IRS Final Rules and Draft Form Address Premium Tax Credit | Practical Law

IRS Final Rules and Draft Form Address Premium Tax Credit | Practical Law

The Internal Revenue Service (IRS) has issued final regulations addressing the premium tax credit under the Affordable Care Act (ACA). The final regulations, which impact individuals who enroll in qualified health plans under the ACA insurance exchanges and claim the premium tax credit, amend implementing regulations under Internal Revenue Code Sections 36B and 162(l). The IRS also issued a draft reporting form regarding the premium tax credit.

IRS Final Rules and Draft Form Address Premium Tax Credit

Practical Law Legal Update 1-576-0136 (Approx. 5 pages)

IRS Final Rules and Draft Form Address Premium Tax Credit

by Practical Law Employee Benefits & Executive Compensation
Published on 29 Jul 2014USA (National/Federal)
The Internal Revenue Service (IRS) has issued final regulations addressing the premium tax credit under the Affordable Care Act (ACA). The final regulations, which impact individuals who enroll in qualified health plans under the ACA insurance exchanges and claim the premium tax credit, amend implementing regulations under Internal Revenue Code Sections 36B and 162(l). The IRS also issued a draft reporting form regarding the premium tax credit.
On July 24, 2014, the IRS issued final and temporary regulations addressing the Affordable Care Act's (ACA's) premium tax credit (see Practice Note, The Affordable Care Act (ACA): Premium Tax Credit under Health Insurance Exchanges). The regulations impact individuals who enroll in qualified health plans through the health insurance exchanges (see Practice Note, Health Insurance Exchange and Related Requirements under the ACA) and claim the premium tax credit. The final regulations amend existing tax regulations implementing:
In related developments, the IRS issued a draft form for reporting premium tax credit information (see Draft IRS Form 8962 Addressing Premium Tax Credit). Also, two circuit courts of appeals have addressed whether the premium tax credits are available to individuals who purchase health insurance coverage on the federally-facilitated exchanges (see Legal Update, Conflicting Rulings on Tax Credits under the ACA).

Health Insurance Premium Tax Credit Amendments

The ACA added Section 36B, which provides a premium tax credit to certain taxpayers to help make health insurance purchased through the exchanges affordable. The premium tax credit is available to taxpayers who:
  • Have household income for the tax year between 100% and 400% of the federal poverty level.
  • Cannot be claimed as a dependent by another taxpayer.
  • File a joint return if married.
The ACA permits certain individuals to receive advance payment of the tax credit, if the taxpayer later reconciles any difference between the advance payment and the tax credit for the year.
Section 162(l) allows self-employed individuals to take a deduction for health insurance premiums paid during the year for the individual and the individual's spouse, and dependents under age 27.
The final regulations address various issues that were previously unaddressed, including:
  • Married taxpayers filing separately. Earlier regulations required married taxpayers to file a joint return in order to receive the tax credit. The temporary regulations provide a special rule for victims of spousal abandonment or domestic abuse, as defined in the regulations, that allows these individuals to satisfy this requirement without filing jointly. However, a married taxpayer that is the victim of domestic abuse or spousal abandonment may not qualify for relief from the joint filing requirement for more than three consecutive years. Adopting Notice 2014-23, but extending that guidance beyond 2014, the temporary regulations enable a victim of domestic abuse or abandonment to file separately if the taxpayer:
    • lives apart from the taxpayer's spouse when filing;
    • is unable to file a joint return because the taxpayer is a victim of domestic abuse or spousal abandonment; and
    • certifies on the taxpayer's tax return that these criteria are satisfied.
  • Indexing. The temporary regulations provide additional detail regarding the meaning of certain indexing concepts relating to the premium tax credit, including an affordability percentage used to determine whether an employer's offer of coverage to an employee is affordable. Revenue Procedure 2014-37, released simultaneously with the temporary regulations, provides greater specificity regarding adjustment methods involving the tax credit.
  • Allocations regarding family members. The temporary regulations address how taxpayers determine tax credit amounts and reconcile advance payments of the tax credit in situations where an individual is enrolled by one taxpayer but a second taxpayer claims a personal deduction regarding the individual. In general, the taxpayer who enrolls the individual and the taxpayer claiming the individual may agree on any allocation percentage between zero and 100%. The temporary regulations also provide a default allocation rule if the taxpayers do not agree to an allocation percentage.
  • Allocation between divorced or separated spouses. The temporary regulations address how taxpayers who were married but then divorce or separate during the tax year must allocate the benchmark plan premium, and the premium for the plan in which the taxpayers and their dependents were enrolled, for calculating the individuals' respective tax credits and any excess advance credit payments. The taxpayers generally may allocate these items in any proportion, but must use this same proportion for allocating all items. If the taxpayers fail to choose an allocation, the default rule is that 50% of each item is allocated to each taxpayer.
  • Reconciliation for married taxpayers who file separately. Additionally, the temporary regulations clarify how taxpayers reconcile advance credit payments when:
    • the taxpayers indicated they were married when applying for advance credit payments; but
    • one or both of the taxpayers later files a tax return using the head of household filing status.
    Subject to several exceptions, taxpayers who qualify to use the head of household filing status may be eligible for a tax credit, and 50% of the advance credit payments for a given coverage period in a qualified health plan are allocated to each taxpayer.
  • Health insurance deductions for self-employed individuals under Section 162(l). Under Section 162(l), self-employed individuals may take a deduction for health insurance premiums paid during the year. The temporary regulations provide rules addressing the interaction of the Section 162(l) deduction and the premium tax credit.

Draft IRS Form 8962 Addressing Premium Tax Credit

The IRS also issued a draft Form 8962 (Premium Tax Credit). Among other things, the draft form will be used by individuals to report their eligibility for a tax credit, and includes a section in which the individual will calculate household as a percentage of the federal poverty limit. Additional sections in the draft form address:
  • An individual's annual allowed premium tax credit, relative to advance payment of the credit.
  • Repayments of any excess advance payment of the tax credit.

Practical Impact

The regulations' additional relief from the joint filing requirement for victims of domestic abuse and spousal abandonment, which is allowed for up to three years, offers greater flexibility for individuals in these situations, and will be welcome news to commenters who requested that such rules be included in the regulations.
In addition, the draft Form 8962 provides a useful first look at how individuals will report information regarding the premium tax credit (and reflect advance payments of the credit and repayment of excess payments). However, a dedicated website regarding the draft form (www.irs.gov/form8962) is not yet live on the IRS' website.