because it is a calculated reporting value rather than an actual payment amount.
The amount may appear unexpected if:
You did not enroll in employer coverage
You are covered under a spouse's plan
You purchased Marketplace coverage
You are comparing the amount to payroll deductions
The value is based on a plan you never selected
What should I do if I think Line 15 is wrong?
If you believe Line 15 was reported incorrectly:
Verify your employment status for the month shown on the form.
Review any health coverage offers provided by your employer.
Contact your employer or benefits administrator for clarification.
Only your employer can determine whether a correction is required.
Does Line 15 affect my taxes?
Line 15 itself does not create a tax payment or tax refund.
However, it may be used as part of IRS determinations related to:
ACA affordability
Employer reporting requirements
Marketplace premium tax credit eligibility
If you have questions about how Form 1095-C affects your personal tax situation, consult a qualified tax professional.