Instructions For Form 8962 - Premium Tax Credit (Ptc)

proportion to each taxpayer's applicable SLCSP premium as

qualified health plan for Jane's coverage. Therefore, 20% of the

follows. Gary’s allocated enrollment premiums are $10,000

enrollment premiums, APTC, and the applicable SLCSP

($15,000 x $12,000/$18,000) (67% of the total premiums of

premium are allocated to Alice and 80% are allocated to Joe.

$15,000) and Jim’s allocated enrollment premiums are $5,000

According to

Table

3, Joe and Alice use the rules under

($15,000 x $6,000/$18,000) (33% of the total premiums of

Allocation Situation 4. Other situations where a policy is shared

$15,000).

between two tax

families.

Gary enters Jim’s social security number on line 30, column

In computing PTC, Joe takes into account $10,400 of

(b), and enters “0.67” in column (e). Jim enters Gary’s social

enrollment premiums ($13,000 x 0.80). Joe must reconcile

security number on line 30, column (b), and enters “0.33” in

$4,911 of APTC ($6,139 x 0.80). Joe’s tax family for 2017

column (e). Gary and Jim leave line 30, columns (f) and (g),

includes only Joe and Chris, and Joe’s household income of

blank.

$60,876 is 380% of the federal poverty line for a family size of

two. Joe’s applicable SLCSP premium for 2017 is $9,600

Allocation Situation 4. Other situations where a policy is

($12,000 x 0.80). Joe’s PTC for 2017 is $3,701 (the lesser of

shared between two tax families. Complete Part IV using the

$3,701, the excess of Joe’s applicable SLCSP premium of

rules in this section if you need to allocate policy amounts and

$9,600 minus the contribution amount of $5,899 ($60,876 x

Allocation Situations 1 through 3 do not apply.

0.0969), or $10,400, Joe's enrollment premiums). Joe has

Allocation Situation 4 generally applies if another taxpayer

excess APTC of $1,210 (the excess of the APTC of $4,911 over

indicated to the Marketplace that he or she would claim the

the PTC of $3,701).

personal exemption for an individual you are claiming, or you

When Joe completes Part IV of Form 8962, he enters Alice’s

indicated to the Marketplace that you would claim the personal

social security number on line 30, column (b), and enters “0.80”

exemption for an individual being claimed by another taxpayer,

in columns (e), (f), and (g). Alice is responsible for reconciling

and APTC was paid on behalf of the individual. In such cases,

$1,228 ($6,139 x 0.20) of APTC for Jane’s coverage. If Alice is

the Form 1095-A sent by the Marketplace for the policy does not

eligible for the PTC, she will take into account $2,600 ($13,000 x

accurately reflect the members of your coverage family and the

0.20) of the enrollment premiums for Jane and $2,400 ($12,000

other taxpayer's coverage family. Therefore, you and the other

x 0.20) of the applicable SLCSP premiums. Alice must compute

tax family must allocate the enrollment premiums, the APTC,

her contribution amount using the federal poverty line

and the applicable SLCSP premium so that each family is able to

percentage for the household income and family size reported

compute their PTC and reconcile their PTC with the APTC paid

on her Form 8962.

for their coverage.

Example 2. The facts are the same as in

Example 1

except

Under the rules in this section, you and the other taxpayer

that Joe and Alice do not agree on an allocation percentage.

may agree on any allocation of the policy amounts between the

Therefore, the allocation percentage equals the number of

two of you. You may use the percentage you agreed on for every

individuals Joe enrolled in a qualified health plan for whom Alice

month for which this allocation rule applies, or you may agree on

claims a personal exemption (1, Jane), divided by the number of

different percentages for different months. However, you must

individuals enrolled in the plan (3, Joe, Chris, and Jane). Thus

use the same allocation percentage for all policy amounts

33% of the policy amounts are allocated to Jane's coverage.

(enrollment premiums, applicable SLCSP premiums, and APTC)

Alice is allocated 33% of the enrollment premiums, APTC, and

in a month. If you cannot agree on an allocation percentage,

applicable SLCSP premiums for the policy and the remaining

each taxpayer’s allocation percentage is equal to the number of

67% of each is allocated to Joe.

individuals enrolled by one taxpayer for whom the other taxpayer

claims a personal exemption for the tax year divided by the total

Lines 30 through 33, Columns (a) through (g)

number of individuals enrolled in the same policy as the

If you shared a policy with another taxpayer in one of the

individual. The allocation percentage you use and that you put

situations described in

Specific Allocation

Situations, earlier,

on line 30 of Form 8962 is the percentage of the policy amounts

complete line 30, columns (a) through (g), as applicable. If you

for the coverage that you will use to compute your PTC and

shared a policy with another taxpayer and you are not making an

reconcile APTC.

allocation in all three columns, (e), (f), and (g), leave the column

Policy amounts allocated 100%. If 100% of the policy

blank that does not apply.

amounts are allocated to you, check “Yes” on line 9 and

complete Part IV by entering 100 in the appropriate box(es) for

If you shared multiple policies during the year or must do

your allocation percentage. If 0% of the policy amounts are

more than one allocation for a single policy, complete lines 31

allocated to you, complete Part IV by entering -0- in the

through 33 for each separate allocation, as needed. For

appropriate box(es) for your allocation percentage.

instructions on making more than four separate allocations, see

Line

34, later.

Note. If APTC is paid for coverage of an individual for whom no

Not an applicable taxpayer. If you are not an applicable

taxpayer claims a personal exemption, the taxpayer who attests

taxpayer because your household income is over 400% of the

to the Marketplace to the intention to claim a personal exemption

federal poverty line or you are using filing status married filing

for the individual is responsible for reporting and reconciling the

separately and

Exception 2—Victim of domestic abuse or

APTC. See

Individual you enrolled for whom no taxpayer will

spousal

abandonment, earlier, does not apply to you, you

claim a personal exemption

under Lines 12 through 23—Monthly

cannot take the PTC. Unless you are electing the alternative

Calculation, earlier.

calculation for year of marriage, do not enter any percentages in

Example 1. Joe and Alice have been divorced since January

columns (e) or (f) when completing Part IV.

2016 and have two children, Chris and Jane. Joe enrolls himself,

Chris, and Jane in a qualified health plan for 2017. The annual

Lines 30 through 33, column (a). Enter the

enrollment premium for the plan is $13,000. The applicable

Marketplace-assigned policy number from Form 1095-A, line 2.

SLCSP premium is $12,000, APTC is $6,139, and Joe's

If the policy number of the Form 1095-A is more than 15

household income is $60,876.

characters, enter only the last 15 characters.

Jane lives with Alice for more than half of 2017 and Alice

Lines 30 through 33, column (b). Enter the social security

claims Jane as a dependent. Joe receives a Form 1095-A

number of the taxpayer with whom you are allocating policy

showing policy amounts for the qualified health plan. Joe and

amounts. This social security number may or may not be

Alice agree to allocate 20% of the policy amounts for the

-18-

Instructions for Form 8962 (2017)

Instructions For Form 8962 - Premium Tax Credit (Ptc) - 2017 Page 18

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